wound care management technologies (technical insights)
TRANSCRIPT
Wound Care Management Technologies
(Technical Insights)
Growth in the wound care management sector is expected to be driven by
companies focused on elevating patient outcomes, lowering product costs,
and delivering the advanced treatments necessary to heal wounds
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Wound Care Management Industry Outlook
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The rise in prevalence of chronic wounds, that includes venous ulcers, diabetic ulcers, and pressure sores, has
led to more use of wound-care management approaches and device platforms. Wound care management
platforms are believed to improve patient mobility, quality of life, and overall well-being of the individual.
Conventional wound care approaches, such as wound dressings and ultrasound-mediated wound healing
products still constitute a majority of innovations being adopted in this sector, although advanced wound care
approaches, such as nanodelivery of targeted therapies, silver nanocomposites for rapid wound healing, and
detection platforms of early wound healing are helping drive growth in this sector.
Emergent technology options to detect and diagnose early wound healing as well as properly manage the wound
healing mechanisms are being increasingly developed. In order to determine suitable treatment protocols,
healthcare physicians are looking toward more advanced laboratory and diagnostic tests that are capable of
assessing patient’ wound healing phase and the intermittent factors that adversely impact the wound healing
process.
Growth in innovations across wound care management sector is primarily being driven by technologically
advanced products and therapies that are much more clinically efficient and cost-effective than their conventional
counterparts.
Rapid growth in the global wound care management sector has led to very intense competition, with both
multinational companies and emerging start-ups vying to establish their wound management platforms and offer a
comprehensive portfolio of products. Notable companies that are investing in wound management sector with
increasing focus on widely used and cost-effective products includes DermaSciences Inc., Systagenix Wound
Management, Smith and Nephew Plc, Covalon Technologies, and Synthes GmbH, to mention a few.
Globally, the active number of wound care patients is expected to more than double within the next three to four
years. This growth is being mainly influenced in part by an aging population and partly by an increasing amount of
people with diabetes and obesity conditions, both of which delay the wound healing process significantly.
Source: Frost & Sullivan
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Key Findings
Market
Needs
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• Wounds whether of surgical origin or traumatic injury origin have to be closed in order to promote faster
healing and reduce the occurrence of post-operative infections.
• Wound care solutions targeting healing alone are not suffice, but effective wound care platforms that
ensures uninfected and cosmetic results are preferred.
• Wound healing phenomenon encompasses closely related stages, all of which focus on resurfacing,
reconstitution, and regeneration of the tensile strength of damaged skin portions. This requires in depth
understanding by the wound care surgeons in order to facilitate the absence of scar formation.
• Currently, wound healing industry is experiencing a paradigm shift from typical sutures, stapling devices,
laser activation, surgical glues and adhesives to emergent biocompatible polymers, silver nanocomposites-
based dressings, and tissue-engineered skin constructs.
Emerging
Wound
Care
Platforms
• Wound care armamentarium growingly includes many different treatment options and modalities wherein
some of the products are updated and improved variations of previous treatments, while others are the
results of innovations in entirely new fields of study.
• Silver dressings since past several years have been noted for providing improved wound care, but newer
forms of delivery aim to enhance the efficacy while at the same time reducing side effects.
• Negative pressure wound devices are relatively new in wound care management, and the scope of disease
indications benefiting from this form of treatment are continually expanding to encompass aspects of
wound management that previously had fewer options.
• Advanced wound dressing products can help achieve an ideal wound environment to optimize wound
healing conditions. With advent of biological skin grafts and tissue engineering, skin substitutes are being
devised that not only provide effective temporary coverage of wounds, but are also involved in changing
the paradigm of wound management. By well supporting the wound area with growth factors and biologic
substitutes, it is envisioned that these emerging developments will help augment and even modulate the
wound healing process by itself.
• Hyperbaric oxygen treatment is also believed to provide improved wound care, especially in chronic
wounds not responding to any other treatment option.
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Key Findings (continued)
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Market
Focus
• The wound care management sector is witnessing a turmoil of changes in terms of novel biomaterials
being employed as wound dressings.
• Wound care advancements that have gained traction recently includes wound dressings incorporating
controlled release of enzymes and antimicrobial agents; silver nanocomposites exhibiting protective
barrier and anti-inflammatory properties; honey-based wound dressings that have the potential to
demonstrate antimicrobial, wound cleansing, and pain-free debridement properties; adoption of growth
factors and tissue engineering constructs to promote wound healing; and lastly combination medical
devices that assist in delivering targeted wound care therapy to ensure safe and timely closure of wounds.
Emerging
Applications
• Wound healing advances largely require innovations in wound healing approaches, which are capable of
overcoming few delaying factors, such as infections, physical disabilities, suppressed immune system,
and debilitating conditions, such as diabetes and obesity.
• With novel wound healing treatments being designed rapidly, the higher wound care costs associated with
them is a point of major concern.
• In the present-day healthcare settings, wound healing industry participants are aiming at developing
technology approaches, which can significantly provide patient-compliant, cost-effective, and safer
solutions to cure chronic wounds.
