PICO Negative pressure system

This leaflet will help you to understand how to care for your PICO wound covering after a caesarean birth. It is important to understand how to care for your wound to prevent infection. Please speak to your midwife or doctor if you have any questions or concerns.

What is the PICO negative pressure system?

The PICO Negative Pressure Wound Therapy (NPWT) system is a single-use, portable device. It is designed to improve the healing of wounds and closed surgical incisions. It does this by applying controlled negative pressure to the wound site. The PICO system is made up of:

• a small battery-operated pump; and

• a special absorbent dressing, with gentle silicone adhesive that covers the wound.

The pump is small and can fit in the palm of your hand. The front of the pump has a single push button and four LED lights. The LED lights show you the status of your system. The back of the PICO pump allows the user to record the start date of their therapy.

Why do I have this type of dressing on my caesarean wound?

We have identified that you would benefit from a negative pressure dressing to help your wound to heal. It is recommended for wound covering following caesarean birth for those who have the following.

• A body mass index (BMI) more than 40.

• Type 1 diabetes regardless of weight.

• A body mass index (BMI) more than 35, with additional risk factors. For example, patients who:

  • smoke;

  • have diabetes - gestational, type 1 and type 2; and / or

  • are immune suppressed. For example, patients who:

    • take oral steroids (such as prednisolone);

    • are having chemotherapy / radiotherapy; or

    • have had an organ or bone marrow transplant.

• Had a previous surgical site infection, needing a hospital admission.

Wound healing has been proven to have been improved by 63% using this system. This is in comparison to standard wound coverings.

The PICO dressing system is recommended by the National Institute for Health and Care Excellence (NICE) (NICE MTG43).

Will the PICO system be painful?

The first time the PICO pump is turned on, there will be slight pulling or drawing sensation. You should not be aware of this when it is first placed over your caesarean wound. If you experience any pain, please speak to your midwife or doctor for advice.

How do I secure the pump?

• The PICO pump may be carried in your pocket or by using the belt clip. Carry it wherever it is most comfortable for you.

• If there are any issues, the PICO system does not make alarm sounds. Instead the LED lights on the front will let you know if there is a problem.

  For best results

• Carry the pump so you can easily see the indicator lights on the front.

• Check the status of the pump at least once or twice each day, to make sure everything is working properly.

How do I know the system is working normally?

• When the PICO pump is working correctly, the green ‘OK’ light will flash continuously.

• You may occasionally hear the pump running as it maintains the negative pressure, this is normal. The sound is very quiet, so you may not notice it.

• The dressing should look slightly wrinkled and feel firm to the touch.

If the pump stops working or comes off, call Maternity Triage immediately. Their number is listed at the bottom of this leaflet.

How does the PICO system work?

While the PICO pump is working correctly, the green ‘OK’ light will flash all the time. The PICO pump has lights to let you know when there is an issue. These are flashing and non-flashing coloured lights.

The PICO pump does not have alerts (alarms) that you can hear. Carry the PICO pump so that it is accessible. Check the status at least once or twice a day. This is in case there is a fault, or in case of damage.

Battery

1. 
   On the front of the pump, the green ‘OK’ light and orange ‘battery low’ lights will flash together when the batteries need changing.
2. 
   On the reverse of the pump, the battery cover can be slid on and off. The arrow indicators make it simple to insert and remove the batteries.

Press the orange button to pause the pump. Slide the battery cover off from the top of the pump and replace with two new alkaline AA batteries. Put the cover back on and press the orange button to restart the pump.

Air leaks

1. With your hands, smooth down around the outside of your dressing (including the strips) to remove any creases.

2. Make sure the tube connectors have been twisted together securely.

3. Press the orange button to restart the pump. If the air leak remains, the orange ‘leak light’ will flash again after approximately 60 seconds.

4. Contact Maternity Triage if you have continuous issues with the flashing orange air leak light.

Dressing

How do I sleep with the pump attached?

Make sure that the PICO pump is placed somewhere safe while you sleep. This could be in your pocket or somewhere secure. Make sure that it cannot be pulled or knocked off of a table or bedside cabinet onto the floor during sleep.

How do I disconnect my pump before washing or showering?

The PICO pump should remain connected to the dressing at all times. It can be disconnected briefly to wash or have a light shower. Reconnect the pump as soon as possible. Follow these steps when you need to wash or have a light shower.

1. Press the orange button to pause the pump.

2. Unscrew the tubing where it is attached to the pump.

3. Place the pump somewhere safe and dry.

4. Make sure the end of the tubing attached to the dressing is facing down. This stops the water entering the tube while the pump is disconnected. See ‘What happens if my system becomes wet?’ below.

5. Shower carefully. Make sure you do not directly spray or soak the dressing.

6. After showering gently pat the dressing dry.

7. Once you are ready to reconnect the pump, join the pump and plastic tube by twisting together the connectors.

8. Press the orange button to restart the pump.

9. The green ‘OK’ light and orange ‘air leak’ light will start to flash together. This shows the pump is working.

10. The pump should take up to 100 seconds to establish a vacuum.

11. You may feel a pulling sensation whilst the pump creates a negative pressure.

Can I have a bath?

