2019 
Smith & Nephew has announced that the Bone and Joint Research (BJR) journal has published a paper reviewing the evidence for the preventive use of Negative Pressure Wound Therapy (NPWT) on surgical incisions.
Drawn from a comprehensive review of 33 published papers, the evidence shows a reduced incidence of wound healing complications after NPWT for three to five days post surgery.
The BJR paper, jointly authored by a panel of six international experts on NPWT, examines research that investigates new technologies that can be applied to surgical incisions to help minimise complications. The panel conducted the review in orthopaedic and other surgical disciplines. Dr Matthias Brem, MD, MHBA Orthopaedic Surgeon Klinikum Nuerenberg, Mr. Sudheer Karlakki, Consultant Orthopaedic Surgeon at the Robert Jones Agnes Hunt Orthopaedc Hospital, Arthoplasty Department, Ostwestry in Shropshire and Vikas Khanduja, Consultant Orthopaedic Surgeon at Addenbrookes Hospital in Cambridge are all co-authors of the paper.
“According to a consensus of the randomised studies, there is a strong argument for the preventive use of NPWT on high-risk, closed incisions,” says co-author Prof. James Stannard, Professor and Orthopaedic Surgeon at the Missouri Orthopaedic Institute at the University of Missouri, who was the first surgeon ever to report the use of NPWT in this way. “Most surgeons are familiar with the efficacy of the use of NPWT on complex open wounds as that has become a standard of care. However, there is a growing awareness of the potential of incisional NPWT to reduce post-surgical complications in high-risk patients and the related costs involved. We expect that the development of lower cost, single-use NPWT devices will catalyse further studies.”
Dr Brem, and fellow co-authors of the paper Mr Karlakki and Prof. Sandro Giannini, Head of the 2nd Clinic of Orthopedic and Traumatologic Surgery, Rizzoli Orthopedic Institute, Bologna, Italy, are currently recruiting an independent investigator to initiate randomised studies with Smith & Nephew’s PICO™ Single use NPWT system.
“I am looking for a post-operative therapy that makes my high volume elective surgery entirely predictable so there are no unexpected delays in the length of stay of my patients,” says Mr. Karlakki.
“In a previous paper published by my group, we have demonstrated that incisional NPWT reduces the formation of post-operative seromas and provides improved wound healing: the use of incisional NPWT in spinal surgery, which has a relatively high rate of post-operative complications, seems a sensible proposition that we are now testing in a randomised controlled trial. We hope to present our findings at the next EFORT EFORT meeting in London,” says Dr Brem.
“Single-use NPWT devices such as Smith & Nephew’s PICO™ mean that the lower cost of therapy can lead to many more opportunities to build clinical evidence in large randomised studies,” said Dr Robin Martin, Director of Clinical Sciences at Smith & Nephew and another co-author of the paper. “In a future article, we plan to assess the evidence for identifying those patients at greatest risk of surgical site complications (SSC) in orthopaedic procedures and review the guidelines to target certain patient groups with NPWT as a preventive technology. We also plan to examine the economic implications for such an approach as well.”
