A comparative sNPWT study of 10,000+ C-sections shows PICO™ sNPWT reduces complications and cuts healthcare costs by $728,000 per 1,000 patients
Smith+Nephew (LSE:SN, NYSE:SNN), the global medical technology company, today announces findings from a newly published comparative study of single-use Negative Pressure Wound Therapy (sNPWT) devices in Caesarean section (C-section) recovery has identified significant benefits for postpartum use of Smith+Nephew’s leading PICO sNPWT technology. Analyzing real-world data from over 10,000 C-section patients treated at different pressure levels, the study published in WOUNDS (April 2025) reveals that PICO sNPWT contributes to a significant reduction in surgical site complications (SSCs), including a reduction in the incidence of surgical site infections (SSIs), wound dehiscence and seroma, and overall costs, compared to another sNPWT device (P≤0.05).1
New survey: The real-life burden of C-section complications
A complementary survey of new mothers who have undergone C-sections highlighted the impact of SSCs on both mother and baby:2
- Mothers with complications reported requiring hospital readmissions
- Are 5 times more likely to describe their recovery as traumatic
- Over half (55%) reported feeling depressed than those that reported no complications
- Are 5.4 times more likely to be unable to breastfeed
- Two in three mothers (66.3%) reported that their overall c-section recovery impacted their ability to bond with their baby
Dr. Tia Welsh, M.D. Chair of Obstetrics and Gynecology at Valley Medical Group and co-author of the study added, “Postpartum is already a very vulnerable period for mothers, even without complications. 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.”
Real-world data shows the clinical and economic benefits of using PICO sNPWT in patients undergoing C-section procedures
The study used real-world evidence from the Premier PINC AI™ Healthcare Database to analyze outcomes from a geographically diverse mix of community hospitals, teaching hospitals and healthcare systems across the US.
Notable findings include significant reductions with PICO sNPWT, compared to other sNPWT devices in the incidence of*:
- Overall SSIs (p=0.018)
- Superficial SSIs (p=0.017)
- Wound dehiscence (p=0.005)
- Seroma formation(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, DO. Director of Obstetrics and Gynaecology 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. Its unique design helped maintain a high moisture vapor transmission rate supporting an ideal healing environment for recovery, particularly critical for high-risk incisions like C-sections under skin folds, where moisture buildup can lead to infection.”
PICO sNPWT is proven to reduce the odds of surgical site infections (SSIs)3, which could facilitate early mother and baby bonding and positively impacts on the patient’s emotional wellbeing.4
Substantial cost savings with PICO sNPWT
Beyond clinical and patient benefits, the study highlighted substantial cost savings associated with PICO sNPWT, estimating a reduction of US $728,220 per 1,000 patients and 3.8% lower mean index admission costs compared to other sNPWT devices (p<0.001).1
“SSIs alone are associated with costs exceeding US $900 million annually5. 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, Smith+Nephew.
High-risk C-section births require improved post-surgical care
C-sections account for around 32% of all US births6, yet carry a 5-to 20-times higher risk of maternal morbidity than vaginal births.7 Post-surgical complication risk is significantly increased by factors such as obesity, diabetes, smoking, and hypertension, with 44.6% of U.S C-sections considered high risk.8 Obesity alone is associated with a two-to seven-fold higher risk of developing SSIs compared to individuals with lower BMIs.9,10,11
Complications related to C-sections can lead to increased maternal mortality12, prolonged hospital stays and elevated healthcare costs13, while also impacting a mother’s ability to bond with her newborn.14 Despite this, the Center of Disease Control (CDC) estimates that over 80% of maternal mortalities are preventable.12
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About Smith+Nephew
Smith+Nephew is a portfolio medical technology company focused on the repair, regeneration and replacement of soft and hard tissue. We exist to restore people’s bodies and their self-belief by using technology to take the limits off living. We call this purpose ‘Life Unlimited’. Our 17,000 employees deliver this mission every day, making a difference to patients’ lives through the excellence of our product portfolio, and the invention and application of new technologies across our three global business units of Orthopaedics, Sports Medicine & ENT and Advanced Wound Management.
Founded in Hull, UK, in 1856, we now operate in around 100 countries, and generated annual sales of $5.8 billion in 2024. Smith+Nephew is a constituent of the FTSE100 (LSE:SN, NYSE:SNN). The terms ‘Group’ and ‘Smith+Nephew’ are used to refer to Smith & Nephew plc and its consolidated subsidiaries, unless the context requires otherwise.
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*Follow up to 30 days post discharge to establish complication levels post-surgery
1 Vilkins, A, Nherera, LM, Searle, R, Welsh, T. Comparing the effectiveness of two prophylactic negative pressure wound therapy devices in reducing surgical site complications after cesarean sections: Insights from a large US claims database. WOUNDS. 2025.
2 Census wide (Research Agency). C-section complications survey with 1001 mothers who had a C-section (50% experienced complications/infections). Data on file. 2025. Data collected March 14-19,2025.
3 Saunders C, Nherera LM, Horner A, Trueman P. Single-Use negative-pressure wound therapy versus conventional dressings for closed surgical incisions: systematic literature review and meta-analysis. BJS Open. 2021;0(0):1 - 8.
4 Bullough L, Burns S, Timmons J, Truman P, Megginson S. Reducing c-section wound complications. The Clinical Services Journal. 2015:2-6.
5 de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: Incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37(5):387-397. doi:10.1016/j.ajic.2008.12.010
6 Centers for Disease Control and Prevention (CDC) website. Births - method of delivery. Last reviewed April 9, 2024. Accessed March 2025.
7 Erritty M, Hale J, Thomas J, Thompson A, Wright R, Low A, Carr M, George R, Williams L, Dumitrescu A, Rees J, Irukulla S, Fry CH, Fluck D, Han TS. Reduction of adverse outcomes from cesarean section by surgical-site infection prevention care bundles in maternity. Int J Gynaecol Obstet. 2023;1;161(3):963-968. doi:10.1002/ijgo.14605. PMID: 36452991.
8 Barber, EL. Contributions to Rising Cesarean Delivery Rate. Obstet Gynecol. 2011;118(1):29-38
9 Choban PS, Heckler R, Burge JC, Flancbaum L. Increased incidence of nosocomial infections in obese surgical patients. Am Surg. 1995;61(11):1001–1005.
10 Nagachinta T, Stephens M, Reitz B, Polk BF. Risk factors for surgical-wound infection following cardiac surgery. J Infect Dis. 1987;156(6):967–973.
11 Friedman ND, Sexton DJ, Connelly SM, Kaye KS. Risk factors for surgical site infection complicating laminectomy. Infect Control Hosp Epidemiol. 2007;28(9):1060–1065.
12 Centers for Disease Control and Prevention (CDC) website. Preventing pregnancy-related deaths. Published September 25, 2024. Accessed March 2025.
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13 Olsen MA, Butler AM, Willers DM, Gross GA, Hamilton BH, Fraser VJ. Attributable costs of surgical site infection and endometritis after low transverse cesarean delivery. Infect Control Hosp Epidemiol. 2010;31(3):276-236 82. doi:10.1086/650755
14 Hoff CE, Movva N, Rosen Vollmar AK, Pérez-Escamilla R. Impact of maternal anxiety on breastfeeding outcomes: a systematic review. Adv Nutr. 2019;10(5):816-826. doi:10.1093/advances/nmy132. PMID: 31079143.
