‡ In these countries please contact our distributor

How to use PICO

When and how to use PICO Therapy

Below you will find a series of resources to help you decide when to use PICO sNPWT, and how to use it safely and effectively.


PICO Therapy is indicated for a range of acute, chronic, and surgical wound types:1-22

- Closed surgical incisions
- Pressure ulcers
- Diabetic foot ulcers
- Venous leg ulcers
- Partial thickness burns
- Flaps and grafts
- Trauma wounds
- Dehisced wounds


How to apply PICO sNPWT

…on cardiothoracic surgical incisions:

…on C-section surgical incisions:

…on orthopaedic surgical incisions:

…on chronic wounds:

…for bilateral incision management:


How to remove PICO sNPWT

…from closed surgical incisions:

…from chronic wounds:



Additional clinical resources

Resources are available to help guide the success and suitability of PICO Therapy. If you cannot find the resource you need, please contact us.

Using NPWT to prevent complications in high-risk surgical incision

Using NPWT to treat acute and chronic wounds


Need help?

For further information and guidance on the use of PICO sNPWT, email us 


For other wound management needs

RENASYS Traditional Negative Pressure Wound Therapy System – powerfully simple tNPWT with touchscreen interface and adaptable consumables.23-25

VERSAJET II Hydrosurgery System – for precision excision and tissue preservation in debridement.26-32

SECURASkin Care range to help cleanse and protect patient skin.33


Helping you get CLOSER TO ZERO surgical site complications.14,34,35

For detailed product information, including indications for use, contraindications, effects, precautions, warnings, and important safety information, please consult product’s Instructions for Use (IFU) prior to use.

