Negative pressure wound therapy solution subject of medtech briefing

NICE publishes medtech innovation briefing on PICO for the prophylactic use in surgically-closed incisions to reduce surgical site complications

The prophylactic use of the PICO system is proven to be effective in reducing SSCs

Smith & Nephew’s PICO Single Use Negative Pressure Wound Therapy solution (sNPWT) is the latest subject of a Medtech innovation briefing (MIB) published this week by the National Institute for Health and Care Excellence (NICE).

The MIB reports the prophylactic use of PICO as a potentially-more-effective alternative to standard surgical dressings in the prevention of surgical site complications (SSCs).

This is the first and only MIB published by NICE on an NPWT device for preventing SSCs.

Complications from surgical incisions are a significant economic and human burden, costing approximately £1billion to the NHS each year and contributing to significant morbidity and mortality in the UK and globally.

A recent World Union of Wound Healing Societies consensus guidelines reports that up to 60% of surgical site infections (SSIs) are preventable.

The prophylactic use of the PICO system is proven to be effective in reducing SSCs, including SSIs and dehiscence (wound rupturing) of the surgical incision in patients at elevated risk of SSCs.

The PICO dressing has a proprietary AIRLOCK Technology that uniformly and consistently delivers NPWT across a surgical incision and the surrounding zone of injury generated naturally by the incision itself.

This proprietary feature is designed to help reduce the risk of wound complications by reducing post-operative fluid, swelling and associated tension around a closed surgical incision compared with standard dressings. The combination of these actions helps reduce the risk of surgical wound dehiscence and SSIs, the two most-common SSCs.

NICE MIBs are a great resource for NHS organisations and are often a reference used by healthcare systems beyond the UK

Evidence shows how the prophylactic use of PICO resulted in fewer complications, and in earlier discharge from hospitals, reducing length of stay, on average by more than eight days, in closed laparotomy wounds after abdominal surgery, which has the potential to release bed days for the NHS.

In patients undergoing primary hip and knee arthroplasties, it was estimated that care with PICO enabled cost savings of more than £7,000 per high-risk patient compared with care with standard dressings.

Pauline Whitehouse, consultant general and colorectal surgeon at Worthing Hospital, said, “Following the introduction of PICO into our trust for moderate- to high-risk incisions, we quickly noticed a significant reduction in superficial surgical site infections.

“We have now introduced PICO across the trust and are seeing similar reductions in infective complications for other specialities.”

MIBs are objective information on device and diagnostic technologies to aid local decision-making by clinicians, managers and procurement professionals.

They are NICE advice, designed to support NHS and social care commissioners and staff who are considering using new medical devices, and other medical or diagnostic technologies.

The briefing will avoid the need for organisations to produce similar information locally, saving staff time and resources.

MIBs are commissioned by NHS England and produced in support of the NHS Five Year Forward View, specifically as one of a number of steps that will accelerate innovation in new treatments and diagnostics.

As part of the MIB, NICE conducted a thorough review of the published and peer-reviewed data from a variety of meta-analyses and randomised controlled trials (RCTs).

The effectiveness of PICO in reducing SSCs has been examined in 10 RCTs and multiple observational studies. A recently-published 1,839 patient meta-analysis demonstrated the efficacy of PICO, used prophylactically, significantly reducing SSIs by 58% in closed surgical incisions compared with standard care.

PICO has shown significant clinical results in reducing life-threatening infections on closed surgical incisions, which has contributed significantly to improved patient outcomes, in a cost-effective portable solution

PICO is suitable for use in both hospital and community settings and is approved for a number of indications, including surgically-closed incision sites.

Paolo Di Vincenzo, Smith & Nephew’s senior vice president of advanced wound management, said: “NICE MIBs are a great resource for NHS organisations and are often a reference used by healthcare systems beyond the UK.

“We are delighted to see the NICE MIB support for the prophylactic use of PICO as an effective alternative for clinicians who look to reduce their rates of surgical site complications.

“This will provide them with the confidence to use PICO for their at-risk patients and procedures, in support of their efforts to achieve better economic and clinical outcomes.

“PICO has shown significant clinical results in reducing life-threatening infections on closed surgical incisions, which has contributed significantly to improved patient outcomes, in a cost-effective portable solution.”

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