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PICO - Applications and settings

Surgical

Surgery doesn’t end in the theatre

Evidence shows that PICO Single Use Negative Pressure Wound Therapy (sNPWT) is clinically effective in reducing the incidence of surgical site infections (SSI) and complications (SSC) across a broad range of surgical specialities1-17

Understanding the challenges you face.

250 million major surgical procedures are carried out each year18 so we understand your need to minimise the cost and time burden of complications.

According the WUWHS, up to 60% of SSIs are preventable18

 

Proactive prevention of surgical wound complications.

PICO, used prophylactically, is successful in significantly reducing post-operative SSIs and SSCs across a number of specialties and patient profiles1-3, 6,12,14-17

  • Surgically closed incision sites- A meta-analysis demonstrated a 58% reduction in SSIs (i)1. View our study summary.
  • Abdominal surgery for Crohn’s disease - Seroma reduced by 82%, compared with gauze dressings(ii)8
  • Mammoplasty - Improved scar quality(iii)19 and significantly improved surgical dehisence(iv)2. View our study summary
  • Obstetrics (C-section) - PICO offers potential for PICO sNPWT to reduce SSCs(v)13
  • Orthopaedic - In patients undergoing primary hip and knee arthroplasties, superficial SSCs reduced by 76%(vi)5
  • Cardiothoracic - In high-risk CABG surgery, SSCs reduced 70% compared to standard dressings(vii)3
  • Colorectal (Closed laparotomy) - SSI incidence reduced by 74%(viii)6

How much time and money could you save with PICO? Helping you get CLOSER TO ZEROhuman and economic cost of wounds.


View our guide to identifying patients with a high risk of wound complication.

 

Download the PICO 7 size chart and ordering information.



For any specific patient requirements, or for help identifying the right dressing choice, please contact us.

 

For other patient requirements:

ALLEVYN

ACTICOAT
IODOSORB MolecuLightTM i:X
RENASYS    

 

(i) Versus care with standard dressings (Meta-analysis included 10 RCT & 6 observational studies. Reduction in SSI (16 studies included): 1863 patients (2202 incisions); PICO 5.2%; control group 12.5%; p<0.00001. Mean reduction in hospital length of stay (8 studies included): 0.47 days; p<0.0001.)
(ii) Study relates to Crohn’s disease patients. Compared to care with standard dressings (Reduction in seroma; 50 patient study. PICO 2 patients (8%); standard care 11 patients (44%); p=0.008)
(iii) Scar appearance: Significantly better scar quality at 42 days and 90 days assessment; p<0.001.
(iv) Reduction in dehiscence: 200 patients; PICO 32 patients (16%); standard care 52 patients (26%); p<0.001
(v) Analysis of 239 patients, all patients had BMI >35 (1644 patients in total of all BMIs) and were treated with PICO. SSI rate reduced to 3.6% for patients with BMI <35 and 0.4% for patients >35 during study period.
(vi) Reduction in surgical site complications: 200 patient study, PICO 2.0%; control group 8.4%.
(vii) Reduction in wound complications: 80 patient study, PICO 3 patients (7.5%); standard care 10 (25%) p<0.034.
(viii) Reduced SSIs: 50 patient study; PICO 2 patients (8.3%); control group 8 patients (32.0%); p=0.043.

 

