The global wound closure market size was valued at USD 13.24 billion in 2018 and is projected to reach USD 21.03 billion by 2026, exhibiting a CAGR of 6.0% during the forecast period
What is Wound Closure?
Wound closure is the final step of surgical intervention. There are two major types of wound closure: primary and secondary. In primary closure, the skin is closed at the end of the surgery, whereas in the secondary closure the wound is left open at the end of surgery and heals by granulation and contraction. A further type is delayed primary closure, in which wounds are closed a few days after the first amputation and infection drainage. The choice of closure type depends entirely on the degree of drainage, the existing amount of tissue for wound closure and infection status at the site of wound closure. Topical negative pressure therapy, full- and split-thickness grafts, and local and distant flaps also are useful adjuncts for closing deep, complex wounds following debridement. Figure 15.5A and B shows pre- and post-wound closure by skin grafting.
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Wound Closure
Wound closure is particularly important in the head and neck region, where the treatment goals are a mechanically sound wound closure and a cosmetically acceptable scar. Most simple wounds, generated by surgical incisions or clean lacerations, heal rapidly by primary intention. Complex wounds, such as burns, avulsions, and infected or contaminated injuries, usually heal more slowly by secondary intention, and may require skin grafts or flaps. Current wound management focuses on eliminating causative factors, providing systemic support to enhance tissue repair, and maintaining a physiologic local wound environment amenable to optimal healing. All wounds should be as clean as possible, and debrided of non-viable tissues or foreign bodies. Ragged wound margins must be revised and undermined to achieve a tension-free closure as appropriate. Depending on the nature of the wound, sutures, suction drains, or pressure dressings may be applied.
Proper suture technique should incorporate three major principles including proper distribution of tension to the deeper layers, atraumatic handling of tissues, and eversion of wound margins. Where appropriate, closure of the cutaneous wound should be layered. Deep sutures are usually placed in strong, fibrous tissue, such as fascia or dermis, rather than muscle or fat. Wound tensile strength depends on suture integrity in the first few weeks until strong collagen fiber is formed. Hence polyglycolic acid (PGA) sutures are suitable for this purpose. Non-resorbable sutures may be indicated to close wounds under tension. Closure of the dermal (subcutaneous) layer is fundamental for esthetic wound closure. Dermal sutures should be inverted to avoid extrusion of the knots. If the deeper portion of the suture is wider than the portion that crosses the surface, there will be some eversion of the wound margins. Mucosa can be closed with either permanent or resorbable sutures. Skin can be closed with permanent sutures or staples. Depending on the individual wound, simple sutures, horizontal or vertical mattress sutures, half-buried mattress sutures, or running sutures can be used.
Key players covered in the global Wound Closure Market research report:
- Johnson and Johnson Service, Inc.
- Baxter
- Medtronic
- Cryolife
- Stryker
- 3M
- CP Medical
- Boston Scientific Corporation
- Smith & Nephew
- B. Braun Melsungen AG
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