3 September 2020

New study demonstrates PICO◊ Single Use Negative Pressure Wound Therapy System (sNPWT) beats standard dressings in reducing surgical site complications resulting in fewer deep sternal wound infections (DSWI) following cardiac surgery

Smith+Nephew (LSE:SN, NYSE:SNN), the global medical technology business, announces the publication of a new study in cardiac surgery showing that PICO sNPWT significantly reduced the incidence of surgical site complications (SSCs) by 64%,* which resulted in a 68% reduction in DSWIs† by helping prevent the spread of superficial infectious material. In addition, the authors demonstrated that using PICO sNPWT to help reduce SSCs, led to an estimated cost saving of €1,295 per patient versus standard care in high-risk patients.1

The consequence of SSCs following coronary artery bypass graft surgery (CABG) can be devastating. The spread of a superficial infection to deep tissue is of particular concern, with DSWI resulting in an in-hospital mortality rate of up to 35%.2 In addition, length of stay, which can reach 23 days per patient,3 incurs substantial associated healthcare costs.4

In the study, PICO sNPWT was used immediately post operatively on the closed sternal incision in all CABG procedures. Data was compared with a retrospective cohort of patients where PICO sNPWT had not been used. Patients receiving PICO sNPWT had significantly fewer SSCs,* particularly patients with diabetes, BMI ≥35kg/m2, and those who had bilateral internal mammary artery (BIMA) surgery (p<0.05 for all). This resulted in a significant reduction in the incidence of DSWI. †1

“Using PICO sNPWT immediately post operatively was a small change in our clinical practice but we have seen clear benefits for our patients in their recovery” said lead author, Dr Alfred Tabley. “Preventing wound complications is an important concern and will continue to be a major issue for our Health Care Systems in the years to come. Wider use of a system such as PICO sNPWT may be a change in mind-set, but our data shows it is very worthwhile, given the patient benefits we were able to bring out in our survey.”
The study also demonstrated that if the incidence SSCs could be lowered, the length of hospital stay was reduced, releasing an estimated 118.8 days of capacity per 100 patients, and therefore reducing associated healthcare costs. In effect, this could provide capacity to treat a further 10 CABG patients.1

“We are very excited by the results of this study. The proven benefits PICO sNPWT can have on helping reduce SSCs following cardiac surgery is encouraging, as they can often have devastating effects on patients with significant risk of mortality.” said Nick Atkinson, Vice President of Global Marketing, Advanced Wound Management, Smith+Nephew. “Beyond this, the health economic benefits show that PICO sNPWT can not only improve the lives of patients, but also reduces the burden on healthcare systems.”

The unique PICO sNPWT dressing includes the proprietary AIRLOCK◊ Technology for uniform and consistent delivery of therapeutic NPWT across a closed surgical incision and the surrounding zone of injury.5 By helping to minimise wound complications such as oedema, seroma, haematoma formation as well as dehiscence, PICO sNPWT can help improve the speed, strength and quality of incisional wound healing.6-11

PICO sNPWT has a strong evidence base with 137 published papers of which 21 are published randomised controlled trials (RCTs) and 5 are health economic studies.12 This includes medical technology guidance from the UK National Institute for Health and Care Excellence (NICE), which supports the adoption of PICO sNPWT as it provides better outcomes than standard care for helping to prevent SSCs in high-risk patients with closed surgical incisions, with similar overall cost13

To learn more about PICO sNPWT see www.smith-nephew.com/pico


Kirsti Harefallet +44(0)7710085253
*6.3 vs 17.6%; p=0.009; compared to standard dressings
†3.5 vs 11.0%; p=0.029; compared to standard dressings

About Smith+Nephew

Smith+Nephew is a portfolio medical technology business that exists to restore people’s bodies and their self-belief by using technology to take the limits off living. We call this purpose ‘Life Unlimited’. Our 17,500+ employees deliver this mission every day, making a difference to patients’ lives through the excellence of our product portfolio, and the invention and application of new technologies across our three global franchises of Orthopaedics, Advanced Wound Management and Sports Medicine & ENT.

Founded in Hull, UK, in 1856, we now operate in more than 100 countries, and generated annual sales of $5.1 billion in 2019. Smith+Nephew is a constituent of the FTSE100 (LSE:SN, NYSE:SNN). The terms ‘Group’ and ‘Smith+Nephew’ are used to refer to Smith & Nephew plc and its consolidated subsidiaries, unless the context requires otherwise.

For more information about Smith+Nephew, please visit www.smith-nephew.com and follow us on Twitter, LinkedIn, Instagram or Facebook.

To learn more about how we can help you get CLOSER TO ZERO◊ delay in wound healing, please visit www.closertozero.com

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1. Tabley A, Aludaat C, Le Guillou V, et al. A survey of cardiac surgery infections with PICO™ Negative Pressure Therapy in high-risk patients: survey of surgical site complications. Ann Thorac Surg. 2020 [Epub ahead of print]
2. Cotogni P, Barbero C, Rinaldi M. Deep sternal wound infections after cardiac surgery: Evidences and controversies. World J Crit Care Med.2015;4(4):265-273.
3. Jenks PJ, Laurent M, McQuarry S. and Watkins R. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital. J Hosp Infect. 2014;86(1):24-33.Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013;173(22):2039-2046.
4. Smith & Nephew October 2017. Project Opal PICO 7 System Stability Testing, Initial Time Point. Internal Report. DS/17/253/R.
5. Canonico S, Campitiello F, Della Corte A. Therapeutic possibilities of portable NPWT. Acta Vulnologica. 2012;10:57-64.
6. Hyldig N, Birke-Sorensen H, Kruse M, Vinter C, Joergensen JS, Sorensen JA, Mogensen O, Lamont RF, Bille C. Meta-analysis of negative-pressure wound therapy for closed surgical incisions. Br J Surg. 2016;103(5):477-86.
7. Loveluck J, Copeland T, Hill J, Hunt A, Martin R. Biomechanical modeling of the forces applied to closed incisions during single-use negative pressure wound therapy. ePlasty. 2016;16:e20.
8. Malmsjö M, Huddleston E, Martin R. Biological effects of a disposable, canisterless negative pressure wound therapy system. ePlasty. 2014;14:e15.
9. Smith & Nephew 2019. Summary Report of in vitro Wound Model and Negative Pressure Delivery (Nominal -80mmHg) testing for PICO v2 (PICO 7 and PICO 14) System. Internal report. RD/18/134 V2.
10. Data on file reference 1102010 – Bacterial barrier testing (wet-wet) of PICO Dressing with a 7 day test duration against S. marcescens.
11. Smith & Nephew 2020. Evidence Pyramid April 2020. EA/AWM/PICO/030/v1.