Global Trends Analysis: Advancements in Wound Care Devices

Overview:

Chronic dermal wounds are difficult to manage and slow to heal, inflicting pain, and are
potentially life-threatening. Wound management largely can pose several challenges to the
clinician and patient alike; costing healthcare provider’s considerable amounts of money all
of which has a huge impact on the quality of life. Numerous surgical wounds become
delayed healing wounds particularly in the elderly or in diabetic patients. This suggests that
no single treatment addresses the central cause of delayed healing or non-healing in the
wound environment.

Advanced wound healing products/devices designed to improve the healing of chronic

wounds aid in faster healing and recovery of patients in conjunction with the potential to
reduce economic costs associated with lengthy hospitalization. At present, the focus of care
has primarily been on the control of wound care symptoms. However, renewed interest in
comprehending better some of the underlying causes of wound chronicity have led to
manifold imperatives to seek innovative technological approaches to therapy.

Although new technologies may initially be highly expensive, the premise is to save
clinicians time, reduce treatment costs, and overall improve patient outcomes. In order to
gain assured acceptance in the wound care market, manufacturers must provide rigorous
clinical and economic evidence supporting their product’s entry. Adequate reimbursement
for products is another key factor contributing to wound care market growth. The main
objective behind this article is to evaluate emerging technologies in the global advanced
wound care market by identifying and providing a brief snapshot of technology trends for
existing and emerging participants.

In brief, this article covers the following segments of noteworthy emerging technologies in
the global wound management sector. To name a few:

 Electrical Stimulation therapy

 Negative Pressure Wound Therapy

 Hyperbaric Oxygen Therapy

 Maggot Therapy

 Honey-based Dressings

Technology Trends observed in advanced wound care technologies:

Currently, a number of medical devices, which provide assistance in various stages of

healing, are being designed for helping in achieving safe closure of wounds. Hyperbaric
oxygen therapy utilizing/ electrical stimulation using techniques are more preferred than
conventional invasive medical devices nowadays. Clinical investigations support the fact
that usage of dissolved oxygen enabling enhanced delivery along with functional electrical
stimulation technique in addition to ultrasound-based devices has been increasingly
exploited for faster healing of chronic wounds. These technology breakthroughs minimize
wound healing time to a great extent.
There is a growing trend observed toward usability of advanced wound care dressings, in
particular for antimicrobial wound dressings, owing to their potential activity against
multiple drug resistant microbes and their proven clinical validity as compared to other
unfriendly skin wound care dressings. In the near future, elaborate clinical studies examining
the applicability of such advanced wound dressings need to be performed for better wound
healing outcomes.

Some of the prominent industry players and their innovations have been highlighted below:

Coloplast Group with global locations has recently released a breakthrough dressing, Biatin
Ibu, which does the dual role of reducing pain in chronic wounds as well as managing the
fluids that exude from the wounds. This innovation is expected to reduce the barriers for
achieving faster wound healing. This unique dressing also provides moist wound healing
along with continuous release of ibuprofen.

Unomedical based in Denmark has launched Sorbsan Silver Antimicrobial Dressings which
aids in controlling infections and promotes wound healing immensely.

MolnLycke Healthcare based in Sweden owns Mepilex AG antimicrobial dressing that

combines silver with Safetac silicone technology platform.

Alltracell Healthcare Innovation Group, based in Dublin, Ireland, has the

PolyAnhydroGlucuronic Acid(PAGA) technology platform utilizing oxidized cellulose for
delivering wound dressings to the wound care sector.

Ethicon Endo-Surgery Inc., a subsidiary of Johnson & Johnson, has several novel surgical
products for carrying out minimally invasive surgical procedures.

ConvaTec, a Bristol-Myers Squibb firm specializes in advanced wound care products and
holds ownership of an unique gelling foam dressing, which combines the benefits of foam
and hydrofiber to redefine patient care. This product is named as VERSIVA XC.

Paul Hartmann AG, headquartered in West England, manufactures and provides a wide
range of phased wound healing solutions ranging from traditional gauze dressings to
hydroactive foams, sheet hydrogels, and silver dressings.

Advanced Medical Solutions Group plc, based out of UK, develops products under the
brandname ACTIVHEAL, for providing advanced moist wound healing environments.Through
its MedLogic division, AMS leads in the sector of tissue adhesives for closing of wounds too.

AcryMed, based at Oregon a wholly-owned subsidiary of I-FLOW Corporation, California has

developed the SilvaGard Surface Engineered Antimicrobial treatment to improvise the
efficacy of indwelling and implantable medical devices, besides lessening the risk of deadly
medical device related-infections.

