title: Biological effects of a disposable, canisterless negative pressure wound therapy system.
abstract: OBJECTIVE
  Recent developments of negative pressure wound therapy (NPWT) systems have focused on making pumps smaller, lighter, and more portable. The recently introduced PICO system manages wound fluid through a highly breathable film within the dressing, thereby negating the need for a canister, which allows greater mobility and patient concordance. The aim of this study is to compare the biological effects of this system compared to a traditional NPWT system.
  
  
  METHODS
  Laboratory tests were carried out to demonstrate the fluid handling properties of the PICO™ system. Porcine full thickness defect wounds and sutured incisional wounds were used to compare the biological effects. Wounds were treated with PICO dressings or traditional NPWT dressings and connected to either a PICO device or a traditional NPWT device.
  
  
  RESULTS
  The PICO dressing manages exudate predominantly through evaporative loss (up to 85% of all fluid entering the dressing). Both traditional NPWT and the PICO system maintained therapeutic levels of negative pressure in all wounds. Both NPWT systems produced similar effects on wound edge contraction and microvascular blood flow in defect wounds. No significant changes in blood flow or wound contraction were noted in incision wounds for any NPWT combinations tested.
  
  
  CONCLUSIONS
  The disposable, canisterless PICO NPWT system functions in the same manner as the traditional NPWT systems with regard to fluid handling, pressure transmission to the wound bed, tissue contraction, and changes in blood flow.
authors.affiliation: Clinical Sciences, Lund, Lund University and Skåne University Hospital, Lund, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Malmsjö
authors.affiliation: Advanced Wound Management Division, Smith and Nephew Medical Ltd, Hull, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Huddleston
authors.affiliation: Advanced Wound Management Division, Smith and Nephew Medical Ltd, Hull, UK.
authors.forename: Robin
authors.initials: R
authors.lastname: Martin
keywords: Blood flow; NPWT; dressing; vacuum; wound
references.citation: Eplasty. 2012;12:e5
references.pmid: 22292101
references.citation: J Trauma. 2006 Jun;60(6):1301-6
references.pmid: 16766975
references.citation: Wound Repair Regen. 2011 Nov;19(6):727-33
references.pmid: 22092843
references.citation: Am J Orthop (Belle Mead NJ). 2009 Sep;38(9):446-9
references.pmid: 19911098
references.citation: Int Wound J. 2011 Aug;8(4):355-64
references.pmid: 21564551
references.citation: J Orthop Trauma. 2006 Nov-Dec;20(10):705-9
references.pmid: 17106382
references.citation: Br J Plast Surg. 2001 Apr;54(3):235-7
references.pmid: 11254417
references.citation: Surg Innov. 2009 Jun;16(2):140-6
references.pmid: 19460818
references.citation: Ann Plast Surg. 1997 Jun;38(6):563-76; discussion 577
references.pmid: 9188971
references.citation: J Diabetes Sci Technol. 2010 Jul 01;4(4):831-2
references.pmid: 20663445
references.citation: Plast Reconstr Surg. 2009 Feb;123(2):601-612
references.pmid: 19182619
references.citation: Plast Reconstr Surg. 2006 Jun;117(7 Suppl):72S-109S
references.pmid: 16799376
references.citation: Asian J Surg. 2005 Jul;28(3):211-7
references.pmid: 16024319
references.citation: Ann Plast Surg. 2009 Dec;63(6):676-81
references.pmid: 19887926
references.citation: J Wound Care. 2012 Apr;21(4):180, 182
references.pmid: 22584676
references.citation: Ann Plast Surg. 2010 Jun;64(6):789-93
references.pmid: 20489409
references.citation: Int Wound J. 2015 Apr;12(2):195-201
references.pmid: 23647737
references.citation: Wound Repair Regen. 2009 Mar-Apr;17(2):200-5
references.pmid: 19320888
references.citation: Eur J Cardiothorac Surg. 2006 Jul;30(1):85-9
references.pmid: 16730446
references.citation: Surg Innov. 2012 Mar;19(1):67-75
references.pmid: 21868417
references.citation: J Plast Reconstr Aesthet Surg. 2010 Jan;63(1):174-9
references.pmid: 19036656
references.citation: Ann Surg. 1991 Nov;214(5):605-13
references.pmid: 1953114
references.citation: J Orthop Trauma. 2012 Jan;26(1):37-42
references.pmid: 21804414
references.citation: Ostomy Wound Manage. 2007 May;53(5):40-6
references.pmid: 17551174
references.citation: Ann Plast Surg. 2006 Apr;56(4):418-22
references.pmid: 16557076
references.citation: Ann Plast Surg. 1997 Jun;38(6):553-62
references.pmid: 9188970
references.citation: J Wound Care. 2006 Apr;15(4):149-53
references.pmid: 16620043
references.citation: Wound Repair Regen. 2011 Sep-Oct;19(5):588-96
references.pmid: 22092797
references.citation: Bone Joint Res. 2013 Dec 18;2(12):276-84
references.pmid: 24352756
references.citation: Plast Reconstr Surg. 2010 Feb;125(2):502-509
references.pmid: 20124835
references.citation: Am J Clin Dermatol. 2005;6(3):185-94
references.pmid: 15943495