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PICO in orthopedic surgery

PICO sNPWT in orthopedic surgery

Outcomes, costs and active patients

Using PICO therapy after hip and knee surgery can reduce surgical site complications (SSCs), readmissions and length of stay

Surgical site complications following orthopedic surgery can have a significant impact on patient recovery, and the costs associated with readmissions.

Compared to conventional dressings, a postoperative wound care protocol including use of the PICO Single Use Negative Pressure Wound Therapy System (sNPWT) has been shown to reduce the incidence of edema, hemtoma, seroma, dehiscence, and infection.1

This, in turn, may positively affect wound outcomes and help get patients moving.1-3


Mr Sudheer Karlakki outlines how PICO sNPWT has impacted outcomes in his practice



Reducing the length of hospital stay**2

1.75 days less


Used prophylactically, PICO sNPWT was shown to reduce the length of hospital stay by 0.9 days compared to standard care.**2



As part of a meta-analysis, PICO sNPWT in post-op orthopedic care resulted in a 57% reduction in the odds of surgical site infection when compared to standard dressings.**1 

Help to limit the cost of readmissions

$8800 saved


It was estimated that the use of PICO therapy saved more than $8,800 per high-risk patient following primary hip and knee arthroplasty, compared to standard care.***3


Read cost-effectiveness study

From the experts’ perspective

Analyzing the role of PICO sNPWT in an outpatient total joint arthroplasty setting, Dr Ravi Bashyal shares his experience of reducing surgical site complications.



Making 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, compared to standard care, at a similar overall cost.4


Read the medical technology guidance

Application of the PICO System after knee surgery



How does PICO therapy work?

Only PICO sNPWT dressings have AIRLOCK* Technology, to help promote effective outcomes.5-8



Request more information about PICO sNPWT


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  1. 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.
  2. Karlakki SL, Hamad AK, Whittall C, et al. Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: A randomised controlled trial. Bone Joint Res. 2016;5(8):328-337.
  3. Nherera LM, Trueman P, Karlakki SL. Cost-effectiveness analysis of single-use negative pressure wound therapy dressings (sNPWT) to reduce surgical site complications (SSC) in routine primary hip and knee replacements. Wound Repair Regen. 2017;25(3):474-482.
  4. NICE (2019) PICO negative pressure wound dressings for closed surgical incisions [online] accessible from:
  5. Data on file reference 1102010 – Bacterial Barrier Testing (wet-wet) of PICO Dressing with a 7 day Test Duration against S. marcescens.
  6. Malmsjö, M., Huddleston, E. and Martin, R., 2014. Biological effects of a disposable, canisterless negative pressure wound therapy system. Eplasty; 14:e15.
  7. 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.
  8. 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.
  9. 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.

*220-patient primary hip and knee arthroplasty study. PICO 2% vs control group 8.4%, p=0.06.

**Meta-analysis of 29 studies and 5614 patients with closed surgical incisions.
Length of stay – 10 studies, 948 patients, p=0.0002.
Surgical site infection – 5 studies, 607 patients, p=0.02.
Seroma – 6 studies, 771 patients, pSkin necrosis – 2 studies, 474 patients, p=0.0007.
Dehiscence – 9 studies, 1790 patients, 0.01.

***n=209, p=0.002. High-risk patients deemed to be those with BMI >35 or ASA >3