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PICO◊ sNPWT Transforming Pathways

Simplify negative pressure wound therapy...

it's possible

Complete the patient pathway by identifying the risk factors

About

PICO◊ sNPWT is a wound care system, which provides suction known as Negative Pressure Wound Therapy (NPWT). PICO◊ sNPWT consists of an NPWT pump connected to an absorbent gentle adhesive dressing. This draws out excess fluid from a wound, providing a compressive force and protecting the injured area and helping promote healing1. PICO◊ sNPWT has been shown to significantly reduce the risk of surgical site complications (SSC) when compared to standard care dressings 2-8. The risk of developing a post-operative SSC depends on the type of surgery and patient risk factors 9.

The PICO◊ sNPWT Transforming Pathways game and tool is designed specifically for surgeons to assess surgical risk factors and evaluate appropriate PICO◊ sNPWT use. All risk factors and their classifications within the PICO transforming pathways game and tool have been taken from the World Union Wound Healing Societies (WUWHS) consensus document and NICE guidance 10-11. The WUWHS consensus document recommends the application of NPWT for closed surgical incisions as a preventative measure for SSCs in cases with one major risk factor or the presence of two or more moderate risk factors10. Additionally, NICE guidance classifies certain risk factors that warrant the use of PICO° sNPWT 11.

Please note that the PICO◊ sNPWT Transforming Pathways game and tool are intended for informational and guidance purposes only and should not be considered medical advice. They serve as a resource to assist in determining when to utilise PICO◊ sNPWT for SSC prevention. The recommendations contained herein are the local clinical protocols, recommendations, and/or guidelines as set forth regarding the use of PICO◊ sNPWT. Protocol recommendations have not been verified by Smith & Nephew. Smith & Nephew accepts no responsibility for the content of this pathway and shall not be responsible for any reliance placed on the content. Smith & Nephew does not provide medical advice. It is the responsibility of clinicians to determine and utilise products and techniques appropriate for each of their individual patients. For detailed device information, including indications for use, contraindications, precautions and warnings, please consult the product's Instructions for Use (IFU) prior to use.

Your Details

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Welcome!

Create a pathway for a hypothetical patient by assessing their profile based on surgical site complication (SSC) risk factors and their suitability for PICO◊ sNPWT

If you have a patient that may be at a higher risk of SSCs use this tool to build a bespoke SSC prevention pathway with PICO◊ sNPWT

How it works

PICO◊ sNPWT Transforming Pathways: How it works

1 Start a new game to generate a patient pathway board.
2 Select a tile from the first column to reveal a potential risk factor.
3 Categorise this factor* as either low, moderate or high risk.
*These risk factors and risk assessments are based on the WUWHS consensus and NICE guidelines 10 ,11
4 Indicate whether the presence of this risk factor would make you decide to use sNPWT with this patient.
5 Reveal the data from NICE or WUHUS and if it matches progress to the next column10,11.
6 The game ends when either a risk assessment is done in every column, or you’ve appropriately used PICO based on NICE and WUHUS evidence10,11.
7 Our completion time is tracked and presented on a leaderboard.
8 Send your tailored protocol to your email and try the protocol builder.

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Is your patient at risk of surgical site complications (SSCs)?*

Create a tailored SSC prevention pathway for your surgical procedures

1 Select your surgical specialty
2 Select any high risk factors present in the patient
3 Select any moderate risk factors present in the patient
4 Generate your tailored SSC prevention pathway
5 Send pathway to your email

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*The risk factors are based on the WUWHS consensus definition of risk factors. The generated pathways are based on published recommendations and are not provided by Smith&Nephew 10

Step One

Surgical speciality selection:

Select 1 option only

Please select which surgical speciality this template is intended to be implemented.

Next Step
Go Back

Please select 1 option

Please select at least 1 option

Please select at least 1 option

Step Four

Your surgical site complication (SSC) prevention pathway

Help prevent surgical site complications with PICO◊ sNPWT as an alternative to standard surgical dressings.

Major risk factor:

Go Back

Thank you!

Help to significantly reduce surgical site complications with PICO◊ sNPWT*

*Compared to care with standard dressings; p'<'0.05. T2-8

References: 1. Sugrue M, Ciprandi G, Djohan R, et al. World Union of Wound Healing Societies (WUWHS) Consensus Document. Closed surgical incision management: Understanding the role of NPWT. Wounds Int [Internet]. 2016. https://www.woundsinternational.com/resources/details/closed-surgical-incision-managementunderstandingthe- role-of-npwt. 2. Global guidelines for the prevention of surgical site infection, 2nd ed. [online] Available from: https://www.who.int/publications/i/item/global-guidelinesfor- the-prevention-of-surgical-site-infection-2nd-ed Last accessed September 2022.

Please select a white tile

Or

Apply PICO◊ sNPWT

Complete the pathway by categorising risk factors, and using PICO◊ sNPWT if appropriate

Timer
Apply PICO◊ sNPWT

The patient

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According to NICE guidance, the use of PICO may be too premature.

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Your pathway has been sent to your email

References

1: Patient info | Possible with PICO. Smith&Nephew. Available from: https://www.possiblewithpico.com/patient-info Last accessed September 2023

2: Galiano RD, Hudson D, Shin J, et al. Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty. Plast Reconstr Surg Glob Open. 2018;6(1):e1560

3: Pellino G, Sciaudone G, Candilio G, et al. Effects of a new pocket device for negative pressure wound therapy on surgical wounds of patients affected with Crohn’s disease: a pilot trial. Surg Innov. 2014;21(2):204-212.

4: Matsumoto T, Parekh SG. Use of Negative Pressure Wound Therapy on Closed Surgical Incision After Total Ankle Arthroplasty. Foot Ankle Int. 2015;36(7):787- 794

5: O’leary DP, Peirce C, Anglim B, et al. Prophylactic Negative Pressure Dressing Use in Closed Laparotomy Wounds Following Abdominal Operations: A Randomized, Controlled, Open-label Trial: The P.I.C.O. Trial. Ann Surg. 2017;265(6):1082-1086

6: Helito CP, Sobrado MF, Giglio PN, et al. The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention. BMC Musculoskeletal Disorders. 2020;21(490):1 - 8.

7: Witt-Majchrzak A, Żelazny P, Snarska J. Preliminary Outcome Of Treatment Of Postoperative Primarily Closed Sternotomy Wounds Treated Using Negative Pressure Wound Therapy. Przeglad Chirugiczny. 2014;86(10):456-465.

8: Adogwa O, Fatemi P, Perez E, et al. Negative pressure wound therapy reduces incidence of postoperative wound infection and dehiscence after long-segment thoracolumbar spinal fusion: a single institutional experience. The Spine Journal. 2014;14(12):2911 - 2917

9: Global guidelines for the prevention of surgical site infection, 2nd ed. [online] Available from: https://wwwwho.int/publications/l/item/global-guidelinesfor-the prevention of surgical-site-infection-2nd-ed Last accessed September 2022.

10: Sugrue M. Ciprandi G, Djohan R, et al. World Union of Wound Healing Societies (WUWHS) Consensus Document, Closed surgical incision management: Understanding the role of NPWT. Wounds int [internet]. 2016. https://wwwwoundsinternational.com/resources/details/closed-surgical-incision-managementunderstandingthe role-of-npwt.

11: PICO negative pressure wound dressings for closed surgical incision. Medical technologies guidance [MTG43]. National Institute for Health and Care Excellence (NICE), 2019. Available from: https://www.nice.org.uk/guidance/mtg43 Last accessed September 2023.

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