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Smith & Nephew: Evidence and Expert Opinion Highlights Clinical and Aesthetic Benefits of PICO? Single-Use Negative Pressure Wound Therapy in Mammoplasty and Oncological Breast Reconstructive Surgery

Smith & Nephew
Posted on: 30 Aug 16

Smith & Nephew (LSE:SN, NYSE:SNN), the global medical technology business, today announces how expert opinion around the world continues to build around the use of PICO, a novel single use negative pressure wound therapy (NPWT) in avoiding post-operative wound complications. At a recent meeting hosted by Smith & Nephew in Paris, over 160 European experts in plastic and onco-plastic surgery met to share the latest evidenced based best practice around the use of PICO, in the prevention of incisional complications following breast surgery.

Incisional complications and delayed healing are not uncommon following breast surgery and can cause avoidable hospital readmissions or increased lengths of stay, which has implications for both the healthcare system and patient outcomes. Delayed healing is a particular issue in post mastectomy reconstruction where the risk of a surgical complication has been found to be four times higher than in non-oncology breast surgery1, and where any delay to adjunctive treatment such as radiotherapy is to be avoided.

Preventing a wound complication following a mastectomy or lumpectomy is crucial. Even a minor complication can delay radiotherapy or chemotherapy, and can potentially have devastating consequences. Predictable wound healing is vital for this reason but to also save the patient from experiencing psychological distress if treatment is postponed” says Jennifer Rusby, Consultant Oncoplastic Surgeon, Royal Marsden, London, UK.

With regards to breast reduction surgery, other issues were raised with regards to wound care and post operative issues including scar quality. A multicentre-study2 involving 200 bilateral breast reduction patients was presented, which showed significantly fewer wound healing complications for PICO compared to standard care (p=0.004), and a 38% relative reduction in surgical dehiscence by day 21 (a surgical complication in which the wound ruptures along the surgical suture line) from 52 patients (26.4%) to 32 patients (16.2%) (p<0.001). The study also evaluated the scar quality at 42 and 90 days post surgery. PICO showed significantly better scar quality at each time point (p<0.001).

Clinical complications including surgical site infections following breast surgery were also identified as significantly higher amongst patients with a high BMI3, impacting on both clinical and aesthetic outcomes, but also on the hospital’s resources due to re-admissions and further post-operative care.

Professor Laurent Lantieri, Chief of Department of Plastics and Reconstruction surgery, European Hospital Georges Pompidou, Paris, chaired the meeting, and explained further:

"It is very important to bring some of the most experienced and innovative surgeons together at meetings such as this; to share first-hand ideas which you cannot get from reading a journal article or attending large scientific conferences. It is these interactive meetings that are important for the future of education. If I give you one idea and you give me one idea we both have two ideas, and by exchanging these ideas we can improve our knowledge and even inform future practice.”

The Plastic Surgery Expert Meeting hosted by Smith & Nephew is one of a series of six meetings happening during 2016, including the use of NPWT across specialities such as orthopaedic, cardiothoracic and vascular surgery and obstetrics and gynaecology.

For images and video footage from the meeting please visit:

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1 Olsen, M. A., Lefta, M., Dietz, J. R., Brandt, K. E., Aft, R., Matthews, R., & Fraser, V. J. 2008. Risk factors for surgical site infection after major breast operation. J Am Coll Surg 2008;207:326–335

2 Galiano R, Djohan R, Shin J, Hudson D, Van der Hulst, Beugels J, Duteille F, Huddleston E, Cockwill J, Megginson S The effects of a single use canister-free Negative Pressure Wound Therapy (NPWT) System* on the prevention of postsurgical wound complications in patients undergoing bilateral breast reduction surgery (First presented at The British Association of Aesthetic Plastic Surgeons (BAAP’s) 30th Annual Scientific Meeting, London, September 2014)

3 Davis, G. B., Peric, M., Chan, L. S., Wong, A. K., & Sener, S. F. 2013. Identifying risk factors for surgical site infections in mastectomy patients using the NSQIP database. The American Journal of Surgery, 2013 205(2) 194–199

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Last updated on: 30/08/2016

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