A wound treatment appliance is provided for treating all or a portion of a wound. In some embodiments, the appliance comprises a cover or a flexible overlay that covers all or a portion of the wound for purposes of applying a reduced pressure to the covered portion of the wound. In other embodiments, the wound treatment appliance also includes a vacuum system to supply reduced pressure to the site of the wound in the volume under the cover or in the area under the flexible overlay. Methods are provided for using various embodiments of the invention.