Tuesday, 3 July 2018

A NICE Future is One with Fewer Surgical Site Complications

Author of report Dr Vicki Strugala,
Smith & Nephew Professional Education
 – AWM; Europe.
Complications from surgical incisions are a significant economic and human burden, costing an approximate £1 billion[i] to the NHS each year and contributing to significant morbidity and mortality in the UK and globally. A recent World Union of Wound Healing Societies consensus guidelines reports that up to 60% of surgical site infections (SSIs) are preventable[ii] in the first place, which suggests that more needs to be done to reduce this figure.

One such medical innovation that is helping reduce the wound care burden is Negative Pressure Wound Therapy. A recent meta-analysis which included 16 studies, demonstrated the prophylactic application of PICO on surgical site incisions significantly reduced surgical site infections (SSIs) by 58%, wound dehiscence (wound rupturing along a surgical incision) by 26%, and length of stay by 0.5 days when compared to standard care[iii]*.

The meta-analysis evaluated results from 16 peer-reviewed publications (including 10 RCTs), involving 1863 patients and 2202 incisions. It assessed the average effect of the PICO Single Use Negative Pressure Wound Therapy System application across a wide variety of surgical indications.

This study is the latest body of evidence which adds to the literature and research supporting PICO as an effective prophylactic treatment option for SSIs. In addition, it helps provide important insights into optimising clinical management strategies for preventing SSIs, which are an increasing concern for healthcare providers and their patients around the world.

This week, NICE announced its first Medtech Innovation Briefing (MIB) for PICO, which is the first MIB awarded for a Negative Pressure Wound Therapy device, in relation to the prevention of surgical site complications. It is hoped that this latest announcement is expected to provide healthcare professionals with the confidence to treat at-risk patients and procedures with PICO, improving clinical and cost savings.

For example, in patients undergoing primary hip and knee arthroplasties, it was estimated that care with PICO enabled cost savings of more than £7,000 per high-risk patient (BMI ≥35 or ASA ≥3) compared with care with standard dressing[iv]**.

Pioneering medical technologies are therefore key to providing solutions that continue to improve current standards of care and economic outcomes, and most importantly, better patient outcomes.

Rachel Cunningham
Account Director
ROAD Communications
Email: Rachel@roadcommunications.co.uk


[i] Guest J et al, Health economic burden that different wound types impose on the UK’s National Health Service. Int Wound J 2016; doi: 10.1111/iwj.12603

[ii] World Union of Wound Healing Societies (WUWHS) Consensus Document. Closed surgical incision management: understanding the role of NPWT. Wounds International, 2016

[iii] Strugala, V. and Martin, R. Meta-analysis of comparative trials evaluating a prophylactic single-usenegative pressure wound therapy system for the prevention of surgical site complications. Surgical Infections (2017). DOI 10.1089/ sur.2017.156 * Meta-analysis included 10 RCT & 6 observational studies. Reduction in SSI (16 studies included): 1839 patients (2154 incisions): PICO 5.2%; control group 12.5%; p<0.0001. Mean reduction in hospital length of stay 0.47 days (8 studies included): p<0.0001

[iv] 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. April 2017. doi:10.1111/wrr.12530

   * 50-patient study; length of stay reduced: PICO 6.1 days; control group 14.7 days; p<0.019

   ** Calculations based on a 220-patient RCT