Scott A. Asher, MD, and colleagues present one of the largest series of patients (n = 115) treated with negative pressure dressings for head and neck wounds. Most patients had poor wound healing risk factors and complex neck wounds, including salivary contamination, bone exposure, great vessel exposure, recent free tissue transfer, and defects near laryngectomy stomas. The average treatment length was 4 days, and all wounds eventually healed. Four adverse reactions were reported, but there were no mortalities. The authors demonstrate the utility and safety of negative pressure wound therapy in patients with complex wounds and compromised wound healing undergoing head and neck surgery.