References

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 2018; 18 (7):810-819. DOI: 10.1089/sur.2017.156.
2) Galiano R.D., Hudson D, Shin J, et al. Incisional negative pressure wound therapy for prevention of wound healing complications following reduction mammoplasty. Plast Reconstr Surg Glob Open 2018;6:e1560; doi: 10.1097/GOX.0000000000001560; Published online 12 January 2018.
3) Witt-Majchrzak et al, Preliminary outcome of treatment of post-operative primarily closed sternotomy wounds treated using negative pressure wound therapy. Polish Journal of Surgery (2014) Vol 86(Issue 10): 456-465.
4) Rodden D. et al. NPWT: Incision management in high risk cardiothoracic patients reducing surgical site infection and length of stay, Poster presented at STSC Conference 2015.
5) Karlakki SL et al. Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: A randomised controlled trial. Bone & Joint Research (2016) Vol 5 (Issue 8): pp 328-337 doi:10.1302/2046-3758.58.BJR-2016-0022.R1.
6) O’Leary D.P. et al, Prophylactic negative pressure 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.
7) Holt R and Murphy J. PICO incision closure in oncoplastic breast surgery: a case series. Br J Hosp Med 2015; 76(4):217-223.
8) 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.
9) Pellino G et al. Prophylactic Negative Pressure Wound Therapy in colorectal surgery. Effects on surgical site events: current status and call to action, Updates Surg 2015; DOI 10.10007/s 13304-015-0298-z.
10) Canonico S et al. Therapeutic possibilities of portable NPWT. Initial multidisciplinary observation with the negative pressure therapy device. Acta Vulnol Issue 2, 2012; 10: 57-66.
11) Nordmeyer M et al. Negative pressure wound therapy for seroma prevention and surgical incision treatment in spinal fracture care. Int Wound Journal 2015; DOI: 10.111/iwj.12436.
12) Matsumoto, T. and Parekh S.G. Use of negative pressure wound therapy on closed surgical incision after total ankle arthroplasty. Foot & Ankle International (2015) Vol 36 (Issue 7): 787-794.
13) Bullough,L. et al. Reducing C-section wound complications. The Clinical Services Journal (2015) April: 2-6.
14) Pellino G. et al, Effects of a new pocket device for negative pressure wound therapy  on surgical wounds of patients affected with Crohn’s disease: A pilot trial; Surgical Innovation, Jul 2014;21 (2):204-212
15) Schwartz J.A., et al, 2015: Single-Use Negative Pressure Wound Therapy for the treatment of chronic lower leg wounds. Journal of Wound Care Issue S2, 24: S4-9.
16) Bullough et al; Changing wound care protocols to reduce post-operative C-section infection and readmission. Wounds UK 2014, Vol 10, No.1, 72-76
17) Adogwa, O. et al. 2014: Negative pressure wound therapy reduces incidence of post-operative wound infection and dehiscence after long-segment thoracolumbar spinal fusion: A single institutional experience. The Spine Journal 14(12):2911-17
18) World Union of Wound Healing Societies (WUWHS). Consensus document. Closed surgical incision management: understanding the role of NPWT. Wounds Int, 2016.
19) Tanaydin V, et al. Randomized controlled study comparing disposable negative-pressure wound therapy with standard care in bilateral breast reduction mammoplasty evaluating surgical site complications and scar quality. Aesthetic Plast Surg. 2018. doi. 10.1007/s00266-018-1095-0.

Chronic

Fast healing for chronic wounds*1

PICO Single Use Negative Pressure Wound Therapy (sNPWT) is clinically effective for the treatment of chronic wounds such as pressure, venous and diabetic ulcers1-4.


Understanding the challenges you face

15% of chronic wounds are unhealed after a year, continually adding to patient distress5
Over an hour per wound is spent every week in managing chronic wounds5, costing over £3billion in the UK alone6


Alleviating the burden of chronic wounds1-2

  • In chronic wounds that responded to PICO sNPWT, wound size was shown to reduce by an average of 21% per week*1
  • Shown to help heal chronic wounds that responded 6 times faster - reducing healing time by an average of 10 weeks, compared to that predicted with standard care1


How much time and money could you save with PICO? Helping you get CLOSER TO ZERO human and economic cost of wounds.


Multiple mechanisms of action for optimal performance7

 

Successful in treating hard-to-heal wounds2

PICO has been shown to improve the healing trajectory of hard-to-heal wounds, when compared with standard care**2


View our guide to identifying patients with a high risk of wound complication.

 

All PICO dressings can be used with gauze filling to ensure direct contact is made with the wound bed8.

 

If used in conjunction with filler, the filler and PICO dressing should be changed 2-3 times per week in accordance with local clinical protocol and manufacturer’s instructions for use.


Download the PICO size chart and ordering information.


Do you require assistance identifying a wound to get the right wound therapy? Please contact us.


For other patient requirements:

ALLEVYN

ACTICOAT
IODOSORB MolecuLightTM i:X
RENASYS    

 

*based on 5 out of 9 wounds responding: wound mean duration prior to study 44 weeks. n=9.
** A prospective cohort study of 52 wounds, less than 3 months duration n=17, 8 wounds healed and 8 wounds on a healing trajectory

 

 

 

Anatomy of a chronic wound

i) Malmsjö M. et al. Biological effects of a disposable, canisterless Negative Pressure Wound Therapy system. Eplasty 2014; 14:e15.
ii) Data on File DS/18/015/R. Summary Wound Model Report for Opal PICO 7. January 2018
iii) Data on file reference 1102010 – Bacterial Barrier Testing (wet-wet) of PICO dressing with a 7 day test duration against S.marcescens; Helen Lumb, February 2011.
iv) Karlakki S, Brem M, Giannini S, Khanduka V, Stannard J and Martin R (2013) Negative pressure wound therapy management of the surgical incision in orthopaedic surgery: A review of evidence and mechanisms for an emerging indication. Bone and Joint research, [online] 2(12), pp. 276-284. Available at: http://bjr.boneandjoint.org.uk/content/2/276.long [Accessed 4 Oct, 2017].