Saunders, C., Buzza, K. and Nherera, L. 2019. A single use negative pressure system reduces surgical site complications compared with conventional dressings in closed surgical incisions: a systematic literature review with meta-analysis. Poster presented at the European Wound Management Association annual meeting, June 5-7, 2019, Gothenburg, Sweden.
2. Karlakki, SL, Hamad AK, Whittall C et al. Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: a randomised controlled trial. 2016; 5(8): 328-337.
3. Nherera LM, Trueman P, Karlakki SL. Cost-effectiveness analysis of single-use negative pressure wound therapy dressings (sNPWT) to reduce surgical site complications (SSCs) in routine primary hip and knee replacements. Wound Repair Regen. April 2017. doi:10.1111/wrr.12530.
4. 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] Available at: Annals of Thoracic Surgery.
5. Holt R, Murphy J. PICO™ incision closure in oncoplastic breast surgery: a case series. British Journal of Hospital Medicine. 2015;76(4).
6. Sim K, Mackowski A, Bevis H, Hamza S. The use of PICO dressing in mastectomy patients: A Retrospective Analysis. Paper presented at: World Congress of Surgery; 2017; Basel, Switzerland.
7. Hyldig N, Vinter CA, Kruse M, et al. Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: a pragmatic randomised clinical trial. BJOG. 2018.
8. Searle RJ, Myers D. A survey of caesarean section surgical site infections with PICO Single Use Negative Pressure Wound Therapy System in high-risk patients in England and Ireland. Journal of Hospital Infection. 2017;97(2):122 - 124.
9. Holt R, Murphy J. PICO™ incision closure in oncoplastic breast surgery: a case series. British Journal of Hospital Medicine. 2015;76(4).
10. Sim K, Mackowski A, Bevis H, Hamza S. The use of PICO dressing in mastectomy patients: A Retrospective Analysis. Paper presented at: World Congress of Surgery; 2017; Basel, Switzerland.
11. O'Leary DP, Peirce C, Anglim B, et al. Prophylactic Negative Pressure Dressing Use in Closed Laparotomy Wounds Following Abdominal Operations: A Randomized, Controlled, Open-label Trial: The P.I.C.O. Trial. Ann Surg. 2017;265(6):1082-1086.
12. Selvaggi F, Pellino G, Sciaudone G, et al. New Advances in Negative Pressure Wound Therapy (NPWT) for Surgical Wounds of Patients Affected with Crohn's Disease. Surgical Technology International. 2014;24:83-89.
13. Smith & Nephew December 2018.Summary of PICO v2 (PICO 7 and PICO 14) Human Factors Testing. Internal Report. RD/18/136.
14. Kirsner R, Dove C, Reyzelman A, Vayser D, Jaimes H. A Prospective, Randomised, Controlled Clinical Trial on the Efficacy of a single-use Negative Pressure Wound Therapy System, compared to Traditional Negative Pressure Wound Therapy in the Treatment of Chronic Ulcers of the Lower Extremities. Wound Repair and Regeneration. 2019;27(5):519 - 529.
15. Schwartz JA, Goss SG, Facchin F, Avdagic E, Lantis JC. Single use-negative pressure wound therapy for the treatment of chronic lower leg wounds. Journal of Wound Care. 2015;24(2).
16. 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 Mangement. 2014;60(3):30-36.
17. Stryja J, Staffa R, Říha D, Stryjová K, Nicielniková K. Cost-effectiveness of negative pressure wound therapy in outpatient setting. Prolekare. 2015.
18. Dunn R, Hurd T, Chadwick P, et al. Factors associated with positive outcomes in 131 patients treated with gauze-based negative pressure wound therapy. Int J Surg. 2011;9(3):258-262.
19. Young SR, Hampton S, Martin R. Non-invasive assessment of negative pressure wound therapy using high frequency diagnostic ultrasound: oedema reduction and new tissue accumulation. Int Wound J. 2013;10(4):383-388.
20. Hampton J. Providing cost-effective treatment of hard-to-heal wounds in the community through use of NPWT. Community Wound Care. 2015:S14-S20.
21. Canonico S, Campitiello F, Della Corte A, et al. Therapeutic Possibilities of Portable NPWT Initial Multidisciplinary Observation with the Negative Pressure Therapy Device. Acta Vulnol. 2012;10:57-66.
22. Payne C, Edwards D. Application of the Single Use Negative Pressure Wound Therapy Device (PICO) on a Heterogeneous Group of Surgical and Traumatic Wounds. ePlasty. 2014:152-166.
23. Forlee M, van Zyl L, Louw V, Nel J, Fourie N, Hartley R. A randomised controlled trial to compare the clinical efficacy and acceptability of adjustable intermittent and continuous Negative Pressure Wound Therapy (NPWT) in a new portable NPWT system. Paper presented at: EWMA; 2018; Krakow, Poland.
24. Forlee M, Richardson J, Rossington A, Cockwill J, Smith J. An interim analysis of device functionality and usability of RENASYS™ TOUCH – a new portable Negative Pressure Wound Therapy (NPWT) system. Paper presented at: Wounds UK; 2016; Harrogate, UK.
25. Smith & Nephew 2016. Smith and Nephew’s RENASYS™ Touch Device Features – Adjustable Settings. Internal Report. DS.16.138.R.
26. Granick, MS et al. Efficacy and Cost Effectiveness of a High-Powered Parallel Waterjet for Wound Debridement. Wound Repair & Regeneration, 2006. 14, 394-397.
27. Granick, MS et al. Toward a common language: Surgical Wound Bed Preparation and Debridement. Wound Repair & Regeneration, 2006. 14, S1-S10.
28. Cubison CS et al. Dermal preservation using the VERSAJET Hydrosurgery System for Debridement of Paediatric Burns. Burns, 2006. 32, 714-720.
29. Matsumura H et al. The Estimation of Tissue Loss During Tangential Hydrosurgical Debridement. Ann Plast. Surg, 2012. 69, 521-525.
30. Gurunluoglu R. Experiences with Waterjet Hydrosurgery System in Wound Debridement. World J. Emerg. Surg. 2007. 2, 10.
31. Gravante G, Delogu D, Esposito G & Montone A. VERSAJET hydrosurgery versus classic escharectomy for burn debridement: a prospective randomised trial. J. Burn Care Res. 2007. 720-4.
32. McCardle JE. VERSAJET Hydroscalpel: Treatment of Diabetic Foot Ulceration. British Journal of Nursing, 2006. 15, Tissue Viability Supplement
33. Smith & Nephew January 2018.Design Validation Summary. Internal Report. WMP/12/499.
34. Dowsett C, Hampton K, Myers D, Styche T. Use of PICO to improve clinical and economic outcomes in hard-to-heal wounds. Wounds International. 2017;8(2):52-58.
35. Smith & Nephew. April 2019. Outcomes following PICO compared to conventional dressings when used prophylactically on closed surgical incisions: systematic literature review and meta-analysis. Report reference EO/AWM/PICO/004/v3