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Necrotizing enterocolitis (NEC) is a disease of the intestine detrimental that occurs in approximately 10% of neonates who weigh 1500 g or less; it is associated with a 25% mortality rate. Additional abdominal wall defects and disturbance of environmental surroundings further compromise the likelihood of mortality. Early intervention and aggressive surgical treatment have been shown to decrease the mortality rate of this disease process.This case study describes wound and ostomy management on a neonate with NEC who, after bowel perforation, required a distal and proximal jejunostomy and a colostomy. Frequent dressing changes were disrupting the neonates' environmental factors that affect growth. Management began with an alginate dressing, but it was unsuccessful in containing the drainage. Negative pressure wound therapy was then applied to eliminate exudate and infectious material, control odor, and decrease environmental factors affecting growth, as well as to assist in wound closure.Necrotizing enterocolitis and potential complications such as perforation and dehiscence can be devastating for hospitalized neonates. In this case, negative pressure wound therapy promoted tissue growth and managed exudate and odor, while decreasing intervals between dressing changes. The abdominal wound healed, allowing for a better plane for stoma pouching. The neonate's ostomies were successfully reversed and he continues to thrive to date.