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Evidence and expert opinion highlights clinical and aesthetic benefits of PICO◊ Single-use Negative Pressure Wound Therapy in mammoplasty and oncological breast reconstructive surgery

Smith & Nephew (LSE:SN, NYSE:SNN), the global medical technology business, today announces how expert opinion around the world continues to build around the use of PICO, a novel single use negative pressure wound therapy (NPWT) in avoiding post-operative wound complications. At a recent meeting hosted by Smith & Nephew in Paris, over 160 European experts in plastic and onco-plastic surgery met to discuss new data and share the latest evidenced based best practice around the use of PICO, in the prevention of incisional complications following breast surgery. 

Incisional complications and delayed healing are not uncommon following breast surgery and can cause avoidable hospital readmissions or increased lengths of stay, which has implications for both the healthcare system and patient outcomes. Delayed healing is a particular issue in post mastectomy reconstruction where the risk of a surgical complication has been found to be four times higher than in non-oncology breast surgery[i], and where any delay to adjunctive treatment such as radiotherapy is to be avoided.

“Preventing a wound complication following a mastectomy or lumpectomy is crucial. Even a minor complication can delay radiotherapy or chemotherapy, and can potentially have devastating consequences. Predictable wound healing is vital for this reason but to also save the patient from experiencing psychological distress if treatment is postponed” says Jennifer Rusby, Consultant Oncoplastic Surgeon, Royal Marsden, London, UK.  

With regards to breast reduction surgery, other key issues were raised with regards to wound care and post operative issues including scar quality. A multicentre-study[ii] involving 200 bilateral breast reduction patients was presented to delegates, which showed significantly fewer wound healing complications for PICO compared to standard care (p=0.004), and a 38% relative reduction in surgical dehiscence by day 21 (a surgical complication in which the wound ruptures along the surgical suture line) from 52 patients (26.4%) to 32 patients (16.2%) (p<0.001). The study also evaluated the scar quality at 42 and 90 days post surgery. PICO showed significantly better scar quality at each time point (p<0.001).

Clinical complications including surgical site infections following breast surgery were also identified as significantly higher amongst patients with a high BMI[iii], impacting on both clinical and aesthetic outcomes, but also on the hospital’s resources due to re-admissions and further surgery or post-operative care.

“A complication following any kind of breast surgery has implications not just financially, but also to the hospitals and surgeons’ reputations and we have a duty to our patients to minimise risk and get the best possible patient outcome” said Hanne Birke Sørenson, Plastic and reconstructive surgeon, Aleris-Hamlet Hospital Denmark.

Birke Sørenson continues, “Collective data presented at this meeting around the use of PICO as a prophylactic use in high risk patients undergoing breast reduction surgery have demonstrated where  the device can reduce complications but also improve cosmetic outcomes. PICO is definitely part of the avoidance of wound complications in the future.”

Professor Laurent Lantieri, Chief of Department of Plastics and Reconstruction surgery, European Hospital Georges Pompidou, Paris, chaired the meeting, and explained further:

"It is very important to bring some of the most experienced and innovative surgeons together at meetings such as this; to share first-hand ideas which you cannot get from reading a journal article or attending large scientific conferences. It is these small and interactive meetings that are important for the future of education. If I give you one idea and you give me one idea we both have two ideas, and by exchanging these ideas we can improve our knowledge and even inform future practice.”

The Plastic Surgery Expert Meeting hosted by Smith & Nephew is one of a series of six meetings happening during 2016, including the use of NPWT across specialities such as orthopaedic and obstetrics and gynaecology. Upcoming meetings include challenging wounds (10th-11th November) and cardiothoracic and vascular surgery (25th-26th November).

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About Smith & Nephew

Smith & Nephew is a global medical technology business dedicated to helping healthcare professionals improve people's lives. With leadership positions in Orthopaedic Reconstruction, Advanced Wound Management, Sports Medicine and Trauma & Extremities, Smith & Nephew has around 15,000 employees and a presence in more than 100 countries. Annual sales in 2015 were more than $4.6 billion. Smith & Nephew is a member of the FTSE100 (LSE:SN, NYSE:SNN).

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Smith & Nephew will be presenting more of the latest research on surgical site complications at WUWHS 2016

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[i]  Olsen, M. A., Lefta, M., Dietz, J. R., Brandt, K. E., Aft, R., Matthews, R., & Fraser, V. J. 2008. Risk factors for surgical site infection after major breast operation. J Am Coll Surg 2008;207:326–335

[ii] Galiano R, Djohan R, Shin J, Hudson D, Van der Hulst, Beugels J, Duteille F, Huddleston E, Cockwill J, Megginson S The effects of a single use canister-free Negative Pressure Wound Therapy (NPWT) System* on the prevention of postsurgical wound complications in patients undergoing bilateral breast reduction surgery (First presented at The British Association of Aesthetic Plastic Surgeons (BAAP’s) 30th Annual Scientific Meeting, London, September 2014)

[iii] Davis, G. B., Peric, M., Chan, L. S., Wong, A. K., & Sener, S. F. 2013. Identifying risk factors for surgical site infections in mastectomy patients using the NSQIP database. The American Journal of Surgery, 2013 205(2) 194–199

 

Press pack

ZIP file (216 KB) containing:

- Press release (with translations in Dutch, French, German, Italian and Spanish)

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Video

Interview with Laurent Lantieri, Chief of department of Plastics and Reconstruction Surgery at European Hospital Georges Pompidou, Paris on the 2016 Negative Pressure Wound Therapy (NPWT) experts meeting.

Laurant Lantieri introduces NPWT experts meeting 2016

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Highlights from the NPWT experts meeting 2016 in Paris.

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