The Medical Market: Charting Progress

June 14, 2005

manufacturers seek balance of protection and comfort

During the past three or four decades, the medical market has seen a steady conversion from reusable products to disposable goods. While this trend has historically been most evident in the U.S. market, technological benefits, as well as rising concerns over healthcare costs, have more recently expanded the use of disposables in foreign markets such as Europe and Asia.

As this market continues to mature, the next challenge for disposable medical goods will be to improve breathability, wearer comfort and increased barrier resistance. Manufacturers of these goods, in partnerships with their nonwovens suppliers, have made strides in these areas in recent years, redefining what the word disposable means when it comes to the medical market.

Our suppliers are definitely spending significant resources on developing new materials for the medical market, explained Jim Stauner, president of periooperative products and services at Chicago-based drape and gown manufacturer Cardinal Healthcare. The result has been new and improved products.

As nonwovens growth in medical applications continues to level off across the globe, manufacturers will become more reliant on innovation to fuel their individual growth. DuPont Nonwovens, Wilmington, DE, for one, this year made a huge splash in the medical market with the introduction of its Advanced Composite Technology, which combines the properties of polyester and polypropylene into one material. With its long history of participation in the medical segment, DuPont is hoping this new, patent-protected technology will complement its Softesse spunlaced material and its Acturel laminate material, which is already well penetrated into the medical market. While DuPonts development was one of the years sexiest medical market introductionsat least on the nonwovens side of the businessmost roll goods producers doing business in this segment have upped their offerings this year, to increase their share of this critical market.

The medical market is a business with a wide variety of products, explained Bob Dale, vice president of medical sales for PGI Nonwovens, N. Charleston, SC. There are commodity products for unsophisticated applications, and there are high-tech fabrics for highly specialized applications. This makes it a unique market in the nonwovens industry.

Disposing Of Costs

The majority of surgical gowns used in the U.S. are single-use.
Using disposables in the medical market has proven to be less costly than reusables, according to industry estimates. The high cost of reusable gowns and drapes made from traditional textiles, coupled with the expense of laundering and stocking them, as well as their tendency to wear out or disappear quickly, makes their costs outweigh their benefits, chief among which are patient and worker comfort.

This cost benefits of disposable gowns has long been recognized in the U.S., where nearly 90% of all medical apparel is single use, but has only recently become well recognized globally. This has much to do with the squeezing of health care costs brought on by insurance companies and other agency initiatives.

Disposable products can provide a cost advantage versus the labor, inventory and management costs of reusables, explained Paul Marold, vice president and general manager of medical products for Ahlstrom FiberComposites. Most importantly, advancements in nonwovens technologies during the past two years have allowed medical companies to upgrade the performance of their products without sacrificing comfort and cost-performance ratios.

Ahlstrom recently announced initiatives to streamline its medical operations, particularly on the converting side in Europe where it is closing its medical products, converting department in Sweden. Instead, the company will serve its European medical operations from a distribution center in central Europe, and all converting operations will be housed in Windsor Locks, CT. These initiatives were designed to leverage global production to keep costs as low as possible.

Companies quest to minimize costs has come at time when demand for innovation is at an all-time high. Increased awareness of infectious diseases, most notably Sudden Acute Respiratory Syndrome, (SARS) has brought concerns for worker protection to an all time high. Gown and drape manufacturers have responded to these concerns with value-added products.

Cardinal Healthcare launched a surgical drape fabric called Tiburon in March. This microfiber composite contains three fabric layers: an absorbent fluid-control layer, an impermeable membrane and a patient comfort layer. These layers outperform competitive technologies in a wide range of industry tests including puncture resistance, strength and absorbency. Cardinal executives said this technology was created in response to widespread reports highlighting the risk of hospital-acquired infections. More than 103,0000 deaths were linked to hospital-acquired diseases in 2003, and 75,000 of these were preventable. This problem costs the industry an estimated $3 billion annually.

The antibacterial benefits are a way that we are helping our customers limit infection, Cardinals Mr. Stauner explained. You will continue to see more work on how they are reducing these infections. We will never be able to eliminate this problem entirely but we will do the best we can.

