Table of Contents

1. CLINICAL ISSUES IN WOUND MANAGEMENT…………………………………. 1-1
1.1 Physiology of Wound Closure ………………………………………………….. 1-1
1.1.1 Layers of the Skin and Supporting Structures ………………. 1-2
1.1.1.1 Epidermis …………………………………………………. 1-2
1.1.1.2 Dermis……………………………………………………… 1-5
1.1.1.3 Hypodermis ………………………………………………. 1-5
1.1.1.4 Fascia………………………………………………………. 1-6
1.1.1.5 Muscle……………………………………………………… 1-6
1.1.1.6 Bone………………………………………………………… 1-6
1.1.2 Wound Closure Process……………………………………………. 1-7
1.1.2.1 Hemostasis ………………………………………………. 1-7
1.1.2.2 Inflammation……………………………………………… 1-9
1.1.2.3 Proliferation …………………………………………….. 1-10
1.1.2.4 Remodeling Phase…………………………………… 1-11
1.2 Factors Affecting Wound Closure……………………………………………. 1-12
1.2.1 Intrinsic Factors……………………………………………………… 1-14
1.2.1.1 Age and Chronic Illness ……………………………. 1-14
1.2.1.2 Body Composition ……………………………………. 1-15
1.2.1.3 Nutritional Status……………………………………… 1-15
1.2.2 Extrinsic Factors…………………………………………………….. 1-16
1.2.2.1 Ambient Temperature……………………………….. 1-16
1.2.2.2 Desiccation/Hydration ………………………………. 1-16
1.2.2.3 Infection………………………………………………….. 1-17
1.2.2.4 Maceration ……………………………………………… 1-17
1.2.2.5 Medication and Other Treatment Modalities…. 1-17
1.2.2.6 Necrotic Tissue and Debris ……………………….. 1-18
1.2.2.7 Oxygen…………………………………………………… 1-18
1.2.2.8 Stress …………………………………………………….. 1-18
1.2.2.9 Wound Creation and Depth……………………….. 1-19
1.2.2.10 Wound Closure Techniques ………………………. 1-19
1.2.2.11 Other Extrinsic Factors……………………………… 1-20
1.2.3 Complications of Wound Healing ……………………………… 1-20
1.2.3.1 Scarring………………………………………………….. 1-20
1.2.3.2 Bleeding …………………………………………………. 1-21
1.3 Wound Types ………………………………………………………………………. 1-21
1.3.1 Illness-Related Wounds…………………………………………… 1-21
1.3.1.1 Etiology ………………………………………………….. 1-21
1.3.1.1.1 Arterial Ulcers ………………………. 1-23
1.3.1.1.2 Diabetic Ulcers……………………… 1-23
1.3.1.1.3 Venous Ulcers ……………………… 1-24
1.3.1.2 Epidemiology…………………………………………… 1-25
1.3.2 Pressure Ulcers……………………………………………………… 1-25
1.3.2.1 Etiology ………………………………………………….. 1-25
1.3.2.2 Epidemiology…………………………………………… 1-27
1.3.3 Surgical Wounds ……………………………………………………. 1-27
1.3.3.1 Etiology ………………………………………………….. 1-29
1.3.3.2 Epidemiology…………………………………………… 1-31
1.3.4 Traumatic Wounds …………………………………………………. 1-31
1.3.4.1 Etiology ………………………………………………….. 1-31
1.3.4.1.1 Abrasions, Contusions,
and Lacerations ……………………. 1-31
1.3.4.1.2 Amputations…………………………. 1-35
1.3.4.1.3 Burns ………………………………….. 1-35
1.3.4.2 Epidemiology…………………………………………… 1-39
Exhibit 1-1: Layers and Supporting Structures of Human Skin……………………….. 1-3
Exhibit 1-2: Phases of the Wound Closure Process……………………………………… 1-8
Exhibit 1-3: Intrinsic and Extrinsic Factors Affecting Wound Closure …………….. 1-13
Exhibit 1-4: Illness-Related Wounds, Facts and Figures,
1996-2006, and 2009 ……………………………………………………………. 1-22
Exhibit 1-5: Pressure Ulcers, Facts and Figures, 1996-2006, and 2009 ………… 1-26
Exhibit 1-6: Stages of Pressure Ulcers……………………………………………………… 1-28
Exhibit 1-7: Surgical Wounds, Facts and Figures, 1996-2006, and 2009……….. 1-30
Exhibit 1-8: Lacerations and Other Types of Traumatic Wounds,
Facts and Figures, 1996-2006, and 2009…………………………………. 1-32
Exhibit 1-9: Amputations, Facts and Figures, 1996-2006, and 2009……………… 1-33
Exhibit 1-10: Burns, Facts and Figures, 1996-2006, and 2009 ………………………. 1-34
Exhibit 1-11: Classification of Burns, by Mechanism of Injury ………………………… 1-36
Exhibit 1-12: Classification of Burns, by Extent of Injury ……………………………….. 1-38
2. COMPRESSION THERAPY PRODUCTS …………………………………………… 2-1
2.1 Passive Compression Devices …………………………………………………. 2-1
2.1.1 Compression Bandages ……………………………………………. 2-2
