Background. Negative pressure wound therapy (NPWT) is empirically expanding across the globe. Yet published data with NPWT in acute, contaminated wounds is limited, and several concerns arise regarding contemporary acute wound care NPWT practice. Specifically, there are no evidence-based time intervals specifying when NPWT should be changed after initial placement in such cases; therefore, NPWT was studied in acute, contaminated wounds. Methods. The authors retrospectively reviewed 86 consecutive patients, and a total of 97 contaminated wounds. All wounds were class IV, based on Centers for Disease Control and Prevention (CDC) criteria. All patients were managed with NPWT. Patient and wound-specific variables were analyzed. Outcome endpoints included durability of wound closure and death. Results. Mean time of subsequent NPWT after initial placement was 2.9 days, median time 3 days, mode 2 days, and standard deviation (SD) 1.24 days. Durability of wound closure was 73/79 (92%). Deaths were noted in 6/86 (7%) of patients. No deaths appeared related to NPWT. Conclusions. Based on the findings in this study, analyzing NPWT in the largest known patient cohort of this type, a time interval of 1.7 days to 4.1 days (mean time 2.9 days, SD 1.24), between initial and subsequent placement of NPWT in acute, contaminated wounds is safe and effective.