See the updated, published 2012 Report #S190, “Surgical Sealants, Glues, Sutures, Other Wound Closure and Anti-Adhesion, Worldwide Markets, 2012-2017.”
Wounds have been closed and secured through the use of suture materials since ancient Egyptian times. In the modern medical age, suture materials have evolved through a succession of stages from non-resorbable, to resorbable, to stapling devices. Sutures still represent the majority of products used for wound closure and securement, but their days of being the sole means to secure and seal wounds is in decline. Nonetheless, sutures (and other mechanical closure) represent a traditional “gold standard” that all advanced wound closure products must measure up to, whether alone or as products used adjunctively with other closure methods to optimize wound management.
There are six main categories of closure and securement devices:
- sutures, staples, and other mechanical closure devices
- medical tapes
- fibrin and other sealants
- high-strength medical adhesives
- post-surgical adhesion prevention
For over a hundred years simple wound closure was achieved through the use of well-established suturing techniques and products. Early in the 1980s the need to control bleeding during new surgical procedures led to an increased use of biological hemostats and sealants. Made from human fibrin as well as thrombin, collagen and gelatin from other species, these materials came into widespread use, particularly in Europe and Asia, led by homologous, pooled, fibrin products such as Beriplast from CSL Behring and Tisseel from Baxter. It was not until 1997 that homologous, pooled fibrin products were approved for use in the United States. The products offer significant benefits for surgical procedures where blood loss is a major factor, but are not strong enough to be used alone for wound closure; consequently they are usually used as adjuncts to suturing.
During the 1990s an opportunity for new surgical closure products was created by the introduction of many new minimally invasive procedures. The ensuing product demand was temporarily addressed with sutures and suturing/stapling devices, autologous fibrin prepared prior to the surgical procedure, bovine and porcine hemostasis products (based on thrombin, collagen and gelatin) and chemically derived cellulose products. However, these products were less than ideal for wound closure and, as a result, were largely (and are still) used for adjunctive hemostasis. The unfilled need for more advanced products, and the huge market potential, led to the creation of biotech-based companies targeting surgical closure products. In the early 1990s this market expanded with the advent of products for adhesion prevention (prevention of fibrotic repair after surgical interventions).
Currently, sutures, staples and other mechanical means of wound closure represent roughly 60% of the global market for wound closure technologies. Hemostats, fibrin and other sealans, high-strength medical adhesives and glues and other wound securement products have seized from traditional wound closure an aggregate market of almost $4 billion globally and continue to expand in use as they not only further penetration traditional wound closure markets but also find new, untapped applications.
Source: MedMarket Diligence, LLC; Report #S180.
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