This patient handbook will provide you with important information while
you are receiving negative pressure wound therapy (NPWT) from Smith
& Nephew’s PICO™ system. The handbook will answer basic questions
about the therapy. Please keep it in a safe place with other healthcare
documents. The handbook includes instructions about how to use the
Information on what PICO is for
When not to use the product
Warnings and precautions for safe and effective use of PICO
General operation of PICO
What does PICO do?
PICO provides suction known as negative pressure wound therapy (NPWT)
which draws out excess fluid from a wound and protects the injured area
from getting dirty to ultimately help promote healing.
How does PICO work?
PICO consists of an NPWT pump connected to an absorbent gentle
The dressing is applied to the wound bed and extra strips are placed over
the outside edge to help hold the dressing in place. When the pump is
turned on, air is pulled out of the dressing and excess fluid from the wound
will start to enter the dressing. The dressing helps to prevent bacteria from
entering the wound. It may also improve blood flow to the wound which will
help it to heal.
The therapy pump is battery operated. The batteries may be changed
with 2 lithium AA batteries if required. They should only be changed if the
battery indicator flashes (see section regarding pump alarms).
How many hours a day do you need to use the
To get the full benefit, we recommend that you maintain use of the therapy
as prescribed by your physician or nurse.
How long will it take to improve your wound?
The length of time that the therapy takes to improve a wound is different
for every patient. It will depend on your general health, the size and type of
wound that you have and the treatment you have been prescribed. In many
cases, an improvement in the wound can be seen when the first dressing
is changed, but in some cases, it may take several weeks. If your wound
shows no improvement, the therapy might be stopped. Your nurse or
doctor will discuss when and why it will be stopped when they assess your
wound at each dressing change.
Will it be painful?
The first time the PICO™ pump is turned on, you may feel a slight pulling or
If you experience any pain, please speak to your nurse or doctor for advice.
They may prescribe pain-relief medication.
What will the dressings look like when the therapy
The dressing will pull down against your skin when the therapy is working
and be firm to the touch.
How often will the dressings have to be changed?
Disconnection of the pump from the dressing
The dressings may be left in place for up to 7 days depending on the
amount of fluid from the wound. This will depend on the size, type,
drainage amount and position of your wound. Your nurse or doctor will
determine how often your dressings should be changed.
Some people may experience slight discomfort during dressing changes,
specifically during cleaning of the wound, depending on the type and
position of the wound. If you feel any discomfort, please tell the person who
is changing your dressing. This way, they will be able to give you advice
and, if necessary, pain-relief medication to help ease the discomfort.
The pump may be disconnected from the dressing. There is a connector
built into the tubing between the pump and dressing. This should be left
screwed together all the time unless there is a requirement to disconnect
the pump – such as the need to have a shower.
Press the orange button to pause the therapy. Unscrew the two parts of the
connector. Place the pump somewhere safe.
Once you are ready to reconnect the pump, screw the two halves back
together. Ensure your dressing is smoothed down to make sure there are
no creases that could cause air leaks. Press the orange button to restart
the therapy. The green light will start flashing to show that the pump is
starting to apply therapy. If after one minute the orange “air leak” light starts
to flash refer to the section regarding alarms.
Can you move around while on the therapy?
Showering and washing
Patients using PICO™ can move around but this will depend on
recommendations provided by your nurse or doctor. PICO is discrete and
can be easily carried around in a pocket or the PICO bag to allow maximum
The PICO™ pump is splash proof but should not be exposed to jets of water.
It may be disconnected from the dressing if showering is required, as
Make sure the tube attached to the dressing is held out of the water and
that the end of the tube is pointing downwards so that water cannot enter
The dressing on top of the wound is water resistant. You can shower or
wash with the dressing in place, as long as you take care not to expose it
to direct jets of water and not to soak it. Soaking the dressing may cause it
to fall off.
Will the dressing changes hurt?
When you are asleep
Make sure that the PICO pump is placed somewhere safe and cannot be
pulled off a table or cabinet onto the floor during sleep.
Position of the pump, while therapy is being
The PICO™ pump may be carried with you in your pocket or wherever is the
most comfortable for you, considering the size and location of the wound.
A PICO bag is available if you would prefer to carry it in that way.
How do I know if the PICO system is working?
While the PICO pump is
working correctly a green
light located at the top
of the device will flash
What happens if the PICO™ pump alarms?
The PICO pump has a visual alarm for “Low Battery” and “Low
Vacuum”. These issues are easily solved, for example:
• “Low Battery” – The pump will begin to alert you with a flashing orange light
(above the battery symbol) when there are 24 hours and less of battery life.
The batteries should be changed at this point. Press the orange button to
pause the therapy. Take the battery cover from the top of the pump and
replace with two new lithium AA batteries. The way in which the batteries
should be positioned is displayed inside the battery compartment. Put the
cover back on and press the orange button again to restart your therapy.
The green light and the orange
light above the battery will flash
together when the batteries
The dressing should
have a slightly wrinkled
appearance and feel firm to
When will I need a new pump?
• “Low Vacuum” – If there is a low vacuum (low suction) in the dressing, a
flashing orange light (above a
symbol) will alert you and you will hear
the pump make a buzzing sound as it tries to get to the right vacuum.
The dressing is still capable of absorbing fluid with a low vacuum but the
therapy is not being delivered.
The pump is designed to stop working after seven days of continuous use.
After this time it will stop and will not restart even with new batteries. All
the lights will go off and stay off.
Negative pressure therapy is not being applied at this point so your nurse
or doctor will need to apply a new PICO™ therapy system if needed.
The vacuum may be low due to an air leak in the seal around the dressing.
Check for any small lifts in the dressing and smooth down around the
outside of your dressing including the strips with your hands.
The pump will look like this
when it has come to the
end of its life.
Press the orange button to restart your therapy. The green light will flash to
indicate that the pump is trying to apply therapy. After about one minute,
if the orange low vacuum light starts to flash again, the air leak is not yet
resolved. Continue to smooth the dressing and strips to ensure there is no
entrance for the air and repress the orange button.
After one minute, if the green light continues to flash the air leak has been
Contact your nurse or doctor if you have continuous issues with the
flashing low vacuum light.
The orange light will flash like
this if the pump cannot reach
the proper vacuum level.
Call your nurse or doctor immediately if:
You notice a big change in the colour or amount of the fluid in the dressing,
If it changes from clear to cloudy or bright red.
You see the dressing fill rapidly with blood.
Your wound looks more red than usual or has a foul smell.
The skin around your wound looks reddened or irritated.
The dressing feels or appears loose.
You experience pain.
The alarm does not turn off.
If you have any other questions, please speak to your nurse or doctor.
If you have any other questions, please
speak to your nurse or doctor
Smith & Nephew 24hr NPWT support line:
UK: 0845 1200167
Ireland: 01217 0484
Other useful numbers:
Smith & Nephew
101 Hessle Road
Hull HU3 2BN
T 01482 222200
F 01482 222211
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© Smith & Nephew May 2011