High strength medical and surgical glues versus sutures, staples, clips

One of the real upsides to advanced wound closure is in the use of high strength medical adhesives and surgical glues.  These are the products that accomplish wound closure by annealing wound edges via biologically-driven adhesion as opposed to physical approximation of wound edges left to adhere through normal physiologic processes.

However, there is a huge existing business in traditional wound closure technologies like sutures, staple, clips and other “mechanical” closure technologies. Even if these products are bioabsorbable (a growth trend in sutures, for example), they still represent a method of closing wounds that is predicated on the same tenet as wound closure technologies going back hundreds of years — simply bringing wound edges in proximity to facilitate the body’s normal process of healing.  Ultimately, however, the limitations in such traditional wound closure methods are that wound margins can only be as closely aligned as the “wavelength” of suture/clip insertions, resulting in puckering or other suboptimal gaps that may be associated with incomplete wound closure, inadequate sealing (especially problematic for vascular, lung or other critical applications), formation of scar tissue and other problems.  The advantage to traditional wound closure is the tremendous facility with which surgeons and other clinicians may get the job done, especially if they are well experienced with methods like subcutaneous suturing, but the counter to this is that methods to closely align wound margins from superficial to deep via sutures and staples are only as effective as can be accomplished via either separate subcutaneous (deep) and superficial suturing or staples that cross both layers.

The ideal closure method would include tight annealing of edges not limited by the number of sutures but by a continuous adhesion of these edges, a tight closure that resists leakage of fluids and gases and a rapid “curing” of the adhesive such that closure is accomplished nearly as quickly (or as quickly) as physical closure methods via sutures, staples or other mechanical means.

It is unsurprising that while there may be many competitors pursuing advanced wound closure through high strength medical adhesives, the overall market for wound closure also includes competitors in the “traditional” segment (e.g., Ethicon, Covidien and Braun/Aesculap) who are active in the development and marketing of multiple traditional/advanced wound closure technologies, including mechanical closure, non-resorbable sutures, resorbable sutures, staples and related devices, clips and related devices, high strength glues/adhesives, and others (see below) in order to hedge their bets by gaining benefit of new technology adoption.

Source: MedMarket Diligence, LLC; Report #S190.


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