i am a nurse in new york and, while I can understand the difficulties regarding supplies, equipment, cost, etc., there is NOTHING comparable to the VAC for negative pressure wound therapy. It seems like a lot of nurses need to be educated on this subject and perhaps wound care in general. All aspects of the dressing application, the foam (its not a sponge - it is hydrophobic and allows fluid to pass through it) and the application of negative pressure evenly to the wound bed atconsistent and measurable rates is crucial to results. Gauze only soaks up edudate and actually hinders removal and using other systems is paying for suction (which you already have) because that is all you are getting! I would urge you to contact KCI and have one of their RN consultants come in and provide inservice and education for you and your staff.