From the Executive Summary (excerpt) from “Worldwide Wound Management 2007-2016 ,” report #S245, published November 2007. See link.
The skin is our protection from the environment. Far from being just a physical barrier, the skin is a complex organ, protecting our bodies from chemical, biological and physical insult, keeping organs and tissues in their place, and regulating various secretions including sweat (to control temperature), and pheromones (to act as sexual attractants). It is constantly renewed and maintained. Injuries to the skin cause the potential for infection and significant disruption to the healthy functioning of the tissues beneath. Healing of the skin has been an essential pre-requisite for evolutionary and individual survival, and complex biochemical systems have evolved for repair of the skin.
Surgical wounds account for the vast majority of skin injuries. There are almost 100 million surgical incisions every year which require some wound management treatment. In approximately 80% of these cases, some form of wound closure product is used: sutures, staples, and tapes. Many require hemostasis (blood clotting) promoters, and of course the use of fabric bandages and surgical dressings is almost universal.
Traumatic wounds occur at a rate of about 1.4 million cases every year. Lacerations are a specific type of trauma wound that are generally minor in nature and require only cleansing and dressing for a shorter period. Lacerations occur frequently (approximately 19 million cases a year), as a result of cuts and grazes. They can usually be treated in the doctorâ€™s surgery, outpatient medical center, or hospital accident and emergency department.
Burn wounds can be divided into minor burns, medically treated, and hospitalized cases. Out- patient burn wounds are often treated at home, at the doctorâ€™s surgery, or at outpatient clinics. As a result a large number of these wounds never enter the formal health service system. We estimate that approximately 3.1 million burns in this category do enter the health service system and receive some level of medical attention. These burns are mostly treated using hydrogels and advanced wound care products, or even with consumer based products for wound healing.
Medically treated burn wounds get more specialist levels of care to remove heat from the tissue, maintain hydration, and prevent infection. Advanced wound care products are used on these wounds. There are approximately 6.0 million burns like this treated medically every year.
Hospitalized burn wounds are rarer and require more advanced and expensive care. These victims require significant care, nutrition, debridement, tissue grafting and often tissue engineering where available. They also require significant nursing care and rehabilitation to mobilize new tissue, and physiotherapy to address changes in physiology.
Chronic wounds generally take longer to heal, and care required is enormously variable, as is the healing time. There are approximately 5.2 million pressure ulcers in the world that require treatment every year. Optimally, these wounds receive advanced wound management products and appropriate care to address the underlying defect that has caused the chronic wound. Pressure ulcers are caused by compression of the skin and underlying tissues, as when a patient is bedridden and the buttocks are pressed onto the mattress; a number of advanced devices exist to reduce pressure for patients.Â Other skin ulcers are caused by poor circulation, even without the added complication of pressure. There are approximately 7.6 million venous ulcers, and approximately 7.0 diabetic ulcers in the world requiring treatment.
Chronic wounds are growing in incidence due to the growing numbers of elderly individuals in the population, and the caseload is also increasing due to improved diagnosis and education. At present these factors are contributing to growth of this pool of patients faster than new technologies are reducing the incidence of wounds by healing them.
Wound management techniques are also used for a number of other conditions including amputations, carcinomas, melanomas, and other complicated skin cancers, which are all on the increase.
Products Used in Advanced Wound Management
Dressings can be divided into categories using a number of different classification systems. In report #S245, “Worldwide Wound Management 2007-2016,” we focus our product, marketing, and technology review on the category known as Advanced Wound Management. This includes Film dressings, Hydrocolloids, Foam Dressings, Alginate Dressings, Hydrogels, Non-Adherent Dressings, Antimicrobial dressings, Cleansing and debridement products, Tissue engineered products, Pharmacological products, (including Pain control, Antibiotics, Growth Factors, Non-Growth Factor Modulators, Gene Therapy, and Scarring Modulators), Physical treatments (like pressure devices, hydrotherapy, electrical stimulation, electromagnetic stimulation, ultraviolet therapy, hyperbaric oxygen therapy, mechanically assisted wound closure devices, ultrasound, laser and information systems. Some of these product categories are well established; others are in development.
(Excerpted from “Wound Management 2007-2016,” report #S245, published November 2007.)