Existing Methods

Suture

Suture is the most common used method today and global sales was estimated to $3,4 billion in 2011 representing over 40% of the total wound closure market.

Sutures are thread-like products designed to hold tissues in close approximation until sufficient healing occurs to withstand stress without mechanical support. They are of two major types: absorbable and non-absorbable. Absorbable sutures are constructed from natural and synthetic materials that metabolize within the body, losing their tensile strength within 60 days and being resorbed by the body within 3 to 4 weeks.

Sutures’ share of the entire wound closure market has been gradually declining over the past decade due to the drive to find easier, faster, and less invasive alternatives.

Staples

Staplers and staples represent the second largest segment of the wound closure market, with 30% of market value, accounting for an estimated $2,6 billion in sales in 2011.

Initially, these devices were introduced to address the limitations of suturing, such as knot tying challenges, the high risk of infection associated with sutures, and the time-consuming nature of the technique. Over time, staples have been found to offer several additional advantages, including speed of deployment; cost effectiveness; reduced tissue trauma (due to less handling), leading to more reliable and faster healing; improved access to specific sites, especially during G.I. procedures; and their typically less irritating and allergenic nature compared to sutures.

Disadvantages of staples include permanent scars if used incorrectly; the need for a second operator; and improper aligning of wound edges, which can lead to delayed or abnormal healing. Operator misuse has become a primary concern, as have stapler malfunctions, both of which can cause injuries and even death. Examples of stapler malfunctions include the staples’ inability to close around the tissue; the stapler’s failure to release staples, resulting in leakage; and the stapling gun becoming affixed in the patients’ skin, which can lead to complications and force the surgeon to switch from minimally invasive to open surgery. Although fairly high complication rates have hindered popularity within some practices, staplers and staples continue to record significant sales based on their convenience and other advantages.

Source: "Health Research International (2009) - McKinsey & Co."