pico dressing instructions
What is PICO Dressing?
PICO dressing is a type of single-use negative pressure wound therapy (sNPWT) system. It consists of a pump connected to an absorbent adhesive dressing. The PICO system applies negative pressure to the wound bed, aiding in fluid removal and promoting wound healing.
What is PICO Dressing?
PICO dressing is a cutting-edge single-use negative pressure wound therapy (sNPWT) system designed to promote efficient wound healing. The system consists of a small, portable pump connected to an absorbent and gentle adhesive dressing that is applied directly to the wound. The dressing is designed to maintain a consistent negative pressure of -80mmHg, even without a complete seal, thanks to its unique AIRLOCK Technology.
The primary function of the PICO dressing is to apply negative pressure to the wound bed, which helps to remove excess fluid, reduce edema, and promote blood flow to the area. By creating a closed and controlled environment, PICO dressing facilitates tissue granulation, reduces the risk of infection, and accelerates the overall healing process.
The gentle silicone adhesive used in PICO dressings ensures easy application and removal while minimizing pain and trauma to the surrounding skin. PICO dressings are indicated for use on a variety of wounds, including surgical incisions, chronic wounds, and traumatic injuries, and are particularly useful in managing wounds with low to moderate levels of exudate. The system is designed to be user-friendly, showerproof, and quiet, enhancing patient comfort and mobility during the healing process.
Indications for PICO Dressing Use
PICO dressing is indicated for a wide range of wound types where negative pressure wound therapy (NPWT) can facilitate healing. It is commonly used on closed surgical incisions to help prevent seroma formation, reduce the risk of surgical site infections, and promote faster healing. PICO is also appropriate for acute wounds such as traumatic injuries, lacerations, and abrasions, particularly those with low to moderate exudate levels.
Chronic wounds, including diabetic foot ulcers, venous leg ulcers, and pressure ulcers, can benefit from PICO dressing to manage exudate, promote granulation tissue formation, and reduce wound size. Furthermore, PICO is suitable for use on dehisced surgical wounds, where the incision has reopened, to help close the wound and prevent further complications.
PICO can be applied to wounds with depths less than 2cm without the need for a filler. The dressing is also indicated for use on wounds with anticipated small to moderate amounts of exudate, typically up to 50ml per day or 300ml per week. It’s crucial to assess each wound individually to determine if PICO dressing is the most appropriate treatment option.
Contraindications for PICO Dressing Use
While PICO dressing offers numerous benefits, certain conditions and wound characteristics make it unsuitable for use. Wounds with exposed blood vessels, nerves, or organs should not be treated with PICO dressing due to the risk of damage or complications from negative pressure. Untreated osteomyelitis (bone infection) is a contraindication, as the negative pressure could potentially exacerbate the infection.
Malignant wounds, unless used for palliative care, are generally not appropriate for PICO dressing. Wounds containing necrotic tissue or eschar should be debrided before applying PICO, as the dressing’s effectiveness is reduced in the presence of non-viable tissue. Patients with uncontrolled bleeding disorders or those taking anticoagulant medications may be at increased risk of bleeding complications with NPWT.
PICO dressing is also contraindicated for patients with known allergies or sensitivities to any of the dressing components. Caution should be exercised when using PICO in patients with compromised skin integrity or fragile skin, as the adhesive dressing could cause skin stripping or damage upon removal. It is essential to conduct a thorough patient assessment to identify any contraindications before initiating PICO therapy.
Materials Needed for PICO Dressing Application
Proper preparation is crucial for successful PICO dressing application. First and foremost, you will need the appropriate PICO dressing kit, which includes the sterile dressing and the PICO pump unit. Ensure the dressing size is suitable for the wound dimensions. Sterile gloves are essential to maintain asepsis throughout the procedure.
You will also need sterile saline solution for wound cleansing. Gauze pads or swabs are required for cleaning and drying the wound bed. Skin preparation wipes or solutions are necessary to ensure proper adhesion of the dressing to the surrounding skin. Additional adhesive strips may be needed to secure the dressing edges, particularly in areas of high movement or friction.
A measuring device, such as a ruler or measuring guide, is useful for accurately assessing the wound size. Sterile scissors may be necessary for trimming excess dressing material or shaping the dressing to fit the wound contours. Finally, a disposal bag is needed for proper disposal of used materials, adhering to infection control protocols. A camera may be used to document the wound before and after dressing application.
PICO Dressing Application Steps
Begin by gathering all necessary materials and donning sterile gloves. Cleanse the wound thoroughly with sterile saline solution, removing any debris or exudate. Gently dry the wound and surrounding skin with sterile gauze pads. Assess the wound size and select an appropriately sized PICO dressing.
Prepare the skin around the wound with skin preparation wipes to enhance dressing adhesion. Remove the PICO dressing from its sterile packaging, being careful not to contaminate it. Peel off the first release liner and position the dressing centrally over the wound, ensuring the soft port is facing upwards. Gently apply the dressing to the wound, smoothing out any wrinkles or air pockets.
Apply additional adhesive strips to the dressing edges for extra security, especially in areas prone to movement. Connect the PICO pump to the dressing tubing by twisting the connectors together. Press the orange button on the pump to initiate negative pressure wound therapy. Observe the pump indicators to ensure proper functioning, typically indicated by a flashing green light. Properly dispose of all used materials in a designated disposal bag.
