Partnering the burn community

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* At smith&nephew we seek imaginative solutions that improve wound outcomes for patients and at the same time conserve resources for healthcare systems. Partnering the burn community Dedicated to the management of soft tissue injuries NEW Prepare VERSAJET II Protect ACTICOAT BIOBRANE* Progress RENASYS NEW PICO

Introduction Smith & Nephew is a global medical technology business, specialising in Orthopaedics, including Reconstruction, Trauma and Clinical Therapies, Endoscopy and Advanced Wound Management products. Smith & Nephew is a global leader in arthroscopy and advanced wound management and is one of the leading global orthopaedics companies. The last decade has seen some remarkable developments in burn wound management. New research has advanced our knowledge of burn wounds, new technologies have followed and at the same time the overall level of clinical experience is maturing. That s why we partner the burn community with the key goal of developing advanced woundcare products, backed up with thorough education and training, to ensure that the most appropriate dressing is used in the most appropriate way, at the most appropriate time. Key stages in burn wound care include: 1. The preparation of the wound bed where we have introduced the VERSAJET II Hydrosurgery system to maximise tissue preservation and provide precise debridement. 2. Infection management where the use of ACTICOAT antimicrobial barrier dressings with SILCRYST Silver, provides an effective antimicrobial barrier to microbial contamination. 3. Progression of the wound where we have introduced the RENASYS Negative Pressure Wound Therapy System to optimize granulation tissue formation, reduce exudate levels and stabilize the wound to enhance graft take. Introducing PICO Single use Negative Pressure Wound Therapy PICO opens a new era in the application of Negative Pressure Wound Therapy. PICO provides effective therapy through a pocket sized pump 1 and manages fluid through an advanced dressing instead of a bulky canister. 2 The highly portable system allows patients more freedom of movement whilst supporting their injury s progress to healing. BIOBRANE* biosynthetic wound dressing which can be used on both adult and pediatric patients on superficial burns to reduce pain and trauma throughout the healing process. 3,4 Smith & Nephew have a range of advanced dressings including ALLEVYN, ALLEVYN Ag and ALLEVYN Gentle Hydrocellular Foam Dressings for donor site management and other soft tissue related injuries Smith & Nephew produce many other market-leading advanced wound management dressings to support our belief that no-one should live with a wound for one minute longer than necessary. 1. Data in File 1104011 Assessment of simplified NPWT device in pre-clinical blood flow studies. 2. OR DOF 013. A prospective, open, non-comparative, multi-centre study to evaluate the functionality and dressing performance of a new negative pressure enhanced dressing in acute wounds. 3. Travis MJ, Thornton JW, Bartlett RH et al.,: A new composite skin prosthesis. Burns 1979; 7:123-130. 4. Gerding RL, Imbembo AL, Fratianne RB: Biosynthetic skin substitute vs. 1% silver sulfadiazine for treatment of inpatient partial thickness thermal burns. Journal of Trauma 28(8): 1265-1269,1988.

Prepare with... VERSAJET II Hydrosurgery system Precise Excision Precision Precisely evacuate unwanted tissue, while sparing viable tissue 1 Create a smooth wound bed to enhance graft take Control Tangential excision for immediate or staged closure Effectively access difficult to reach and contoured areas Value Reduce the need for repeat procedures 2 Help reduce debridement time 1. Cubison, CS et al., 2006, Dermal preservation using the VERSAJET Hydrosurgery System for debridement of pediatric burns, Burns, 32, pp. 714-720. 2. Granick, MS et al., 2006, Efficacy and cost-effectiveness of a high-powered parallel waterjet for wound debridement, Wound Repair & Regeneration, 14, pp. 394-397.

Protect with... ACTICOAT Antimicrobial dressing Effective Flexible, conformable and absorbent range of dressings 1,2 Compatible as a wound contact layer with Negative Pressure Wound Therapy for up to 3 days 3,4 Shown to reduce overall treatment costs when compared to SSD treatment 5,6 Powerful Bactericidal with proven broad spectrum kill against fungi, yeast, gram-positive, gram-negative, anaerobic and resistant bacteria including multiple MRSA strains 7,8 Provides continuous availability of bactericidal silver for up to 7 days* Fast Rapid onset of protection begins within 30 minutes Delivers a quick kill to reduce the risk of resistance 9 and inhibit biofilm formation as shown in in-vitro studies 10 *With ACTICOAT Flex 7, ACTICOAT 7, Site and Post Op With ACTICOAT, ACTICOAT 7, ACTICOAT Flex 3, ACTICOAT Flex 7 ACTICOAT Flex 3, ACTICOAT Flex 7 1. Daubney, L; ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1 2. Smith & Nephew Data on File Report 0403002 3. Data on file 0810015. Smith & Nephew Wound Management. 4. Bannister, N., Negative Pressure Wound Therapy study. 5. Cheng et al., A tale of two dressings part 4: Money Matters. 2004. Poster presented at Australian and New Zealand Burn Association, Annual Scientific Meeting, 2004. 6. Stephens et al., An evaluation of ACTICOAT dressing with regards to cost and control of infection. 1999. Poster presented at 31st Annual Meeting of the American Burn Association. 7. In vitro study data on file: Scientific Background #0109003 and #0107010. 8. Wright JB et al., Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350. 9. Yin HQ et al., Comparative evaluation of the antimicrobial activity of ACTICOAT antimicrobial barrier dressing. J Burn Care Rehabil. 1999;20:195-200 10. Data on file 0512011, Smith & Nephew Wound Management. of partial-thickness burns: Which method is less painful? 2006, J. Burn Care Rehabil. 26, 4: 344-347

