A PICO dressing is a small, portable wound therapy system that uses gentle suction to help surgical incisions and other wounds heal faster. Made by Smith & Nephew, it applies negative pressure (a mild vacuum) to the wound surface at around −80 mmHg, pulling away excess fluid and promoting tissue repair. Unlike traditional negative pressure wound therapy systems that require bulky machines and canisters to collect fluid, the PICO is lightweight, battery-powered, and designed to be worn under clothing during everyday activities.
How the PICO Dressing Works
The system has two parts: a thin, multi-layered dressing that covers the wound and a small pump about the size of a credit card that connects to it via a short tube. The pump creates continuous suction across the wound bed, which does three things. It draws excess fluid away from the wound, reduces swelling in the surrounding tissue, and brings the wound edges closer together.
What makes the PICO different from larger wound vacuum systems is that it has no canister. Instead, the dressing itself absorbs wound fluid and allows it to evaporate through its top layer. This is possible because of a four-layer design. The bottom layer, which sits against the skin, is a soft perforated silicone that won’t stick painfully to the wound. Above that sits an “airlock” layer that distributes suction evenly across the wound surface. The third layer absorbs fluid like a sponge. The top film allows moisture to pass through and evaporate while keeping the dressing sealed.
What It’s Used For
PICO dressings are most commonly placed over closed surgical incisions, the stitched-up wounds you’d have after an operation. The goal is preventive: reducing the risk of complications like surgical site infections and seromas (pockets of fluid that can collect under the skin after surgery). In one trial of patients who had emergency abdominal surgery, the infection rate dropped from 14.3% with standard dressings to 4.3% with PICO, and seroma rates fell from 40.8% to 23.4%.
Beyond closed incisions, negative pressure wound therapy is also used on a wide range of wound types: open wounds healing from the bottom up, diabetic foot ulcers, pressure ulcers, burn wounds, traumatic injuries, skin grafts, and sternal wounds after heart surgery. It’s particularly useful in patients with risk factors for poor healing, such as obesity or diabetes.
PICO 7 vs. PICO 14
The system comes in two versions. The PICO 7 is designed for up to 7 days of continuous therapy, while the PICO 14 extends that to 14 days. Each version comes with its own pump and a set of dressings. Your surgical team will choose the version based on the type of procedure and how long they expect the incision to need support. Revision hip or knee surgeries, for example, may call for the longer 14-day option.
Both versions are single-use. The pump runs on batteries for the full treatment period, and the entire system is discarded once therapy is complete.
Living With a PICO Dressing
The pump is small and quiet enough to clip to a waistband or tuck into a pocket, so most people can go about their normal routine while wearing it. You can shower with the dressing on, but you’ll need to disconnect the pump first and place it somewhere dry. The dressing itself shouldn’t be held under a direct spray or submerged in water. A simple trick is wrapping the area in plastic wrap before stepping into the shower. While the pump is disconnected, keep the end of the tubing pointing downward so water doesn’t flow into it.
To disconnect, you press the orange button on the pump to pause therapy, then unscrew the two-part connector. Reconnecting afterward is straightforward, and the pump will resume suction on its own.
Understanding the Pump Lights
The pump has a few indicator lights on its front that tell you what’s going on. A flashing green light means everything is working normally. If the green light and an orange light flash together, it typically means the batteries are running low and need replacing. An orange “leak” light means the seal around the dressing has broken somewhere, and you may hear a quiet buzzing as the pump works harder to maintain suction. This often happens if the adhesive edges lift slightly, and re-pressing the dressing borders against the skin can fix it. If an orange “dressing full” light appears, the absorbent layer is saturated and the dressing needs to be changed.
Dressing changes are usually handled by a nurse or wound care specialist, so if you see a “dressing full” alert, contact your care team rather than attempting to replace it yourself. The silicone wound contact layer is designed to peel away without damaging new tissue, making changes relatively painless compared to traditional adhesive dressings.
How It Compares to Traditional Wound Vac Systems
Traditional negative pressure systems operate at higher pressures, typically around −125 mmHg, and use a bedside or portable canister unit to collect wound drainage. They’re powerful tools for large, open, or heavily draining wounds. The PICO operates at a gentler −80 mmHg and handles fluid through absorption and evaporation rather than collection, which makes it smaller and simpler but less suitable for wounds producing large volumes of drainage.
For closed surgical incisions and smaller wounds, the tradeoff is worthwhile. The compact size means patients can leave the hospital wearing the device and manage it at home with minimal instruction, rather than being tethered to a larger machine. The lack of a canister also eliminates the need to empty or dispose of collected fluid, which most patients find more comfortable and less disruptive to daily life.