Lower extremity evidence

New clinical evidence demonstrated the PICO system’s performance on diabetic foot and venous leg ulcers1

A recent multisite RCT compared our PICO Single Use Negative Pressure Wound Therapy (sNPWT) System to traditional NPWT (tNPWT) for the treatment of diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) over a 12-week period. See the exciting results below...

Aiming to redefine standard of care for wound closure and patient satisfaction1

Our PICO sNPWT System demonstrated, over 12 weeks from baseline:

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A 73.1% reduction in wound area, compared to 31.3% in the tNPWT group (n=161, ITT) (i)1

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A 48.1% reduction in wound depth, compared to 12.7% in the tNPWT group (n=161 ITT) (i)1

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Conclusion: PICO sNPWT demonstrated superior wound closure rates for DFUs and VLUs combined, over 12 weeks compared to tNPWT.1

Potential to improve patient satisfaction1 

patient satisfaction

In this study, our PICO sNPWT System was rated higher by patients for comfort, mobility and sleep impact, compared with tNPWT (ii).1


The ability to change economic outcomes using sNPWT2

Based on this recent RCT, a cost-analysis model was created to estimate the savings using sNPWT instead of tNPWT: Click here to learn more.

Study results

In the original randomized controlled trial, results were statistically significant for DFUs alone, and DFUs and VLUs combined. Consideration: filler utilization was not assessed during this study.

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This suggests that using PICO sNPWT for DFUs and VLUs combined may provide estimated overall reduced costs of up to 70.9%, and improve wound closure rates, when compared with tNPWT. Policy makers may have opportunities to reduce economic burden, while simultaneously improving patient outcomes (ii, iii).2

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Why settle for tNPWT on DFUs and VLUs? See how PICO compared to tNPWT in a new clinical study. 

Contact us to arrange for a Smith & Nephew representative to contact you to discuss how our PICO sNPWT System could help your staff and patients. 

PICO sNPWT – designed to be different

Pioneering technology found only in our PICO sNPWT System has demonstrated clinical efficacy for chronic wounds and closed surgical incisions.1,3

  • AIRLOCK Technology delivers evenly distributed negative pressure across the wound, wound margin, and periwound area, for up to 7 days of uninterrupted use, depending on exudate levels.4
  • The dressing’s silicone adhesive helps to minimize trauma and pain to the periwound area when the dressing is removed (iv).5
  • Optimal fluid management to reduce the risk of maceration (iv).6
  • In-vitro testing demonstrated up to 99.9% of bacteria is locked away from the wound once absorbed into the third layer.7

Click here to read the study.



For detailed product information, including indications for use, contraindications, effects, precautions, warnings, and important safety information, please consult product’s Instructions for Use (IFU) prior to use. 


  1. 161-intention-to-treat (ITT) patient multisite RCT over 18 centers. 80 patients using sNPWT, 81 patients using tNPWT.
  2. 161-ITT patient multisite RCT over 18 centers. 80 patients using sNPWT, 81 patients using tNPWT. Overall satisfaction p=0.006, comfort p<0.001, mobility p<0.001, sleep impact p=0.017.
  3. 161-ITT patient multisite RCT over 18 centers. 2-state Markov model with 26-week time horizon and 1-week cycle length.
  4. Pre-clinical study.


  1. Kirsner R, et al. Randomized controlled trial on the efficacy and acceptance of a single-use negative pressure wound therapy system versus traditional negative pressure wound therapy in the treatment of lower limb chronic ulcers (VLU and DFU). Poster presented at Wild on Wounds National Wound Conference. September 12–15, 2018. Poster 18.
  2. Searle R. The cost-effectiveness of single-use negative pressure wound therapy (sNPWT) compared to traditional negative pressure wound therapy (tNPWT) for the treatment of chronic lower extremity ulcers. Poster presented at Wild on Wounds National Wound Conference. September 12–15, 2018. Poster 27.
  3. 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 Vol 18 Number 07 (2017). DOI: 10.1089/sur.2017.156. 810-819.
  4. Data on file. DS/17/253/R version2. Project Opal PICO 7 system stability testing, initial time point. November 2017.
  5. Loveluck J et al. Biomechanical modelling of forces applied to closed incision during single-use negative pressure wound therapy. Eplasty 2016; 16e20.
  6. Malmsjö M et al. Biological effects of a disposable, canisterless Negative Pressure Wound Therapy system. Eplasty 2014; 14:e15.
  7. Data on file report 1712012. The retention of aeruginosa and S. aureus bacteria within PICO dressings after 72 hours under NPWT in a dynamic model. December 2017.