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Friday 20 September 2019
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PICO wound care device receives NICE guidance

Smith & Nephew welcomes the launch of new medical technologies guidance from the UK National Institute for Health and Care Excellence (NICE). 
 
In the guidance, NICE recommends that PICO Single Use Negative Pressure Wound Therapy System (sNPWT) should be considered as an option for closed surgical incisions in patients who are at high risk of surgical site infections (SSIs).1 Key patient risk factors include a high BMI, diabetes, renal insufficiency and smoking.2
 
NICE concluded that PICO sNPWT is associated with fewer SSIs and seromas compared with standard wound dressings across several types of surgery. Cost modelling suggests that compared with standard wound dressings, PICO sNPWT provides extra clinical benefits at similar overall cost to the NHS.1 For some types of surgery, PICO sNPWT is cost saving.1
 
When making its recommendations, NICE considered a review of 31 studies, 15 of which were randomised controlled trials.1 A supporting meta-analysis showed that PICO reduced the risk of SSIs by 63%, the risk of seroma by 77% and the risk of dehiscence by 30%.3 Significantly, it also showed there was an almost 2-day reduction in length of hospital stay, providing substantial cost savings and efficiency gains across the healthcare system.3
 
Surgical site complications are an increasing concern for healthcare providers and patients,” said Simon Fraser, President, Advanced Wound Management, Smith & Nephew. “NICE’s recognition of the proven impact PICO can make on both clinical outcomes and cost efficiencies will hopefully challenge existing standards of care around the world.''
 
The PICO sNPWT dressing includes a proprietary AIRLOCK™ Technology layer that uniformly and consistently delivers sufficient NPWT across a surgical incision and the surrounding zone of injury.4,5 This unique feature is designed to help reduce the risk of wound complications by reducing post-operative fluid6,7 and tension8 around a closed surgical incision, when compared with standard dressings. The combination of these actions helps reduce the risk of surgical wound dehiscence3 and SSIs,3 the two most common surgical site complications.
 
References
  1. NICE Medical Technology Guidance MTG43. PICO Negative Pressure Wound Dressings for closed surgical incisions. May 9th 2019
  2. World Union of Wound Healing Societies (WUWHS) Consensus Document. Closed surgical incision management: understanding the role of NPWT. Wounds International, 2016.
  3. 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
  4. Smith & Nephew October 2017. Project Opal PICO 7 System Stability Testing, Initial Time Point. Internal Report. DS/17/253/R.
  5. Malmsjö M et al. Biological Effects of a Disposable, Canisterless Negative Pressure Wound Therapy System. ePlasty. 2014;14.
  6. 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. Bone Joint Res. 2016;5(8):328-337.
  7. 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.