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NICE backs single use negative pressure wound dressings

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The 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, according to latest guidance on medical devices from the National Institute for Health and Care Excellence.

The negative pressure wound dressing, provided by medical equipment manufacturer Smith & Nephew, is a canister-free, single-use and portable therapy system, which, according to NICE, can lead to fewer surgical infections.

“NICE’s recognition of the proven impact PICO can make will hopefully challenge existing standards of care”

Simon Fraser

In a series of recommendations for the dressings, the institute concluded that using this type of dressing also reduced the rate of seromas – fluid that can develop in the body post-surgery – compared with standard dressings.

Overall, the institute stated in its guidance that there was evidence to support the case for adopting the wound dressing system for closed surgical incisions provided by the NHS in patients considered at high risk of surgical site infections.

For example, it described patients with risk factors including a high body mass index, diabetes, renal insufficiency or who smoked.

NICE also said that using the PICO sNPWT dressings would not add to the overall costs of treatment. NICE stated that cost modelling suggested that the pressure wound dressings provided extra clinical benefits at a similar overall cost, compared with standard versions.

The PICO sNPWT system consists of a sterile pump and multi-layered adhesive dressings. Each dressing has four layers, which include a silicone adhesive wound contact layer that works to minimise pain and damage when peeled back and an airlock layer for even pressure distribution across the wound.

In addition, the dressing has an absorbent layer, designed to remove bacteria from the wound, and a top film later which acts as a physical barrier and allows moisture to evaporate.

“Our independent committee concluded that any additional cost would be offset by savings”

NICE spokesman

A spokesman for NICE said: “The clinical evidence shows that using PICO where the risk of surgical site complications is high is associated with fewer surgical site infections across a range of surgical specialities.”

“The NICE guidance supports using PICO negative pressure wound dressings in people who have closed surgical incisions who are at high risk of developing surgical site complications,” he added.

“Although more expensive than standard surgical dressings, our independent committee concluded that any additional cost would be offset by savings associated with the reduction in surgical site complications,” he said.

Relevant evidence for the guidance came from 31 studies, 15 of which were randomised controlled trials.

Simon Fraser, president for advanced wound management at Smith & Nephew, said: “Surgical site complications are an increasing concern for healthcare providers and patients.

“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,” he added.

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