The relentless proliferation of wound closure technologies

Sutures are not dead. They cling to the wound closure market as tenaciously as, well, non-resorbable sutures.

Though the mainstay in the management of acute and traumatic surgical wounds for literally hundreds of years, sutures have been giving up some of their hold on the market, as a result of a robust rate of development, introduction and clinical acceptance of a wide array of biologically-based, chemically-based or combination of chem/bio products that stop bleeding, seal wound edges to varying degrees (adjunctively and independently) and otherwise close and heal wounds. The value of these products ranges from the critical, such as in new hemostat products with the potential to revolutionize treatment of battlefield wounds, to the aesthetic, with sealants that can dramatically reduce or eliminate scarring.

As the ancient Greek philosopher Heraclitus recognized, however, you cannot put your finger in the same river twice. The surgical arena continues to change dramatically and it challenges and creates enormous incentives for manufacturers to keep pace by developing novel wound closure technologies. Laparo-endoscopic innovations from conventional laparoscopy through single port laparoscopy to natural orifice transluminal endoscopic surgery established new requirements for the manipulation of tissue and manufacturers responded with a wide range of endoscopic sutures, staples, clips and appliers to facilitate MIS procedures.  Even sutures themselves have been reengineered to dissolve in controlled ways to enhance the end result of wound closure.

But where sutures were once THE universally accepted manner to bring wound margins together, they are now challenged on all sides by fibrin and other surgical sealants, hemostatic agents, vascular closure devices, cyanoacrylate and other high strength surgical glues and even sophisticated tapes. For now, sutures hold the slim margin of dominance in this aggregate market, but by 2018, the overall market for wound closure will be represented in the majority, by products other than surgical sutures and staples:

Worldwide Surgical Wound Closure Products Market, by Device Segment, 2018

closure-shares-2018

Source: MedMarket Diligence, LLC; Report #S192