Fasciotomy wounds are a major contributor to prolonged hospital stay and can lead to amputation. Although it is generally recommended to close the fasciotomy wound as early as possible, it is usually challenging. Primary closure is more favorable because it commences more functional and esthetic results with less morbidity. But primary closure is difficult to achieve due to skin edema, retraction and necrosis. Topical negative pressure care (TNP) has been used in other areas of wound care, such as mediastinitis and burn wounds. TNP has recently gained popularity and has shown promising outcomes. Topical negative pressure systems are commercially available but very expensive. We designed a modified negative pressure system with wall-suction and applied it to a complicated fasciotomy wound. We herein report our experience with a review of related literatures.