27 January 2021

Smith+Nephew’s PICO◊ Single Use Negative Pressure Wound Therapy System again shown to significantly reduce surgical site complications

Smith+Nephew (LSE:SN, NYSE:SNN), the global medical technology business, is pleased to announce a new publication showing that its PICO Single Use Negative Pressure Wound Therapy System (sNPWT) significantly reduced the odds of surgical site infections (SSIs) by 63%*, the odds of seroma by 77%, and the odds of dehiscence by 30%. A significant benefit of these reduced odds was an almost 2-day reduction in length of stay§, suggesting potential for substantial efficiency gains across the healthcare system1.

The systematic review and meta-analysis included 29 studies on the outcomes of 5,614 patients. It demonstrated that using PICO sNPWT on closed surgical incisions resulted in significant benefits for patients across different surgical specialties, including orthopaedic, obstetric, cardiothoracic, colorectal, vascular and breast surgery, from a wide geographical distibution1.

The development of post-operative surgical site complications (SSCs), which includes SSIs, are a substantial burden for patients and healthcare systems, globally2. It is estimated that 5% of all patients undergoing a surgical procedure will develop an SSI2. In the U.S. alone, more than 500,000 patients are affected by SSIs each year, resulting in about 8,000 deaths annually3. SSIs are also the most common reason for readmission to hospital, accounting for 19.5% of overall readmissions4. However, 60% of all SSIs are considered preventable2.  

“This new meta-analysis is another significant addition to the growing body of evidence supporting PICO therapy for SSC prevention, and helps provide important insights into optimising clinical management strategies for preventing SSIs, which are an increasing concern for healthcare providers and their patients around the world,” said Cathy Dalene, Senior Vice President Global Marketing, Advanced Wound Management, Smith+Nephew.

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 injury5. PICO sNPWT has been shown to help reduce SSCs by helping to reduce lateral tensile forces6 and oedema7-9, whilst increasing perfusion10, 11 and lymphatic drainage12 across close surgical incision.

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 studies13. 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 cost14.

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




Kirsti Harefallet




* odds ratio (OR) 0.37, 95% confidence intervals (CI) 0.28 to 0.50, p < 0.001, numbers needed to treat (NNT) 20; compared with standard dressings

OR 0.23, 95% CI 0.11 to 0.45, p < 0.001, NNT 13; compared to standard dressings

OR 0.7, 95% CI 0.53 to 0.92, p = 0.01, NNT 26; compared to standard dressings

§ mean difference -1.75, 95% CI -2.69 to -0.81, p < 0.001; 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 TwitterLinkedIn, Instagram or Facebook.

To learn more about how we can help you get CLOSER TO ZERO surgical site complications, please visit www.closertozero.com 

Forward-looking Statements

This document may contain forward-looking statements that may or may not prove accurate. For example, statements regarding expected revenue growth and trading margins, market trends and our product pipeline are forward-looking statements. Phrases such as "aim", "plan", "intend", "anticipate", "well-placed", "believe", "estimate", "expect", "target", "consider" and similar expressions are generally intended to identify forward-looking statements. Forward-looking statements involve known and unknown risks, uncertainties and other important factors that could cause actual results to differ materially from what is expressed or implied by the statements. For Smith+Nephew, these factors include: risks related to the impact of COVID-19, such as the depth and longevity of its impact, government actions and other restrictive measures taken in response, material delays and cancellations of elective procedures, reduced procedure capacity at medical facilities, restricted access for sales representatives to medical facilities, or our ability to execute business continuity plans as a result of COVID-19; economic and financial conditions in the markets we serve, especially those affecting health care providers, payers and customers (including, without limitation, as a result of COVID-19); price levels for established and innovative medical devices; developments in medical technology; regulatory approvals, reimbursement decisions or other government actions; product defects or recalls or other problems with quality management systems or failure to comply with related regulations; litigation relating to patent or other claims; legal compliance risks and related investigative, remedial or enforcement actions; disruption to our supply chain or operations or those of our suppliers (including, without limitation, as a result of COVID-19); competition for qualified personnel; strategic actions, including acquisitions and dispositions, our success in performing due diligence, valuing and integrating acquired businesses; disruption that may result from transactions or other changes we make in our business plans or organisation to adapt to market developments; and numerous other matters that affect us or our markets, including those of a political, economic, business, competitive or reputational nature. Please refer to the documents that Smith+Nephew has filed with the U.S. Securities and Exchange Commission under the U.S. Securities Exchange Act of 1934, as amended, including Smith+Nephew's most recent annual report on Form 20-F, for a discussion of certain of these factors. Any forward-looking statement is based on information available to Smith+Nephew as of the date of the statement. All written or oral forward-looking statements attributable to Smith+Nephew are qualified by this caution. Smith+Nephew does not undertake any obligation to update or revise any forward-looking statement to reflect any change in circumstances or in Smith+Nephew's expectations.


Trademark of Smith+Nephew. Certain marks registered US Patent and Trademark Office.

AWM-AWD- 28682

  1. Saunders C, Nherera LM, Horner A, Truman P. The incidence of surgical site complications with PICO single-use negative pressure wound therapy compared to conventional dressings when used prophylactically on closed surgical incisions: a systematic literature review and meta-analysis. BJS Open. 2021;[Epub ahead of print]
  2. World Union of Wound Healing Societies (WUWHS), 2016. Closed surgical incision management: Understanding the role of NPWT. Wounds International.
  3. Najjar PA, Smink DS. Prophylactic antibiotics and prevention of SSIs. Surg Clin N Am 2015;95(2):269-283.
  4. Merkow RP, et al. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA 2015;313(5):483-495.
  5. Smith+Nephew October 2017. Project Opal PICO 7 System Stability Testing, Initial Time Point. Internal Report. DS/17/253/R
  6. 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.
  7. Birke-Sorensen H, Malmsjo M, Rome P, et al. Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer)-steps towards an international consensus. J Plast Reconstr Aesthet Surg. 2011;64 Suppl:S1-16.
  8. Scalise A, Calamita R, Tartaglione C, et al. Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of Incisional Negative Pressure Wound Therapy. A systematic review of the literature. Int Wound J. 2016;13(6):1260-1281.
  9. Shim HS, Choi JS, Kim SW. A Role for Postoperative Negative Pressure Wound Therapy in Multitissue Hand Injuries. Biomed Res Int. 2018;2018.
  10. Malmsjö M, Huddleston E, Martin R. Biological Effects of a Disposable, Canisterless Negative Pressure Wound Therapy System. ePlasty. 2014;14:1 - 15.
  11. Innocenti M, Santini M, Dreassi E, et al. Effects of Cutaneous Negative Pressure Application on Perforator Artery Flow in Healthy Volunteers: A Preliminary Study. J Reconstr Microsurg. 2018.
  12. Kilpadi DV, Cunningham MR. Evaluation of closed incision management with negative pressure wound therapy (CIM): hematoma/seroma and involvement of the lymphatic system. Wound Repair Regen. 2011;19(5):588-596.
  13. Smith & Nephew 2020. Evidence Pyramid April 2020. EA/AWM/PICO/030/v1.
  14. NICE (2019) PICO negative pressure wound dressings for closed surgical incisions [online] accessible from: https://www.nice.org.uk/guidance/mtg43 . Last accessed January 2021