2.1.1.1 Inelastic Bandages …………………………………….. 2-2
2.1.1.2 Elastic Bandages……………………………………….. 2-2
2.1.1.3 Market Forecast ………………………………………… 2-4
2.1.1.4 Competitive Analysis ………………………………….. 2-7
2.1.2 Compression Stockings…………………………………………….. 2-9
2.1.2.1 Market Forecast ………………………………………. 2-11
2.1.2.2 Competitive Analysis ………………………………… 2-17
2.2 Pneumatic Compression Devices……………………………………………. 2-19
2.2.1 Foot Pumps, Intermittent Pneumatic Compression
Pumps, and Sequential Compression Pumps …………….. 2-19
2.2.1.1 Market Forecast ………………………………………. 2-22
2.2.1.2 Competitive Analysis ………………………………… 2-23
2.3 Combined Market Analysis…………………………………………………….. 2-27
Exhibit 2-1: Thomas Compression Bandage Classification System ………………… 2-3
Exhibit 2-2: 2013, Selected Compression Bandages ……………………………………. 2-5
Exhibit 2-3: Compression Bandages, Market Forecast, 2011-2016 ………………… 2-8
Exhibit 2-4: 2011, Compression Bandages Market, Share by Supplier………….. 2-10
Exhibit 2-5: 2013, Selected Compression Stockings…………………………………… 2-12
Exhibit 2-6: Compression Stockings, Market Forecast, 2011-2016……………….. 2-16
Exhibit 2-7: 2011, Compression Stockings Market, Share by Supplier…………… 2-18
Exhibit 2-8: 2013, Selected Pneumatic Compression Therapy Systems………… 2-20
Exhibit 2-9: Pneumatic Compression Therapy Systems, Market Forecast,
2011-2016 …………………………………………………………………………… 2-24
Exhibit 2-10: 2011, Pneumatic Compression Therapy Systems Market,
Share by Supplier…………………………………………………………………. 2-25
Exhibit 2-11: Compression Therapy Products, Combined Market Forecast,
2011-2016 …………………………………………………………………………… 2-28
3. PRESSURE REDUCTION AND RELIEF PRODUCTS………………………….. 3-1
3.1 Ideal Support Surface Characteristics ……………………………………….. 3-2
3.2 Specialty/Integrated Beds………………………………………………………… 3-4
3.2.1 Air-Fluidized Beds ……………………………………………………. 3-5
3.2.2 Low Air-Loss Beds …………………………………………………… 3-5
3.2.3 Market Forecast ………………………………………………………. 3-7
3.2.4 Competitive Analysis ………………………………………………… 3-8
3.3 Mattress Replacements…………………………………………………………. 3-11
3.3.1 Market Forecast …………………………………………………….. 3-11
3.3.2 Competitive Analysis ………………………………………………. 3-14
3.4 Mattress Overlays…………………………………………………………………. 3-16
3.4.1 Market Forecast …………………………………………………….. 3-19
3.4.2 Competitive Analysis ………………………………………………. 3-19
3.5 Combined Market Analysis…………………………………………………….. 3-22
Exhibit 3-1: 2013, Selected Specialty/Integrated Beds………………………………….. 3-6
Exhibit 3-2: Specialty/Integrated Beds, Market Forecast, 2011-2016………………. 3-9
Exhibit 3-3: 2011, Specialty/Integrated Beds Market, Share by Supplier ……….. 3-10
Exhibit 3-4: 2013, Selected Mattress Replacements…………………………………… 3-12
Exhibit 3-5: Mattress Replacements, Market Forecast, 2011-2016……………….. 3-15
Exhibit 3-6: 2011, Mattress Replacements Market, Share by Supplier…………… 3-17
Exhibit 3-7: 2013, Selected Mattress Overlays…………………………………………… 3-20
Exhibit 3-8: Mattress Overlays, Market Forecast, 2011-2016……………………….. 3-21
Exhibit 3-9: 2011, Mattress Overlays Market, Share by Supplier ………………….. 3-23
Exhibit 3-10: Pressure Reduction and Relief Products,
Combined Market Forecast, 2011-2016 …………………………………… 3-24
4. COMPANY PROFILES…………………………………………………………………….. 4-1
4.1 ArjoHuntleigh/Getinge Group AB………………………………………………. 4-1
4.2 BSN medical, Inc……………………………………………………………………. 4-2
4.3 Hill-Rom Company, Inc./Hill-Rom Holdings, Inc. …………………………. 4-2
4.4 Kendall/Covidien LTD……………………………………………………………… 4-3
4.5 medi USA LP/medi GmbH & Co. KG…………………………………………. 4-4
4.6 ROHO Group, Inc…………………………………………………………………… 4-4
4.7 Smith & Nephew PLC……………………………………………………………… 4-5
APPENDIX: COMPANY LISTING……………………………………………………………… A-1