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PICO Cardio Evidence

Combat the repercussions

Evidence supports PICO sNPWT in reducing wound complications and costs in cardiac surgery*1-3 

Deep sternal wound complications, such as infection and mediastinitis, can have a devastating impact on patients and are associated with an in-hospital mortality rate of up to 35%.4

 10.8% surgical site infection (SSI) rate for cardiac surgery.5



 23-day median additional length of stay following SSI.5



 £11,003 median additional cost following SSI.5

Potential to improve outcomes and efficiencies…particularly for high-risk patients*

A growing body of evidence suggests that prophylactic use of the PICO Single Use Negative Pressure Wound Therapy System (sNPWT) may help*...

…reduce surgical site complications and mediastinitis

 64% reduction in surgical site complications (SSCs).**1




 68% reduction in mediastinistis.**1




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 70% relative reduction in SSCs following coronary artery bypass grafting surgery (CABG)***2




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…reduce infections, reduce antibiotics

 86% relative reduction in superficial SSIs following CABG surgery.***2 




 Use of PICO sNPWT was associated with a reduced need for antibiotics.***2


 …reduce per-patient treatment costs and length of stay

  Shown to save an estimated €1,295 per patient in a study, releasing capacity to treat 10 additional patients.**1


 Demonstrated estimated mean cost savings of €586 per patient following CABG surgery – up to 4 times greater than PICO sNPWT’s mean purchase price.****3




 Read summary


 In a study, length of hospital stay was reduced by ~10 days.**1



Get the experts’ experience of using PICO sNPWT


…make a difference for high-risk patients

Guidance from the UK’s NICE supports the use of PICO sNPWT to help prevent SSCs in high-risk patients with closed surgical incisions, at a similar overall cost.*6

 30% reduction in the risk of dehiscence.7 


 77% reduction in the risk of seroma.

How does PICO Therapy work?

Only PICO sNPWT dressings have AIRLOCK Technology, to help promote effective outcomes.8-11

Find out more about PICO Therapy

Is your patient high-risk?

Identifying high-risk patients is fundamental to preventing major infection following sternotomy.12 

For further information or guidance, please contact us.

Helping you get CLOSER TO ZERO surgical site complications.13 


*compared to conventional dressings/standard care

**Review of anonymised records before and after the introduction of PICO sNPWT for high-risk patients (≥2 SSI risk factors) undergoing cardiac surgery in a hospital in France. 142 patients received PICO sNPWT vs 91 receiving standard care. Mean age: 65-67 years respectively). Reduction in SSCs: 6.3% vs 17.6%. p=0.009. Reduction in mediastinitis: 3.5% vs 11.0%. p=0.029.

***Open label, prospective study of patients with closed sternotomy wounds, treated with either PICO sNPWT (n=40) or conventional dressings (n=40). Mean age: 62 vs 66 years respectively. SSC reduction: PICO sNPWT group 7.5% (n=3) vs conventional dressings 25.0% (n=10). p=0.034. Superficial SSI reduction: PICO sNPWT group 2.5% (n=1) vs conventional dressings 17.5% (n=7). p=0.025. Antibiotics use: p=0.043.

****Economic model using effectiveness data from a single-centre, randomised controlled trial (Witt-Majchrzak A, et al, 2015) over 12 weeks. Mean age of 65 years.




1. Tabley A, Aludaat C, Le Guillou V, et al. A survey of cardiac surgery infections with PICO Negative Pressure Therapy in high-risk patients: survey of surgical site complications. Ann Thorac Surg. 2020 [Epub ahead of print] Available at: Annals of Thoracic Surgery.
2. 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;86(10):456-465. Available at: Polski Przeglad Chirurgiczny
3. Nherera LM, Trueman P, Schmoeckel M, Fatoye FA. Cost-effectiveness analysis of single use negative pressure wound therapy dressings (sNPWT) compared to standard of care in reducing surgical site complications (SSC) in patients undergoing coronary artery bypass grafting surgery. J Cardiothorac Surg. 2018;13:103. Available at: Journal of Cardiothoracic Surgery.
4. Cotogni P, Barbero C, Rinaldi M. Deep sternal wound infection after cardiac surgery: Evidences and controversies World J Crit Care Med 2015;4(4): 265- 273.
5. Jenks, P.J., Laurent, M., McQuarry, S. and Watkins, R., 2014. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital. Journal of Hospital Infection, 86(1), pp.24-33.
6. NICE (2019) PICO negative pressure wound dressings for closed surgical incisions [online] accessible from:
7. Saunders, C., Buzza, K. and Nherera, L. 2019. A single use negative pressure system reduces surgical site complications compared with conventional dressings in closed surgical incisions: a systematic literature review with meta- analysis. Poster presented at the European Wound Management Association annual meeting, June 5-7, 2019, Gothenburg, Sweden.
8. Data on file reference 1102010 – Bacterial Barrier Testing (wet-wet) of PICO Dressing with a 7 day Test Duration against S. marcescens.
9. Malmsjo, M., Huddleston, E. and Martin, R., 2014. Biological effects of a disposable, canisterless negative pressure wound therapy system. Eplasty. 
10. Pellino, G., Sciaudone, G., Candilio, G., Campitiello, F., Selvaggi, F. and Canonico, S., 2014. 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, 21(2), pp.204-212.
11. Hudson, D.A., Adams, K.G., Van Huyssteen, A., Martin, R. and Huddleston, E.M., 2015. Simplified negative pressure wound therapy: clinical evaluation of an ultraportable, no‐canister system. International wound journal, 12(2), pp.195-201.
12. Fowler Jr, V.G., O’Brien, S.M., Muhlbaier, L.H., Corey, G.R., Ferguson, T.B. and Peterson, E.D., 2005. Clinical predictors of major infections after cardiac surgery. Circulation, 112(9_supplement), pp.I-358.
13. 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.

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Intended for healthcare professionals outside of the US only.

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