A comprehensive real-world study analyzing over 10,000 Cesarean section patients has demonstrated that Smith+Nephew's PICO single-use negative pressure wound therapy (sNPWT) device significantly reduces postoperative complications while generating substantial healthcare cost savings compared to other sNPWT systems.
The retrospective cohort study, published in WOUNDS (April 2025), utilized patient data from the Premier PINC AI Healthcare Database, encompassing inpatient claims from a geographically diverse mix of US community and teaching hospitals between January 2017 and June 2022. The research compared outcomes between patients treated with PICO sNPWT (operating at -80 mm Hg) versus another sNPWT device (operating at -125 mm Hg).
Significant Reduction in Surgical Site Complications
The study revealed statistically significant reductions in multiple types of surgical site complications with PICO sNPWT treatment:
- Overall surgical site infections: significantly reduced (p=0.018)
- Superficial surgical site infections: significantly reduced (p=0.017)
- Wound dehiscence: significantly reduced (p=0.005)
- Seroma formation: significantly reduced (p=0.050)
"We've long understood the benefits of NPWT in surgical recovery, but this is the first large-scale study to directly compare different pressure levels in a real-world setting," said Dr. Annmarie Vilkins, Director of Obstetrics and Gynecology at Henry Ford Health and the study's lead author. "We found that PICO sNPWT showed significantly improved outcomes through optimizing pressure, fluid management, and skin adhesion."
Substantial Healthcare Cost Savings
Beyond clinical improvements, the economic analysis revealed significant cost benefits associated with PICO sNPWT usage. The study estimated cost savings of $728,220 per 1,000 patients and demonstrated 3.8% lower mean index admission costs compared to other sNPWT devices (p<0.001).
These savings are particularly meaningful given that surgical site infections alone are associated with costs exceeding $900 million annually in the United States. "This latest data shows that NPWT may help improve clinical outcomes, reduce costly readmissions, improve resource efficiency and provide better post-surgical care for the significant number of new mothers who undergo C-section deliveries," commented Rohit Kashyap, President of Advanced Wound Management at Smith+Nephew.
Impact on Maternal Recovery and Bonding
A complementary survey of 1,001 new mothers who underwent C-sections highlighted the broader human impact of surgical site complications. The survey revealed that mothers experiencing complications:
- Were 5 times more likely to describe their recovery as traumatic
- Had over 55% reporting feelings of depression compared to those without complications
- Were 5.4 times more likely to be unable to breastfeed
- Experienced impaired bonding, with 66.3% reporting that their C-section recovery impacted their ability to bond with their baby
"Postpartum is already a very vulnerable period for mothers, even without complications," said Dr. Tia Welsh, Chair of Obstetrics and Gynecology at Valley Medical Group and co-author of the study. "SSCs add physical pain, prolonged recoveries, emotional distress, and disrupt critical early bonding with newborns. These interruptions carry emotional and practical burdens, increasing the risks of postpartum depression, anxiety, and trauma – costs that can't be captured in dollars alone."
Addressing High-Risk C-Section Population
The clinical significance of these findings is amplified by the prevalence and risk profile of C-section deliveries in the United States. C-sections account for approximately 32% of all US births, yet carry a 5-to-20 times higher risk of maternal morbidity than vaginal births. Post-surgical complication risk is significantly increased by factors such as obesity, diabetes, smoking, and hypertension, with 44.6% of US C-sections considered high risk.
Obesity alone is associated with a two-to-seven-fold higher risk of developing surgical site infections compared to individuals with lower BMIs. Dr. Vilkins noted that PICO's unique design helped maintain a high moisture vapor transmission rate, supporting an ideal healing environment for recovery, which is "particularly critical for high-risk incisions like C-sections under skin folds, where moisture buildup can lead to infection."
Technology and Mechanism
The study's methodology involved identifying adult patients undergoing C-section deliveries using International Classification of Diseases, 10th Edition, Procedure Coding System codes and hospital billing charge descriptions for sNPWT devices. Patients treated with both devices, those with preexisting surgical site complications, open wounds, multiple surgeries within 30 days, or inadequate follow-up were excluded from the analysis.
Primary outcomes included incidence of surgical site complications at 30 and 90 days, as well as healthcare resource utilization metrics such as length of stay and cost. The research represents the first large-scale, real-world comparison of different pressure levels in sNPWT devices for C-section recovery.
Despite the promising results, complications related to C-sections can lead to increased maternal mortality, prolonged hospital stays, and elevated healthcare costs, while also impacting a mother's ability to bond with her newborn. However, the Centers for Disease Control and Prevention estimates that over 80% of maternal mortalities are preventable, highlighting the importance of effective post-surgical interventions like optimized wound therapy systems.