Avoid having a bath, as your pump must not get wet and the dressing must not get soaked.

If you only have a bath, keep the water level very shallow (below the dressing). This will enable you to wash without getting the dressing soaking wet.

What happens if my system gets wet?

The pump must not get wet. Protect it from all sources of fluid, such as spills. Do not use the PICO pump if it is wet or has previously been wet. Your dressing and pump should not be exposed to a direct spray or be submerged (covered) in water.

Please contact your midwife or Maternity Triage if you think your system has become wet. Their contact details are at the bottom of this leaflet.

When will my dressing be removed?

Your midwife will remove your dressing on day 5 after the birth of your baby. This will be done during one of your routine midwife appointments. The PICO dressing will function up until day 6 after the birth of your baby. In some circumstances your midwife or doctor may suggest removing it then.

The pump will automatically stops functioning on day 6, this is normal. All lights will turn off at this time.

How do I dispose of the PICO system?

Dispose of the PICO dressing, pump and fixation strips in your general waste.

1. Press the orange button to pause the pump (if it is still running).

2. Remove the batteries from the pump.

3. Remove the dressing.

4. Place the dressing and the pump (without the batteries) inside a plastic bag, and tie / seal the bag.

5. Place the sealed plastic bag inside another plastic bag and tie / seal (double bag).

6. Recycle or re-use the batteries.

When should I ask for help?

Contact Maternity Triage immediately if have any of the following.

• You notice any signs of infection. See ‘What are the signs of an infection?’ below.

• You have concerns about your wound.

• You feel unwell.

• You notice a change in the colour or amount of fluid in your dressing.

• Your wound fluid changes from clear to cloudy, or bright red.

• You see the dressing fill rapidly with blood.

• Your dressing feels or appears loose.

• You feel pain.

• The warning light(s) on the pump do not turn off.

Maternity Triage are available 24 hours a day, every day. Their number is at the bottom of this leaflet.

Early treatment of infection can prevent more serious complications, like sepsis. It will also make sure that you recover more quickly. Correct wound care and clean hands are essential for a smooth recovery. By following this advice, you can promote healing and reduce your risk of wound infection.

What are the signs of an infection? 

It is important to recognise the following signs of an infection.  

• Redness around your caesarean wound. 

• Swelling or hardening around your caesarean wound. 

• The area around your caesarean wound feeling warmer or hot. 

• Very bad smelling or pus-like discharge. 

• Increased pain or tenderness. 

• Feeling unwell. 

• Fever over 38°C, feeling hot, or chills and sweats. 

Do not wait if you have any symptoms of infection, or feel unwell. Noticing symptoms quickly and early treatment are very important. This will reduce your risk of developing sepsis. Sepsis is when the body’s immune system has an extreme response to an infection. Sepsis can be life threatening.

Contact Maternity Triage if you notice any of the symptoms listed above. Their number is at the bottom of this leaflet. 

Magnet warning

The PICO pump contains a magnet. The magnet can cause interference with other medical devices when close by. The PICO pump must be placed at least 10cm (4 inches) away from any other medical devices that could be affected by magnetic interference. These include but are not limited to the following.

Contact details 

If you have any worries or concerns, please contact Maternity Triage. 

• Maternity Triage
  Telephone: 01227 206737

If you have any signs or symptoms of infection, contact your midwife or GP. You may need antibiotics to help your wound heal. If you have already been given antibiotics, you may need your medication reviewed. 

You can call Maternity Triage up to 42 days after the birth of your baby. They are open 24 hours a day, every day. After 42 days, please see your GP or call 111 if out of hours. 

Useful links    

• East Kent Hospitals. Pain relief after caesarean section. Patient information leaflet. April 2024.

• East Kent Hospitals. Reducing your risk of wound infection after caesarean birth. Patient information leaflet. October 2024.

[Web sites last accessed 10 December 2025]

References    

• National Institute for Health and Care Excellence (NICE). PICO negative wound pressure dressings for closed surgical incisions. Medical technologies guide (MTG43). Last updated 06 August 2019.

• Smith + Nephew. Updated Medical Technologies Guidance supports adoption of PICO sNPWT1.

• Erritty M, Hale J, Thomas J, et al. Reduction of adverse outcomes from caesarean section by surgical-site infection prevention care bundles in maternity. International Journal of Gynecology Obstetrics. 2023; 161: 963-968.

• Smith + Nephew. PICO NICE guidelines clinical leavepiece.

• Saunders C, Nherera, Horner A, et al. Single-use negative-pressure wound therapy versus conventional dressings for closed surgical incisions: systematic literature review and meta-analysis. BJS Open 2021: 5(1): zraa003.

[Web sites last accessed 10 December 2025] 

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