Dressing Selection Based on Wound Size and Exudate
Selecting the appropriate PICO dressing size is crucial for effective wound management. When dealing with moderately draining wounds, ensure the wound size does not exceed 25% of the dressing pad area. A dressing that is too small may become saturated quickly, compromising its ability to maintain negative pressure. Conversely, an oversized dressing might not conform adequately to the wound bed, leading to leaks and reduced therapeutic benefit.
Consider the level of exudate when choosing a PICO dressing. PICO dressings are generally indicated for wounds with small to moderate exudate levels, typically up to 50ml per day or 300ml per week. If the wound produces excessive exudate, a different wound management strategy may be necessary or a PICO dressing with higher absorbent capacity. Regular assessment of the dressing saturation level will help determine if the chosen dressing is appropriate for the wound’s exudate output.
For wounds with minimal exudate, a standard PICO dressing is usually sufficient. However, for wounds with moderate exudate, consider using a PICO dressing with enhanced absorption capabilities.
Using Fillers with PICO Dressing
The decision to use a wound filler in conjunction with a PICO dressing depends largely on the characteristics of the wound. A comprehensive assessment of the wound is recommended to determine if a filler is necessary. If the wound depth is less than 2cm, the PICO dressing can typically be applied directly to the wound bed without a filler. In such cases, the PICO dressing’s absorbent properties are usually sufficient to manage exudate and promote healing.
However, for deeper wounds exceeding 2cm, a filler may be beneficial to bridge the gap between the wound bed and the PICO dressing. Fillers help maintain contact between the dressing and the wound, ensuring consistent negative pressure distribution. This is particularly important for irregular wound shapes or those with undermining. Various types of fillers can be used, including foams, alginates, and hydrogels. The choice of filler depends on the wound type, exudate level, and clinician preference.
When using a filler, ensure it is loosely packed to avoid excessive pressure on the wound bed. Overpacking can impede blood flow and hinder healing. The PICO dressing should then be applied over the filler, following the standard application steps.
Connecting the Pump and Initiating Therapy
Once the PICO dressing is properly applied and secured over the wound (and filler, if used), the next step is connecting the pump to initiate negative pressure wound therapy. This connection is crucial for the PICO system to function effectively. Begin by carefully removing the protective cap from the PICO pump’s connector and the dressing tube connector, if applicable.
Align the connectors and gently twist them together until you hear a click or feel a secure connection. Ensure the connection is firm to prevent air leaks, which can compromise the therapy. Once connected, press the orange “start” button on the PICO pump to begin the negative pressure application.
The green “OK” indicator and the orange “air leak” indicator will likely flash together, signaling that the pump is working to establish negative pressure. The time it takes to establish negative pressure varies depending on wound size, but it typically takes up to 65 seconds. Monitor the pump indicators to confirm proper operation.
If the “air leak” indicator persists after a few minutes, double-check the dressing and pump connections for any leaks. If issues continue, consult a healthcare professional.
Monitoring the PICO System
After initiating therapy, regular monitoring of the PICO system is essential to ensure proper function and optimal wound healing. The green “OK” indicator light on the PICO pump should flash continuously, indicating that the system is working correctly and maintaining negative pressure. The pump may be heard running occasionally as it works to maintain the negative pressure.
Regularly inspect the dressing for any signs of leaks, such as the dressing lifting at the edges or excessive fluid accumulation outside the absorbent pad area. If leaks are detected, address them promptly by applying additional adhesive strips or consulting a healthcare professional if needed.
Monitor the wound site for any changes in drainage, odor, or appearance. Report any concerns to a healthcare professional, as these changes may indicate infection or other complications. Also, pay attention to the “dressing full” indicator, if present, to optimize dressing change frequency. Check the dressing after 2-3 days to see if fluid handling is acceptable or if a dressing change is required.
The PICO system has a limited lifespan (e.g., 7 days), so note the start date to optimize dressing change optimization.
Dressing Change Frequency and Procedure
PICO dressing change frequency depends on factors like wound type, exudate level, and the specific PICO system used. Typically, PICO 7 dressings are changed every 7 days, but a healthcare professional determines the optimal schedule. Dressing change optimization can be aided by the start date field and dressing full indicator.
Procedure
- Gather supplies: new PICO dressing kit, sterile gloves, saline solution, and disposal bag.
- Wash hands and don sterile gloves.
- Gently remove the old dressing, starting from the edges, while observing the wound.
- Cleanse the wound bed with saline solution, following healthcare provider instructions.
- Dry the peri-wound skin.
- Apply the new PICO dressing, ensuring central placement over the wound and proper adhesion.
- Connect the pump, initiate therapy, and monitor its function.
- Dispose of the old dressing as clinical waste.
If further dressings are required based on dressing change frequency, see the system variants section in the Instructions For Use (IFU).
Showering with PICO Dressing
The PICO dressing is designed to be showerproof, allowing patients to maintain hygiene. However, precautions must be taken to protect the pump. Before showering, disconnect the PICO pump from the dressing. Ensure the end of the tubing attached to the dressing is facing down to prevent water from entering.
It is crucial to protect the PICO pump from water exposure. Do not submerge the pump in water or expose it to direct shower spray. After showering, pat the area around the dressing dry. Reconnect the pump to the dressing, ensuring a secure connection by twisting the connectors, and confirm that the system is functioning correctly, indicated by the flashing green OK indicator. If any issues arise, consult a healthcare professional.
The dressing itself is designed to withstand moisture, but prolonged exposure to water should be avoided. If the dressing becomes excessively wet or compromised during showering, it may require a change. Consult with a healthcare professional for guidance on dressing integrity and the need for potential changes.