31 March 2015

Growing body of evidence supports the use of PICO◊ Negative Pressure Wound Therapy to address the challenges of surgical incision complications

Smith & Nephew (LSE: SN, NYSE: SNN), the global medical technology business, announces the conclusion of the 6th International Negative Pressure Wound Therapy (NPWT) Expert Meeting, where over 300 international experts from 36 countries convened in Berlin, Germany, between 20-21st March.

35 speakers from 11 countries defined the challenges of surgical site complications, and shared new evidence on the clinical outcomes of using Smith & Nephew’s PICO, a unique, canister-free NPWT system for reducing closed incision complications in high risk patients. Evidence for PICO on closed incisions is rapidly growing in a number of surgical areas, including orthopaedic, cardiothoracic and plastic surgery.1-4 The Meeting saw data presented from 14 studies involving PICO, including 7 randomised controlled trials (RCTs) across different clinical niches.

Complications post-surgery can be devastating for the patient, and it is estimated they can double the cost of the initial surgery5. NPWT helps prevent wound complications by stimulating blood flow in the peri-incisional area, removing excess fluid, helping to reduce oedema, and stabilising the incision site by reducing lateral tension. These actions work together to reduce complications such as surgical dehiscence, seroma and haematoma formation and surgical site infections (SSIs).6-9

In the past few years, there has been a shift to include the use of NPWT, including portable NPWT units such a PICO on closed incisions in a prophylactic way. A recent, international, multi-centre RCT3 involving 200 bilateral breast reduction patients found that use of PICO significantly reduced the incidence of surgical dehiscence and improved the visual appearance of the scar at 42 and 90 days post-surgery. Professor Donald Hudson, Head of the Department of Plastic and Reconstructive Surgery at the University of Cape Town and Groote Schuur Hospital, South Africa, noted, “There is no doubt in my mind that the indications are going to extend to all aspects of breast surgery, such as onco-plastic and reconstructive surgery. There are early suggestions that the scarring is better with PICO, and therefore I see this product extending into cosmetic surgery.”

Mr John Murphy, Consultant Onco-plastic, Reconstruction and Cosmetic Breast Surgeon at University Hospital South Manchester, England, presented clinical experience of using PICO in complex breast reconstructions after mastectomy; procedures with a relatively high rate of wound complications (10.9%, according to the National Mastectomy and Reconstruction Audit, 2010 – HSCIC England). He underlined the need for interventions to help oncology patients avoid the psychological effects of complications and potential impact on therapies such as chemotherapy or radiotherapy: “The last 10 years have seen a new generation of breast surgeons arise, with onco-plastic surgery as a new cross-speciality”.

Mr Michael Sugrue, Consultant Breast and General Surgeon, Letterkenny General Hospital/UCHG, County Donegal, Eire, noted “The global burden of infection is severe, and the impact of NPWT is enormous in terms of reducing cost and morbidity, so we are seeing progress. We’ve opened our minds to the future, and shown negative pressure has a place in it.”

Mr Richard Ingemansson, Senior Consultant in Cardiothoracic Surgery at the University of Lund, Sweden, summarised: “The potential for wound complications in many areas of surgery is great. We need to cut infection rates where they tend to be high, and look further into the risk factors involved, so we can identify patients who could benefit the most.” Mr Sudheer Karlakki, Consultant Orthopaedic and Arthroplasty Surgeon at Robert Jones & Agnes Hunt Orthopaedic Hospital Foundation Trust, Wrexham, England, pointed out the need to cut SSIs in joint replacement surgery: “Our RCT found very few complications when using NPWT, compared to the control group. Joint replacement is for life. You do it once, so get it right. Don’t allow for infection.”

Andy Boyes, Senior Vice President, Smith & Nephew, said, “This annual meeting has provided a forum for surgeons around the world to discuss new data on the role of NPWT. This year, it focused on the critical issue of surgical site complications and their impact on patient and healthcare system. Evidence continues to build regarding the role of PICO over surgical incisions and the positive effect it has on clinical and health economic outcomes. Smith & Nephew is proud of its continued support for healthcare professionals.”

The International NPWT Expert Meeting and the associated educational activities are supported by the Advanced Wound Management Division of Smith & Nephew. More information about the 2015 edition and the past International NPWT Expert meetings can be found at http://www.smith-nephew.com/education


Images and video

Images and video footage can be downloaded from our International NPWT Expert Meeting album on Flickr



For all enquiries, including interview requests, please contact ROAD Communications:

Rachel Cunningham: rachel@ROADcommunications.co.uk www.ROADcommunications.co.uk              

 +44 (0)7837 209143 / +44 (0)20 8995 5832


About PICO◊

PICO is cleared for use in hospital and homecare settings in Europe, US, Canada, Japan and Australia. Click here for more information about the PICO system and the NPWT portfolio of products from Smith & Nephew.


About Smith & Nephew

Smith & Nephew is a global medical technology business dedicated to supporting healthcare professionals in their daily efforts to improve the lives of their patients. With leadership positions in Orthopaedic Reconstruction, Advanced Wound Management, Sports Medicine and Trauma & Extremities, Smith & Nephew has around 14,000 employees and a presence in more than 100 countries. Annual sales in 2014 were more than $4.6 billion. Smith & Nephew is a member of the FTSE100 (LSE: SN, NYSE: SNN).

For more information about Smith & Nephew, please visit our corporate website www.smith-nephew.com, follow @SmithNephewplc on Twitter or visit SmithNephewplc on Facebook.com


Forward-Looking Statements  

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  1. Adogwa O, Fatemi P, Perez E, Moreno J, Gazcon GC, Gokaslan ZL, Cheng J, Gottfried O, Bagley CA. Negative pressure wound therapy reduces incidence of postoperative wound infection and dehiscence after long-segment thoracolumbar spinal fusion: a single institutional experience. Spine J. 2014 Dec 1;14(12):2911-7
  2. Matsumoto T, Parekh SG. Use of Negative Pressure Wound Therapy on closed surgical incision after total ankle  arthroplasty. Foot Ankle Int. 2015 Mar 3. pii: 1071100715574934. [Epub ahead of print]
  3. Witt-Majchrzak A, Żelazny P, Snarska J. Preliminary outcome of treatment of postoperative primarily closed sternotomy wounds treated using negative pressure wound therapy. Pol Przegl Chir. 2015 Feb 3;86(10):456-65.
  4. 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. Presented at the 30th Annual Scientific Meeting of the British Association of Aesthetic Plastic Surgeons, London 25/26 September 2014
  5. Nosrati et al. Excess costs associated with common healthcare-associated infections in an Iranian cardiac surgery unit.  J Hosp Infect 2010 ; 76 :304-7
  6. Karlakki S, Brem M, Giannini S, Khanduja V, Stannard J, Martin R. Negative pressure wound therapy for management of the surgical incision in orthopaedic surgery: a review of evidence and mechanisms for an emerging indication. Bone Joint Res 2013;2:276–84
  7. Stannard JP, Volgas D, McGwin G, et al. Incisional negative pressure wound therapy after high-risk lower extremity fractures. J Orthop Trauma 2012;26:37–42
  8. Gomoll AH et al. Incisional Vacuum-assisted closure therapy. J Orthop Trauma 2006 Nov-Dec; 20(10): 705-9.
  9. Reddix RN et al. Incisional Vacuum-assisted wound closure in morbidly obese patients undergoing acetabular fracture. Surgery AM J Orthop (Belle Mead NJ) 2009 Sep; 38(9):446-7