 

References

1) Hampton J. Providing cost-effective treatment of hard-to-heal wounds in the community through use of NPWT. Br J Community Nurs. 2015; 20:S14–S20.
2) Dowsett C et al. Use of PICO to improve clinical and economic outcomes in hard-to-heal wounds. Wounds Int. 2017; 8(2):52-58.
3) Stryja J et al, 2015: Farmakoekonomika Ambulantní Terapie RanKontrolovaným Podtlakem (Cost-Effectiveness of Negative Pressure Wound Therapy in Outpatient Setting). Rozhl Chir 94(8): 322–28, 2015
4) Dunn R et al. Factors associated with positive outcomes in 131 patients treated with gauze-based negative pressure wound therapy Int J Surg. 9(3):258-262. 2011.
5) Jorgensen S.F. et al. Meeting the challenges of wound care in Danish home care. J Wound Care 2013; 22(10).
6) Guest J.F. et al. Health economic burden that wounds impose on the National Health Service in the UK. Br Med J Open 2015; 5:12, e009283.
7) Karlakki S.L. et al. Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: A randomised controlled trial. Bone & Joint Research (2016) Vol 5 (Issue 8): pp 328-337 doi:10.1302/2046-3758.58.BJR-2016-0022.R1.
8) Report reference DS/11/021/R1 – Wound model investigation of the compatibility of PICO with a range of wound fillers and a wound contact layer. Sarah Roberts, March 2011.

Acute

Shown to help prevent infection and dehiscence for acute wounds1-4

Our PICO Single Use Negative Pressure Wound Therapy (sNPWT) system is clinically effective in the treatment of acute, subacute and traumatic wounds, flaps and grafts5-9. NPWT has demonstrated clinical efficacy on partial thickness burns10-11.


Understanding the challenges you face.

The annual cost of wound infections is over $7bn*12

How much time and money could you potentially save through prophylactic use of PICO? Helping you get CLOSER TO ZEROhuman and economic cost of wounds.


All PICO dressings can be used with gauze filling to ensure direct contact is made with the wound bed13

If used in conjunction with filler, the filler and PICO dressing should be changed 2-3 times per week in accordance with local clinical protocol and manufacturer’s instructions for use.


Proactive wound infection prevention1

PICO sNPWT, used prophylactically, has been shown to help prevent infection and improve healing in dehisced wounds3

View our guide to identifying patients with a high risk of wound complication.


Do you require assistance identifying a wound to get the right wound therapy? Contact us now.

 

For other patient requirements:

ALLEVYN

ACTICOAT
IODOSORB MolecuLightTM i:X
RENASYS  

 

*In the US alone.

 

References

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 2018; 18 (7):810-819. DOI: 10.1089/sur.2017.156.
2) Galiano R. D., Hudson D., Shin J., et al. Incisional negative pressure wound therapy for prevention of wound healing complications following reduction mammoplasty. Plast Reconstr Surg Glob Open 2018;6:e1560; doi: 10.1097/GOX.0000000000001560; Published online 12 January 2018.
3) Dowsett C. et al. Use of PICO to improve clinical and economic outcomes in hard-to-heal wounds. Wounds Int. 2017; 8(2):52-58.
4) Pellino et al., Effects of a new pocket device for negative pressure wound therapy on surgical wounds of patients affected with Crohn’s disease: A pilot trial; Surgical Innovation Jul 2014;21(2):204-212.
5) Canonico S. et al. Therapeutic possibilities of portable NPWT. Initial multidisciplinary observation with the negative pressure therapy device. Acta Vulnol Issue 2, 2012; 10: 57-66.
6) 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.
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 Apr 2014, 14: e20.
8) Dunn R. et al. 2011. Factors associated with positive outcomes in 131 patients treated with gauze-based negative pressure wound therapy Int J Surg. 9(3):258-262.
9) Rossington, A; A prospective, open, non-comparative, multicentre study to evaluate the functionality and dressing performance of a new negative pressure enhanced dressing (NPED) in acute wounds, CT09/02, May 2015.
10) Kamolz L. P.et al; Use of sub-atmospheric pressure therapy to prevent burn wound progression in humans. Burns, 2004 30(3):253-258
11) Molnar J. A. et al; Management of an acute thermal injury with subatmospheric pressure; J Burns Wounds, March 2005; 4:e5
12) World Union of Wound Healing Societies (WUWHS). Consensus document. Closed surgical incision management: understanding the role of NPWT. Wounds Int, 2016.
13) Report reference DS/11/021/R1 – Wound model investigation of the compatibility of PICO with a range of wound fillers and a wound contact layer. Sarah Roberts, March 2011.