Background and Objectives: Vacuum-assisted closure (VAC) technology has proven to be effective in the management of soft tissue loss from infections, vascular insufficiency, and traumatic disorders and may have a similar benefit in the musculoskeletal oncology patient. This study reports a single institution's experience with VAC technology in the management of radiation-associated wound complications in patients with soft tissue sarcomas. Materials: Twenty-two patients treated with both surgical intervention and radiation therapy developed either superficial or deep wound complications that were managed with the VAC device. This study group was compared to a retrospectively identified comparison group of 19 patients, in which the VAC device was not used. Results: Hospital stay (P < 0.025), length of overall treatment (P < 0.025), number of operative debridements (P < 0.05) and success of wound closure without the need for soft tissue transposition (P < 0.01) was found to be significantly less in the study groups as compared to those not treated with the VAC device. Conclusion: VAC technology appears to be safe and effective in the treatment of radiation-associated wound complications. © 2007 Wiley-Liss, Inc.