• Rising preference for regeneration of tissues rather than just achieving wound closure has sparked
interest in promising applications of wound healing technologies.
• A few noteworthy technology applications that are gaining widespread adoption includes stem cell
therapies for wound closure; tapping the advantages of growth factors and tissue constructs for achieving
rapid wound healing with lesser side effects; and promising medical devices equipped with capabilities,
such as nanodelivery of targeted therapies and electrical stimulation for ensuring safer closure of wounds.
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Wound Care
Management
Wound Care Management Products–Responding to Demand
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• Venous ulcers are treated using compression therapy, debridement of necrotictissues, and by offering a moist wound environment. Likewise, the treatment ofdiabetic foot ulcers necessitates the control of blood glucose levels, saline dressingsthat can provide moist wound environment, debridement, and evaluation.
• Surgical wounds are treated using drug delivery-enabled wound closure devices andtissue sealants. Negative pressure wound therapy, tissue grafts, and applyingrecombinant growth factors to wound area are few other promising woundmanagement techniques.
• The treatment approach toward pressure ulcers requires prolonged surgical andprimary care.
• During such a prolonged treatment process, patients remain at risk for developingnew pressure ulcers in other regions, so the treatment must be based on the stagingof the pressure ulcer.
• Nowadays, doctors are focused upon debridement, topical wound care, treatment ofinfections, control of chronic wound contamination, and the use of support surfaces toenhance wound healing.
• Chronic wound care typically begins with moist wound healing and moist wounddressings are capable of creating an environment that ideally supports the cellsneeded for wound repair while at the same time preventing further damage.
• Moist wound dressings are found to minimize the pain associated with dressingchanges and offer much more cost-effective healing rates when compared to gauze-based wound dressings. A few moist wound healing dressing options that have beenavailable for the past five to six years include alginates, hydrocolloids, foams,collagens, and hydrogels.
• Newer trend is geared toward creation of products that provide a moist and occlusiveenvironment, thereby paving the way for advanced wound dressings incorporatingnanocomposites and bioengineered skin substitutes/gels.
Source : Frost & Sullivan
Analyst Insights
The most promising technologies for
advanced wound care identified to date are
negative pressure wound therapy and
ultrasonic wound debridement systems.
Growth in both these wound management
technologies sector is driven by solid
evidence-based research.
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Notable emerging wound care
management technologies
Wound Care Management–Innovation Capability
Wound closure devices
providing non-invasive
wound healing
Pressure relief devices
that enable tissue
perfusion
Usage of silver and
combination dressings
Nanotechnology-enabled
drug delivery to wounds
Therapeutic
ultrasound
Recombinant growth
factors and tissue
scaffolds for wound
closure
Many of technological advancements in wound care management sector are concentrated across innovations in
advanced wound management, wound closure devices, and pressure-relief devices. Advances in wound
management products are noted to be an expanding sector with opportunities designed for treatment of both acute
and chronic wounds.
Other Emerging Wound Management Technologies
Source : Frost & Sullivan
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Cost Effective Wound Management
Wound Care Drugs and Biologics
Increase of Home and Extended-care Wound
Treatments
Source : Frost & Sullivan
Wound Management Technologies–Noteworthy Trends
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These days advanced biological materials are available in the form of enzyme
preparations and mechanical debridement tissue scaffolds that help remove dead
cells. Potential benefits to patients by utilizing such advanced biological materials
includes fewer reapplication of dressings, lesser discomfort and pain, much faster
healing, and reduced risk of complications that includes infection and amputations.
This enables cost-effective treatment to be achieved.
With product innovation spurs in drug delivery approaches for wound care
management, more and more patients will leave the hospital sooner without post-
surgical wounds and traumatic wounds that are not healed. This shift will ensure an
increase of at-home and extended care wound healing initiatives to be provided
outside of a sterile environment.
Wound care companies that are most successful in advanced wound management
sector are those that find ways to innovate around wound care and healing. These
firms are engaged towards development of products that enable rapid wound healing
within home settings and at the same time decrease the risk of hospital-acquired
infections significantly.
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DeveloperWound Care Drug/Biologic and
Targeted Indication
Drug
Class
Developmental
Status
Renovo Group Plc
Manchester, UK
Juvista injectable solution for prevention and
reduction of scarring
Human
active
recombinant
transforming
growth
factor beta-3
inhibitor
Phase 3- approval
clinical studies are
ongoing
Biotec Pharmacon ASA
Biotec BetaGlucans ASA
Norway
Woulgan Biogel for treatment of painful ulcers
and slow-healing wounds
Biogel with
active beta-
glucan
component
Phase 3-approvalclinical
studies are on-going
MediWound Limited
Tel Aviv, IsraelNexoBrid for wound debridement and healing
Enzymatic
debriding
agent
Completed Phase 2 &
Phase 3 clinical studies
and its marketing
authorization application
is currently under
review
Capstone Therapeutics
Corp.
