Objective. This study was designed to clinically evaluate the efficacy of a bacteria- and-fungi-binding mesh (BFBM) dressing to modify the bacterial load of pressure ulcers (PUs) of categories 3 and 4, when used as a wound contact layer (WCL) during negative pressure wound therapy (NPWT). Methods. This was an observational single-centre study in patients with PUs of categories 3 or 4, who were treated with NPWT. Patients were observed for 7 days and received NPWT at -80 mm Hg with the BFBM dressing as the WCL. Wound biopsies were performed at inclusion (B0), at 48 hours (B1), and at day 7 (B7). Bacteria- and fungi-binding mesh dressings were examined for bacterial load at 48 hours (D1) and at 7 days (D7). The primary endpoint was the changes in bacterial loads. Results. Fifty patients were enrolled; 43 (86%) of their PUs were on the sacrum. At B0, 3 groups of wounds were identified by the bioburden level: group A had negative results (28%) to bacterial loads from 102 to 5 x 103 colony forming units (CFU) CFU/mL (18%); group B had 104 to 105 CFU/mL (18%); and group C with ≥ 106 CFU/mL (36%). The authors did not find any significant difference in bacterial loads in group A, but significant differences were found in group B at B1 and B7 (P = 0.04 and P = 0.0067) and in group C at B1 and B7 (P < 0.00001). There was no significant difference on the bacterial loads of the dressing at D1 and D7 (P = 0.823). No device-related adverse events were reported. Conclusion. The BFBM dressing seems to be at the origin of a statistically significant reduction of bacterial burden in wounds with moderate or high levels of colonization. The authors’ findings suggest BFBM dressings may be a WCL of choice during the treatment of chronic wounds with NPWT.