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PICO technology in abdominal surgery

Evidence collection - addressing the burden of surgical site infections1-2

We’re aiming to redefine standard care following abdominal surgery through prophylactic use of our PICO Single Use Negative Pressure Wound Therapy System (sNPWT). Surgical site infections (SSIs), and their associated costs, don’t have to be accepted as ‘normal’.

  • An average 8.6-day hospital length of stay reduction for closed laparotomy abdominal wounds, compared with standard care(i)2.
  • 74% reduction in post-operative abdominal SSIs at 30 days, for closed laparotomy abdominal wounds, compared with standard care(ii)2.
  • The incidence of seroma was reduced by 82% for abdominal surgery on Crohn’s patients(iii)3 compared with standard dressings.


View our new, dedicated abdominal surgery evidence collection, which demonstrates how PICO sNPWT may improve your outcomes1-3 and efficiencies1-5 by reducing surgical site complications (SSCs)1-2.

Surgical site infection (SSI) – early intervention to help reduce SSI rates and facilitate early discharge with standard dressings


Dr Pauline Whitehouse (UK) outlines the mechanisms of NPWT on preventing SSIs, including the role of PICO sNPWT in challenging, contaminated large bowel surgery.

NPWT for closed laparotomy wounds


Dr Colin Pierce shares the results of a study on using NPWT for closed laparotomy wounds and using PICO to prophylactically reduce SSIs. 


We’ll update you on more content coming soon.


Why accept superficial infections?

Time to challenge your standard care

Some SSIs are preventable1, yet many may become complex and costly complications6-7. Proactive, prophylactic use of PICO sNPWT has demonstrated success in reducing both SSCs1-2 and SSIs1-2, when compared with standard care.

Consider how superficial infections affect your caseload and budgets, particularly readmissions and prolonged length of stay.

How would a potential 74% reduction in SSIs, as demonstrated in patients with with closed laparotomy wounds following abdominal surgery, affect your budgets?


Visit our collection, then request a call from a Smith & Nephew representative.


PICO sNPWT - designed to be different

Unique technology found only in PICO is designed to provide far more than just fluid removal. Delivering effective negative pressure wound therapy, it has been shown to reduce complications such as infection1-2, dehiscence(iv)1 and seroma3 in abdominal surgery, with particular benefit observed in high-risk patients1.  

- Unique AIRLOCK◊ Technology layer distributes pressure evenly across the zone of injury consistently for up to 7 days, depending on exudate levels.8.
- Optimal fluid management to help minimise the risk of maceration9.
- Softport facilitates use on weight-bearing areas, with negative pressure delivered effectively even under compression10.
- Gentle silicone contact layer designed to help minimise pain and trauma on application and removal10.
- Designed to treat the underlying zone of injury9,11 and reduce lateral tension11.
In vitro testing demonstrated that 99.9% of bacteria was locked away from the wound when absorbed into the AIRLOCK Technology layer12.

Helping create a pathway to reduced SSCs(v)1-2


PICO sNPWT is helping you get CLOSER TO ZEROsurgical site complications.


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(i) 50-patient study. Length of stay reduced: PICO 6.1 days, control group 14.7 days. p=0.019
(ii)50-patient PICO 2 patients (8.3%); control group 8 patients (32%); p=0.043.
(iii)Reduction in seroma: 50-patient study. PICO 2 patients (8%), standard dressing 11 patients (44%). p=0.008
(iv) Meta-analysis included 10 RCT & 6 observational studies. Reduction in SSI (16 studies included): 1839 patients (2154 incisions); PICO 5.2%; control group 12.5%; p<0.0001. Mean reduction in hospital length of stay (8 studies included): 0.47 days; p<0.0001. Dehiscence based on 6 articles and 1068 patients. p<0.01. High risk patients considered those with BMI ≥35 or ASA ≥3
(v) Smith & Nephew does not provide medical advice. The information presented is not, and is not intended to serve as, medical advice. For detailed device information, including indications for use, contraindications, precautions and warnings, please consult the product’s Instructions for Use (IFU) prior to use. It is the responsibility of healthcare professionals to determine and utilise the appropriate products and techniques according to their own clinical judgment for each of their patients. The information presented may not be appropriate for all jurisdictions.



1) Strugala V and Martin R. Meta-analysis of comparative trials evaluating a prophylactic single-use negative pressure wound therapy system for the prevention of surgical site complications. Surgical Infections Vol 18 Number 07 (2017). DOI: 10.1089/sur.2017.156. 810-819.
2) O’Leary DP et al: Prophylactic negative dressing use in closed laparotomy wounds following abdominal operations. A randomised, controlled, open-label trial: The P.I.C.O. trial. Ann Surg. 2017; Jun 265(6):1082-1086.
3) Selvaggi F et al: New Advances in Negative Pressure Wound Therapy (NPWT) for Surgical Wounds of Patients Affected with Crohn’s Disease. Surgical Technology International XXIV; 83-89.
4) Dowsett et al 2017: Use of PICO to improve clinical and economic outcomes in hard to heal wounds. Wounds International 2017. 8(2), 52-58. A prospective cohort study of 52 wounds.
5) Nherera LM, Trueman P, Karlakki SL. Cost-effectiveness analysis of single-use negative pressure wound therapy dressings (sNPWT) to reduce surgical site complications (SSC) in routine primary hip and knee replacements. Wound Repair Regen. April 2017. doi:10.1111/wrr.12530.
6) World Union of Wound Healing Societies (WUWHS) Consensus Document. Closed surgical incision management: understanding the role of NPWT. Wounds International, 2016.
7) Tanner et al (2009): Post-discharge surveillance to identify colorectal surgical site infection rates and related costs. J Hosp Infect 72; 243-250.
8) Data on File. DS/17/253/R version 2. Project Opal PICO 7 system stability testing, initial time point. November 2017.
9) Malmsjö M et al. Biological effects of a disposable, canisterless Negative Pressure Wound Therapy system. Eplasty 2014; 14: e15.
10) Hurd T; Trueman P; Rossington A; Use of a portable, single-use negative pressure wound therapy device in home care patients with low to moderately exuding wounds: a case series; Ostomy Wound Management supplement, 60: 30-36. Issue 3, 2014.
11) Loveluck J et al. Biomechanical modelling of forces applied to closed incision during single-use negative pressure wound therapy. Eplasty 2016; 16e20.
12) Data on file report 1712012. The retention of P.aeruginosa and S. aureus bacteria within PICO dressings after 72 hours under NPWT in a dynamic model. December 2017.

NICE recognition for PICO

 A medical technology innovation briefing on PICO sNPWT

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Helping you get
surgical site complications

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Negative pressure wound therapy

Find out more about our pioneering negative pressure wound therapy (NPWT) products

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