Products and markets for the advanced closure and securement of wounds

{Below is drawn from MedMarket Diligence Report #S180.}

Products for the advanced closure and securement of wounds are not fundamentally changing the practice of surgery, but their advantages are sufficient to drive strong adoption rates in a wide range of clinical specialties.  In particular, these products provide for rapid and efficient closure of surgical wounds, and internal securement of tissues to reduce pain and accelerate rehabilitation. Appropriate use of these products can reduce risk of infection, and can optimize the repair process to enhance the speed and strength of tissue repair, as well as reducing complications such as those resulting from post-surgical adhesions.  For this reason, they represent a $10 billion annual market that has nowhere to go but up.

Sutures and Staples. Sutures are medical devices made out of woven or single filament fibers of steel, synthetic polymer or natural biomaterials that are used to secure cuts, lacerations, and incisions in the surface or internal tissues. Staples are rigid or semi-rigid suture-like materials delivered through a closure device and consisting of single- or multi-filament fibers of steel, synthetic polymer or natural biomaterials that are used to secure cuts, lacerations, and incisions in the surface or internal tissues. Sutures are one of the most well-established technologies in surgery and staples have emerged to represent almost a market extension of sutures in terms of clinical application and market dynamics. Long-term development in the sutures market will be affected by technical innovation but no major breakthroughs are anticipated in this regard. However, established and new niche entrants are expanding suturing business to take advantage of profit premiums available in specialist anchoring, stapling, endoscopic and tissue engineering segments.

Tapes. Tapes are fabric and polymer-based medical devices that are used to secure cuts, lacerations, and incisions in the surface of the skin as an adjunct to wound closure. The global market for adhesive tapes is roughly $250 million, but with annual growth at only 3%, the only real stimulus to growth is the gradual increase in numbers of relevant surgical procedures.

Hemostats. A hemostat reacts in the presence of blood to establish the normal cascade of factors that arrest bleeding. These products can be added to a bleeding field during surgery to prevent further bleeding, and are mostly dependent on a full complement of normal factors in the patient’s blood. Global hemostat sales are well over $1 billion annually and will see double digit growth over the next few years fueled by increased incidence of surgery, greater adoption of these products within the European surgical environment, and the need for improved hemostasis products during minimally invasive surgical procedures.

Sealants. A sealant will prevent leakage of fluid and/or gas from a surgical incision (such as pulmonary gases or spinal fluids). These products will often hold back pressurized fluids from normal vascular activity. Although their efficiency does not normally require the full complement of active clotting factors in blood to be within normal levels, these products (e.g., fibrin sealants) normally also have some hemostatic activity. Like other advanced technologies in wound closure and management, especially emerging ones that have yet to fully penetrate the readily available caseload, the sealant market growth rate is in double digit annually. The success of synthetic and biological sealants will be based on the uniqueness of procedure-based benefits, which enable niche high added-value segments to be created. Although these products offer potential for active delivery and adjunctive repair with sutures, their scope will be more limited than the stronger cyanoacrylate technologies.

Glues/adhesives. Glues and adhesives (e.g., cyanoacrylate glues) are used to attach organs, structures, or tissues to each other or to effect repair. These materials can be enhanced by incorporating additional hemostatic or sealant properties, such as Angiotech’s Vitagel (a combination of collagen and thrombin) and Nycomed’s Tachocomb (a combination of thrombin, collagen and fibrin). The market for glues and adhesives (often referred to as “high strength” glues and adhesives) is growing at a rate only slightly less than sealants due to some regulatory constraints and technology limitations the prevent their more widespread use. Nonetheless this even modestly strong growth will be sustained over the next decade, fueled by increased incidence of surgery, greater adoption of these cyanoacrylate and newer adhesive products for internal surgical applications, and the need for improved, fast-acting and easy-to-use products for use in minimally invasive procedures. In addition, it is becoming recognized that these products have a role to play in reducing infection and improving cosmesis of surgical wounds to the surface of the skin and this will also drive the value of this attractive market segment.

Anti-adhesion. Abnormal joining of two organs or tissues occurring after inflammation, especially post-surgery. Adhesion-prevention products are medical devices or substances made from synthetic polymer or natural biomaterials that are manufactured into gels, fabrics, films, and dried solids that are used to avoid the formation of post-surgical adhesions (PSA). World sales of post-operative adhesion prevention products are building at a critical mass at near double digit rates annually, with the total to soon eclipse $1 billion annually. Growth in post-surgical adhesion product sales is driven by innovations that yield greater utility and effectiveness data, increased incidence of surgery, the greater adoption of these products generally, and specifically their growing use in minimally invasive surgical procedures.

For a complete analysis of the wound closure and securement market, see MedMarket Diligence report #S180, "Worldwide Surgical Sealants, Glues, Wound Closure and Anti-Adhesion Markets, 2008-2015."