Safe . . . Yet Comfortable

A number of gown styles are penetrating the medical market offering various levels of barrier resistance. Standard spunlaced gowns tend to best mimic the comfort and softness of reusable textiles and are widely used in applications where the spread of infection is not a major concern. For more invasive procedures, there are spunmelt gowns which are less comfortable but offer more infection resistance than spunlace. For extremely hazardous situations, users favor microporous film gowns. In some applications the discomfort of these gowns is alleviated with the addition of a nonwoven outercovering, but in most cases comfort is sacrificed for protection in these garments.

There has traditionally been a chasm between comfortable garments and protective garments. DuPont Nonwovens is currently addressing this issue with its new Suprel material for medical garments. Made from a proprietary composite technology, Suprel is made by combining multiple polymers in a variety of structures. In the medical market, Suprel taps the strength of polyester and softness of polyethylene in surgical gowns and patient drapes. It not only meets the high standards for protection in operating rooms but also has a smooth, silky texture, enabling freedom of movement and comfort to patients and healthcare workers.

Normally when there are moderate to high fluid risks in a procedure, healthcare workers use film reinforcement to protect them, said Lori Gettelfinger of DuPont. These gowns and polypropylene SMS gowns are not as comfortable as non-reinforced spunlace gowns. Suprel is eliminating that compromise by offering higher protection in a single layer of fabric.

Suprel was created using the input of operating room nurses who participated in comfort studies conducted at North Carolina State University, Raleigh, NC. This new technology has allowed DuPont Medical Fabrics to make a product with a high level of protection and uncompromising comfort. It has less surface friction than competitive products and transfers heat away from the body quickly.

Patient comfort is a primary concern in the medical market.
One of DuPonts core customers in the medical market, Medline Industries, already has announced plans to launch a gown using Suprel later this year. Chicago-based Medlines new Aurora gown adds to its disposable portfolio, which is designed to cater to a full spectrum of clinicians needs in the medical market. There is innovation in surgery all of the time, explained Frank Czajka, senior product manager of Medlines Proxima disposable gown business.

The Proxima line currently includes a standard spunlaced gown, Sirus, which is made of a spunmelt material, and Prevention, made from a breathable microporous film, that meets ASTM-1671 standards for biotransmission standards. Among the benefits of nonwoven gowns, opposed to textiles or films, is the materials ability to be configured to meet the needs of different types of surgery, including the addition of fluid management pouches or other ease of use features.

PGI is also striving to combine comfort and protection in medical gowns. Next year, the company will launch a spunmelt fabric that combines its Supersoft spunbond technology (featuring high tactile properties) with fine fiber meltblown materials.

Also well aware of the need for choice in the medical market is Ahlstrom. In the past year, Ahlstrom has launched an assortment of products from its Windsor Locks, CT composites facility. The company has used a diverse set of substrates and films to create products with a variety of properties that respond to increased consumer demands for protection, comfort and cost containment. The most successful of these products is an impervious, absorbent drape fabric whose sales are growing substantially throughout the globe and a viral barrier gown fabric that has gained a high level of interest in Asia and Canada where there has been concerns over a resurgence of SARS.

The marketplace is changing rapidly and we as manufacturers need to have the flexibility to change with it, Ahlstroms Mr. Marold explained. I think some of the existing technologies will have to be reinvented in order to continue to effectively use our assets, but the gain will be with the innovators.

While change is constantly a defining factor in the medical marketplace, having a specific product performance trait can be critical to a products success on this market. This has been the case with Nashville-based BBA Fiberwebs Securon spunmelt fabric, which is applied to gowns, drapes and wraps. This product is highly resistant to fluids, one of the fundamental requirements in medical garb. Our customers are constantly looking for improved fabric performance when it comes to fluid resistance, and this is something we are constantly looking for, remarked David Price, vice president of sales and marketing for BBA Fiberweb, the Americas.