Tepha Inc., based in Massachusetts, pioneering a novel generation of absorbable medical

devices has recently designed a wide range of wound management devices using its
proprietary polymers. The company's TephaFLEX sutures can be employed in every known
surgical application with ease of handling and flexibility advantages.

Trends in Biointeractive Innovations Employed for Wound Healing:

Recently, much of the advancements noticed in wound healing applicable technologies are
mainly concerned with providing protection to the wound from getting infected through
controlled release of enzymes and antimicrobial agents in the wound. There are numerous
developments happening to ensure proper pain-free debridement by utilizing collagen and
other polysaccharides, which are not associated with the risk of causing infection. Wound
care industry is currently harnessing the potential behind natural substances such as growth
factors and tissue systems, which are present under normal conditions within the living
systems. Tissue engineering and artificial constructs are also significantly advantageous as
they can replace the current gold standards of autografts and allografts.

There is an increased tapping of nanotechnology, tissue engineering, and genetic-based

therapies for assisting in controlled drug release, provision of desired characteristics and
properties to the natural polymers, in brief providing prospective solutions to wound care.

A brief listing of commercially available biointeractives for chronic wound therapy has been
discussed below:

Advanced BioHealing Inc., based in California, has designed a unique human fibroblast-
derived dermal substitute, DERMAGRAFT, which can be used in the treatment of full-
thickness diabetic foot ulcers.

Forticell Bioscience Inc., based in New York, enables faster wound healing through its
bilayered cellular matrix product--OrCel. This serves as an absorbable biocompatible matrix,
which provides a favorable environment for host cell migration and has been shown to
comprise of cell-expressed cytokines and growth factors.

LifeCell Corporation, based in New Jersey, owns AlloDerm, an acellular dermal matrix derived
from donated human skin tissue, belonging to the banked human tissue classification by the
FDA. This patented human tissue matrix can be used in the treatment of burns or full-
thickness wounds.

Genzyme Biosurgery, based in Massachusetts, has devised a unique bioengineered skin

substitute called Epicel, which targets treatment of deep partial-thickness and full-thickness
burns.

Integra Lifesciences Corporation, based at New Jersey has the Integra skin substitute
targeting deep partial-thickness and full-thickness burns.

Characterization of Trends Seen in Alternative Wound Healing Techniques:

A keen observation of emerging trends in wound repair techniques studies suggest that
negative pressure therapy, employing products are being increasingly utilized in managing
infected sternal wounds that often occur post cardiac surgery. Negative pressure wound
therapy as well as topical negative pressure are found to improve healing of the diabetic foot
amputation site along with enhancement of skin graft integration, which have been proved
by two independent recent studies conducted by clinical research team.

In cases of novel therapies and products based on ultrasound principle and electric currents,
there has been complete replacement of moist wound dressings such as hydrogels.
However; there is a point of concern over establishing the value of these adjunctive wound
healing techniques and their beneficial features in comparison to older ones.
Future Trends Overseen in Wound Healing Techniques Developed:

Currently, a lot of research studies are being carried out for examining the efficacy of honey
in wound dressings. In the near future, honey-based dressings have a huge potential to
capture a lucrative market mainly due to their antimicrobial, wound cleansing, and healing
properties. Future investigations are expected to yield vital information concerning the basic
phenomenon of cell differentiation and tissue morphogenesis in conjunction with their
crucial role played in wound healing. Moreover, experimental studies conducted in human
subjects as well as animals should reveal greater insights into the role of therapeutic agents
and anti-inflammatory drugs on the success of wound repair. Increasing clinical evidence
must be populated regarding heparin's role in improving outcome of burn patients in terms
of mortality, wound healing, pain, and cosmesis (surgical dermal tissue reconstruction
method) . Much less is known about the impact of mechanical forces/physical devices on
wound healing and this necessitates the exploration of principal mechanism behind many of
these vacuum-assisted devices, electrical forces utilizing devices, and ultrasound-assisted
devices. In the forthcoming years, wound healing strategies should have the capabilities to
prevent cells from undergoing apoptosis but stimulate rapid cell division and proliferation.

Conclusion:

Many of these technologies are not entirely new segments in the advanced wound care
market. The main reasons for the limited use of these technologies are lack of awareness of
advanced therapies, high pricing and lack of appropriately skilled clinicians. Although
various studies have shown that these technologies are beneficial in wound healing, few
studies compare the various devices in relationship to cost effectiveness, patient comfort,
odor control and ease of use. As a result, most of these technologies have been slow in
gaining market penetration.

While manufacturers improve therapy techniques, provide substantiated data and training,
clinicians are more likely to shift from conventional wound treatments to newer
technologies. With rising costs associated with wound treatment, there is a resurgence of
interest in utilizing these devices to generate greater efficacy. The industry is reexamining
these technologies, creating inventive ways to implement them into cost-effective
treatments.