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C-section clinical evidence

The PICO System may help reduce the risk of surgical site infections (SSIs) as part of a comprehensive clinical protocol.1

In women undergoing C-sections that have any of these high risk factors that could lead to complications, the use of PICO should be considered.

  • Smokers
  • Comorbidities including diabetes, obesity, hypertension, poor vascular status, immuno-compromised
  • Lengthy surgeries
  • Emergency procedures
  • Etiology of the problem

A recent study showed effects of PICO Single Use Negative Pressure Wound Therapy System (sNPWT) use on the incidence of surgical site infections in women with BMI ≥30 kg/m² undergoing C-section

Hyldig N, et al. BJOG (2019)1

Study overview

Open-label, pragmatic randomized study at five centers in Denmark

Who participated in the study?

Pregnant woman

Pregnant women

undergoing C-section
(elective or emergency)



BMI ≥30 kg/m²

5 days

PICO sNPWT (n=432)

Could stay in place for approximately 5 days*

24 hours

Standard dressings (n=444)

Could stay in place for ≥24 hours


*PICO dressings have a wear time of up to 7 days, depending on exudate levels


31 percent lower

Wound exudate (patient reported)

Relative reduction

(22.4% for PICO sNPWT vs 32.9% for standard dressings; p=0.001)

92 patients had wound exudate with PICO sNPWT (n=410) versus 137 patients with standard dressings (n=417)

Similar results for PICO sNPWT versus standard dressings in:


Health status questionnaires

Visual Analoge Score of 83 vs 82

Key conclusions

>In pregnant women undergoing C-section with a pre-pregnancy BMI ≥30 kg/m²:

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PICO sNPWT helped to significantly reduce the incidence of SSIs versus standard dressings

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Wound exudate was also reduced with PICO sNPWT

c section

Discover how reducing the odds of wound complications in high-risk C-section patients can help improve quality and appearance of scarring.4


Read more

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A new study shows how

the PICO System helps to reduce the risk of SSIs and deliver cost savings for certain high-risk C-section patients.5


Read the study

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Pain reduction

The prophylactic use of the PICO System in women undergoing C-section with a pre-pregnancy BMI ≥ 30 demonstrated a statistically significant reduction in pain scores as part of a post-operative care regime (compared to care with standard dressings; p=0.02; post-operative day 2).6

Application on a C-section



  1. Hyldig N, Vinter CA, Kruse M, et al. Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: A pragmatic randomised clinical trial. BJOG. 2019 Apr;126(5):628-635.
  2. Jenks PJ, Laurent M, McQuarry S, Watkins R. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital. Journal of Hospital Infection. 2014 Jan 1;86(1):24-33.
  3. Bullough L, Burns S, Timmons J, Truman P, Megginson S. Reducing c-section wound complications. The Clinical Services Journal. 2015:2-6.
  4. Hyldig N, Möller S, Joergensen JS, Bille C. Clinical Evaluation of Scar Quality Following the Use of Prophylactic Negative Pressure Wound Therapy in Obese Women Undergoing Cesarean Delivery: A Trial-Based Scar Evaluation. Ann Plast Surg. 2020 Dec;85(6):e59-e65.
  5. Hyldig N, Joergensen JS, Wu C, et al. Cost-effectiveness of incisional negative pressure wound therapy compared with standard care after caesarean section in obese women: a trial-based economic evaluation. BJOG. 2019;126(5):619-627.
  6. Tuuli MG, Martin S, Stout MJ, et al. 412: Pilot randomized trial of prophylactic negative pressure wound therapy in obese women after cesarean delivery. Paper presented at: American Journal of Obstetrics and Gynecology; 2017.