Progress with... RENASYS Negative Pressure Wound Therapy Optimize RENASYS creates the foundations for tissue granulation prior to flapping or grafting procedure. 1,2,3 RENASYS helps to reduce exudate levels enabling the wound to stabilize prior to surgical closure. 2,4 Progress Negative Pressure Wound Therapy may accelerate wound closure which can lead to optimal results post surgery. 5,6 Use of RENASYS on top of a graft or skin substitute has been shown to improve graft take enabling 96% graft take over 5 days. 1 Accelerate RENASYS GO offers excellent portability enabling the patient to accelerate time to rehabilitation. RENASYS allows the clinician to optimize functionality for the patient once rehabilitation has been completed. 3 1. Bondokji S et al., (2011) Clinical Efficacy of a New Variant of Foam-based Negative Pressure Wound Therapy System (RENASYS-F) J Wound Care. 20(2):62, 64-7. 2. Dunn R et al., (2011) Assessment of Gauze-based Negative Pressure Wound Therapy in the Split-Thickness Skin Graft clinical pathway Eplasty. Mar 16;11:e14. 3. Jeffery SL (2009) Advanced wound therapies in the management of severe military lower limb trauma: a new perspective. Eplasty. Jul 21;9:e28. 4. Dunn R et al., (2011) Factors associated with positive outcomes in 131 patients treated with gauze-based negative pressure wound therapy Int J Surg. 9(3):258-62. Epub 2010 Dec 25. 5. Campbell et al., 2008. Retrospective clinical evaluation of gauze-based negative pressure wound therapy. International Wound Journal 5: 280-286. 6. Llanos et al., 2006. Effectiveness of negative pressure closure in the integration of split thickness skin grafts Ann Surg.244: 700-705

Progress with... PICO Single use Negative Pressure Wound Therapy Push the orange button to mobilise the benefits of NPWT Clinically Effective PICO applies the clinical benefits of negative pressure through a pocket sized pump 1 and manages fluid through an advanced dressing instead of a bulky canister. 2 Patient friendly PICO represents the ultimate in portability. The pump is discrete and can be worn on the belt or under clothing. The dressing is comfortable 3, non-bulky and allows freedom of movement 3 to help the patient through physiotherapy and move on with their lives. Easy to use and access PICO can be kept on the shelf, there when it s needed. It s easy to apply and remove 4, helping to preserve valuable time and minimise trauma to the patient. 5 The certainty of cost associated with the disposable nature of PICO helps to manage budgets to support optimisation of resources. PICO makes it possible! 1. Data in File 1104011 Assessment of simplified NPWT device in pre-clinical blood flow studies. 2. OR DOF 013. A prospective, open, non-comparative, multi-centre study to evaluate the functionality and dressing performance of a new negative pressure enhanced dressing in acute wounds. 3. OR DOF 012. A prospective, open, non-comparative, multi-centre study to evaluate the functionality and dressing performance of a new negative pressure enhanced dressing in acute wounds. 4. OR DOF 014. A prospective, open, non-comparative, multi-centre study to evaluate the functionality and dressing performance of a new negative pressure enhanced dressing in acute wounds. 5. CT09/02. Statistics result sheet. A prospective, open, non-comparative, multi-centre study to evaluate the functionality and dressing performance of a new negative pressure enhanced dressing in acute wounds. February 2011.

Progress with... BIOBRANE* Temporary Wound Dressing Efficient Decreases length of patient stay and reduces nursing time 1,2 Reduces overall cost of treatment 2 Rapid Increases speed of healing of superficial burn wounds 1,2 Increases rate of epithelialisation of superficial burn wounds 1,2 Kind Decreases pain compared to topical SSD treatment 1,2 Allows increased patient mobility due to flexible nature of material 1 1. Travis MJ, Thornton JW, Bartlett RH et al.,: A new composite skin prosthesis. Burns 1979; 7:123-130. 2. Gerding RL, Imbembo AL, Fratianne RB: Biosynthetic skin substitute vs. 1% silver sulfadiazine for treatment of inpatient partial thickness thermal burns. Journal of Trauma 28(8): 1265-1269,1988.

For patients. For budgets. For today. Wound Management www.smith-nephew.com/wound Smith & Nephew www.acticoat.com Medical Ltd www.npwt.com 101 Hessle Road www.versajet.com Hull HU3 2BN www.mypico.co UK Trademark of Smith & Nephew Smith & Nephew September 2011 30670 *Trademark of Mylan/UDL T +44 (0) 1482 225181 F +44 (0) 1482 328326