The UK National Institute for Health and Care Excellence (NICE) has released new recommendations for use of the PICO negative pressure wound dressing (Smith & Nephew) for closed surgical incisions, saying the negative pressure dressings are “associated with fewer surgical site infections and seromas compared with standard wound dressings”.
NICE gives the following three recommendations:
1.1 Evidence supports the case for adopting PICO negative pressure wound dressings for closed surgical incisions in the NHS. They are associated with fewer surgical site infections and seromas compared with standard wound dressings.
1.2 PICO negative pressure wound dressings should be considered as an option for closed surgical incisions in people who are at high risk of developing surgical site infections. Risk factors for surgical site infections are described in section 4.2.
1.3 Cost modelling suggests that PICO negative pressure wound dressings provide extra clinical benefits at a similar overall cost compared with standard wound dressings.
Explaining the reasoning behind the new recommendation, NICE states that the dressings were are designed to allow an even distribution of negative pressure on the surface of a closed surgical incision, using a portable system. Clinical evidence shows that using PICO dressings for closed surgical incisions can lead to fewer surgical site infections, with evidence that it also reduces the rate of seromas compared with standard wound dressings. Cost analyses, NICE notes, suggest that using PICO dressings will not add to the overall costs of treatment. NICE have recommended the wound dressings to be used in the UK National Health Service (NHS).
In terms of clinical evidence, 31 studies were reported to have provided evidence relevant to the decision problem. Of these, 15 were randomised controlled trials and 16 were non-randomised comparative observational studies. According to NICE, the 15 randomised controlled trials were done in secondary or tertiary care, and were based on preventing surgical site complications in people with closed surgical incisions who were at high risk of complications after surgery.