Tempe, Arizona
AZX100 for the treatment of dermal hypertrophic
scarring
Synthetic
24-amino
acid peptide
Completed Phase 2
clinical studies
Snapshot of Pioneering Wound Care Drugs and Biologics
Snapshot of Wound Care Innovations
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Source : Frost & Sullivan
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Source : Frost & Sullivan
Therapeutic ultrasound platforms to accelerate wound healing–
Targeted slow-release ultrasound The effects of targeted slow releaseultrasound to help initiate a biological response at the cellular levels havebeen realized to be a potential platform stimulating vascular endothelialgrowth and cell proliferation. Therapeutic ultrasound platforms that allow fora portable electronic driver and disposable ultrasound patch to acceleratewound healing process appears to be a promising technology that sets aninnovation class of its own. The ultrasound technology development allowsfor complementing existing systemic methods of oxygenation and will alsofacilitate greater therapeutic versatility in treatment of wounds, possible inhome care settings within the next few years. Translation of therapeuticultrasound platforms as potential non-invasive wound therapy is envisionedto have a huge impact within the next three to four years.
Next-generation nanofabricated meshes & biomaterials-
Usage of polymeric nanofibers have been cited to impart surgical mesheswith unique material properties in various clinical studies conducted so far.Unique material properties imparted are the following: soft, compliant cloth-like feel, and biological properties that include rapid cellular ingrowth andaccelerated wound healing, all of which make these nanofibers ideal forsurgical use. Extensive academic research has been able to establish thefact that nanotechnology-based platforms allow for the manipulation ofvariables such as varying order, alignment, and thickness, thereby yieldingcustomized surgical meshes for each clinical indication targeted. Theapplication impact of nanotechnology platforms as mesh substitutes andsynthetic biomaterials for wound healing is envisioned to be recognizedwithin 2015.
Potential Technologies to Look Forward to within the Next Three-five Years
High High
Medium High
Forthcoming Technology Innovations and their Impact
Industry ImpactShort Term Long Term
PainShield therapeutic
ultrasound product
Picture credits: NanoVibronix
Inc. (Tel Aviv, Israel)
Nanostructured surgical
meshes
Picture credits: Retectix
LLC (St. Louis, Missouri)
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Source : Frost & Sullivan
Impact Assessment of Technology Accelerators
Optimization of wound care is often considered to be the most
important parameter because it is often the crucial possibility existing
to facilitate healing. This, in turn, depends mainly on the application
of the right product at the given time, thereby paving the way for
innovations to spearhead successful wound healing. With the
increased understanding of wound biology, major improvements in
wound dressings are nowadays feasible. Modern wound
management outlook has shifted toward focused efforts on improving
wound healing mechanism as well as enhancing the patient’ quality
of life. The interest generated toward identifying and designing novel
wound dressings which provide good control of adsorption and fluid
handling properties acts as a major driving force for best practices to
be adopted across wound management.
2010 2012 2014
Rise in hospital-
acquired
infections has
accelerated
usage of
advanced wound
dressings
It can be observed that the number of hospital-acquired infections
has spurred the development of antimicrobial technologies for chiefly
safeguarding the exposed wounds from bacterial exposure.
Emergence of antimicrobial dressings that are chiefly made of
silicone and nano impregnated materials is becoming the standard of
care amongst physicians these days. Widespread adoption of
antimicrobial dressings for wound healing application acts as a
steering force for emphasizing the prevention of wound development
in long-term care settings.
Medium
Drivers
Emphasis on
modern wound
management
High
HighHighMedium
Medium
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Sector Level of Attractiveness Probability of Success
Therapeutic ultrasound-
enhanced wound
management
• The demand for wound care platforms that
provide a greater therapeutic versatility in
treating wounds serves as the key factor for
this technology's higher level of attractiveness.
• Ultrasound technology uniquely utilizes surface acoustic
waves that are implemented within a thin transducer to
allow for effective ultrasound therapy to be delivered
around the application site (wounds). Low-frequency
sonophoresis has been well documented to enhance
the permeability of skin to drugs and patches.
• The potential behind surface acoustic waves technology
is huge in terms of facilitating the delivery of oxygenated
saline at an appropriate depth in wound bed and
physiologically effective in promoting angiogenesis and
collagen formation.
Nanocomposites and
silver-based advanced
wound dressings
• Wound care standards have constantly evolved
from surgical drapes and conventional wound
dressings to present-day advances in terms of
nanocomposites and silver-based dressings.
• Wound dressing platforms have evolved from
hydrocolloid platform to more advanced
polymer and biomaterials-based dressings that
impart antimicrobial or analgesic properties to
wound area. Silver and nanocomposites-based
dressings have been integrated as part of
modern wound management due to efficient
control of bacterial load and local infection
combating properties.
• The rising number in elderly patient population and their
impact on healthcare expenditure suggest a higher
adoption potential of nanocomposites and silver-based
wound dressings.
• The strategy going forward would be identification and
delivery of best available wound care while at the same
time limiting complications and associated treatment
costs.
Potential Technologies—Opportunity Analysis
Source: Frost & Sullivan.
Misonix Sonic One ultrasonic wound care system
Picture credits: Misonix Inc. (Farmingdale, New York)
Antimicrobial silver-based wound dressing
Picture credits: B. Braun AG (Germany)
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Contact
Britni MyersFrost & Sullivan
210.477.8481
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