The medical market is also key for Advanced Fabrics, Al-Ahsa, Saudi Arabia, because it falls into the companys mission of targeting areas where it can add value. The companys spunmelt material, which contains three layers of spunbond and two meltblown layers, is treated with proprietary technology to create the Medilon surgical gown. Executives said this product has the higher barrier resistance while keeping much of the comfort levels inherent in less protective materials.

There has been a lot of competition between spunbond and spunmelt in the medical market, explained Ian Disley of Advanced Fabrics. Spunlace has been successful in mimicking the comfort properties and aesthetic properties of textiles but spunmelt offers more barrier resistance.

Beyond Apparel

The use of disposables is gaining ground in other areas of the medical market. Recognizing the labor expenses associated with reusable textiles, health care facilities are becoming more interested in disposable materials, whether the application is patient care, cleaning and maintenance or worker protection, this is giving nonwovens an expanded role in medical applications.

Arizant Healthcare, a provider of surgical accessories based in Eden Prairie, MN, recently filled a niche for disposable surgical warming blankets in the medical market. Sold under the Bair Paws brand name, the single use gowns contain built in temperature control, eliminating the need for an extra blanket. The gowns are made from DuPonts Softess spunlaced materials. By eliminating the need for nurses to continuously apply warmed blankets to patients as they await surgery, significant time and cost savings are reaped. Under normal conditions, a patient generally goes through nine blankets per surgery, at a total cost of $9.75. While the disposable Bair Paws blanket is somewhat more expensive than the reusable method, it eliminates labor costs associated with reapplying blankets. A lot of clinicians are really praising this product, saying that it is filling an unmet need in the market, explained Julie Wick-Powell, senior product manager of Bair Paws.

According to Ms. Wick-Powell, Arizant used Softesse for the product because its opacity provides patient privacy and its softness allows greater comfort. We are always looking to meet the needs of our customers, she added. It has just made sense for us to expand into this area.

Also in the nonwovens arena, Arizant manufactures Bair Hugger warming blankets, which feature spunbonded materials. These products are used to warm patients in clinical environments and play a hand in preventing hypothermia.

Another medical area in which nonwovens are charting growth is wound care. Rayon/polyester nonwovens provide more absorption and lower costs than traditional cotton scrim products. Medline has been relying on nonwovens to ramp up its wound care line following former supplier Johnson & Johnsons decision to exit this market earlier this year. Avant Deluxe, launched this summer, is a rayon-and-polyester nonwoven material that provides strength and absorbency. The increased material weight increases efficiencies by reducing the number of sponges used in each procedure. In these applications, nonwovens provide increased wicking ability and less linting than in traditional woven sponges. Also recently added to Medlines range is Accu Sorb, a cotton-and-polyester blended gauze that combines the breathability of cotton with the absorbency of polyester.

There is a lot of potential for nonwovens in this market because of its high absorbency and its low linting, explained Michael Tymkiw, president of traditional woundcare for Medline Industries. It is definitely filling a critical need in healthcare.

However, the makeup of synthetic materials such as rayon and polyester prohibit its use in wound packaging. The synthetic fibers can promote bodily allergies. Despite this, growth of nonwoven-based woundcare products are outpacing cotton scrim products by nearly two to one, according to industry estimates.

Meanwhile, the use of medical wipes, while not as prolific, as in some other markets, continues to expand in healthcare. During the past three years, we have developed a surge of products for the medical market, said Ron Pontolilo, director of contract manufacturing sales for the Triad Group, Brookline, WI. Providers are starting to realize the time and cost savings associated with these devices.

In this segment, infection control is also playing a role as disposing with materials after cleaning reduces the opportunity for infections for the both the staff and the patients. These factors have contributed to bring Triads growth in medical to more than 20% in recent years. Its been an easy sell, Mr. Pontolilo admitted. This is a market that is well aware of costs, mostly in finished materials.

As technology advances, disposable medical applications will certainly continue to increase their share in the U.S. textile industry. Reusables will always have their niches but as nonwovens continue to increase the bar, they will keep taking share. This is because nonwovens enable the manufacturer to add more bells and whistles to their products such as fluid management pouches, varying configurations and ease of use features.

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