Nonwovens: On the Front Lines in the Fight for Safe Healthcare

By Tim Wright, Editor | August 7, 2013

Healthcare trends offer opportunities for disposable nonwoven products.

With the improving quality of healthcare in Asian countries along with aging demographics around the world and HAI prevention in full swing, the medical nonwovens market is poised for positive growth in the years ahead.

According to data from INDA, Association of the Nonwoven Fabrics Industry, the global medical nonwovens market in 2012 consumed 355,000 tons, with 170,000 in North America, 116,000 in Asia and 69,000 in Europe. In terms of dollars in North America for 2012 the medical nonwoven roll goods market was valued at $755 million. In tonnage, the medical nonwovens market represents 8.9% of the North American market, making it the fourth largest segment.

The market is dominated by surgical gowns and drapes. In North America alone, disposable surgical gowns, operating room drapes and their pack parts account for 80% of the medical nonwoven category the INDA data says. The remaining categories include: other apparel—scrub suits, caps, masks, shoe covers, patient apparel and isolation gowns—at 8%; sterile packaging—CSR sterilization wrap—at 7%; and wound care—sponges, tapes, non-adherent dressings and pads—at 5%.

Asia and Eastern Europe drive global growth

Over the next several years, positive developments in the Asia-Pacific health care system should provide a lot of opportunity for growth. “By 2017, Asia-Pacific will continue to grow faster (+9.7% annually) than North America and Europe,” says Brad Kalil, director of market research and statistics, INDA. “Therefore, despite a potential slowdown in North American sales to the medical sector, INDA and EDANA expect a continuous overall increase in the medical nonwovens segment, with annual growth rate of 6.5% through 2017.”

Conversely to Asia, the North American market for medical nonwovens is maturing and growth is slowing. “A high proportion of surgical apparel and drapes in Mexico and Canada are reusable products, which would appear to be a potential area for growth, but market penetration, particularly by disposable apparel has been slow in both countries,” says Kalil. “We do not expect this to change in the near term.”

Likewise, the U.S. market for nonwoven gowns and drapes is at maturity, with high penetration, thus there is little opportunity for growth. “Surgical drapes are used in about 90-95% of all major surgical procedures within the U.S., and nonwoven surgical gowns have a captive share, in the high 80% range of the market,” says Kalil. “We expect the U.S. medical nonwovens market will grow in the 2.5% range, keeping pace with an aging population and major surgical procedures, in addition to the potential for innovation through customized procedure trays.”

Europe, on the other hand, shows potential in penetration rate of medical nonwovens. “New European standards and regulations including EN 13795:2011 together with an increased focus on infection prevention, demographic changes and surgical procedures drive the changes towards use of single-use medical nonwovens,” says Kalil.

Within Western Europe, penetration rates for single-use nonwoven surgical drapes are currently estimated in the 60-70% range while gowns are in the 50-60% range, though large differences occur between countries. The growth potential lie in the Central, Southern and Eastern European markets, according to Kalil.

In China single-use medical nonwoven products are rarely used, while conventional textiles are favored, though hospitals tend to be meticulous clean. Because of the lack of health insurance, patient’s families are responsible for providing healthcare needs such as clothing and food to care for family members while in the hospital.

In India, the production and use of single-use medical nonwovens is slowly increasing, but there is limited knowledge of their benefits. Like in China, family members are responsible for providing necessary equipment while in the hospital. Specific self-service medical device shops have opened where patients and family members can buy the utensils and products used for operations including drapes and gowns.

HAI Prevention in Full Swing

In addition to aging demographics where currently the generation that is 65 and older is increasing 2-3 times faster than any other age group, the key growth drivers for medical nonwovens are infection prevention and healthcare economics.

“In developed countries aging populations will require more healthcare visits and surgeries. In addition, the elderly have declining immune systems making them more susceptible to HAIs and treating HAIs adds immensely to healthcare costs, which are currently estimated at $26-33 billion annually in the U.S.,” says Kalil. “As part of the Patient Protection and Affordable Care Act, Medicare/Medicaid may not cover HAIs making the healthcare provider responsible and thus more vested in their prevention. That and a greater societal awareness and concern with ‘germs’ lead to more hygienic healthcare procedures and therefore an increase in medical nonwovens and cleaning wipes. As the awareness of the importance of hygiene in healthcare facilities and operating rooms continues to increase through education and communication the acceptance and usage of medical nonwovens should increase.”

The European Centre for Disease Prevention and Control (ECDC) has published a report that shows the critical need for single-use medical nonwovens in effective infection control.

EDANA, the association representing the nonwovens and related industries, through its Medical Devices Committee, welcomed the survey titlet, “Healthcare associated infections and antimicrobial use in European acute care hospitals,” in an effort to raise understanding and awareness of the impact and cost to both the patient and healthcare professionals for HCAIs.

The survey, conducted in more than 1,000 hospitals in 30 European countries, provides the most comprehensive database on healthcare-associated infections and antimicrobial use in European acute care hospitals to date.

The report says that any given day, about 80,000 patients—or 1 in 18 patients—in European hospitals have at least one healthcare-associated infection. The most common types of such infections are respiratory tract infections, surgical site infections, urinary tract infections and bloodstream infections. In addition, at least one in three patients, receive at least one antimicrobial agent on any given day in European hospitals.

Based on the survey results, the ECDC has made recommendations that should be further developed and implemented across Europe. These recommendations include increasing the skills for surveillance of healthcare-associated infections and antimicrobial use; and raising awareness of HCAIs among healthcare workers across the EU.

“Experience has shown that in surgery single-use surgical barrier materials—surgical gloves, gowns, drapes, and masks—are a key factor to prevent transfer of micro-organisms,” says Pierre Wiertz, general manager of EDANA.

Although in Europe the market penetration of single-use gowns and drapes has reached on average 60 to 65% taking into account geographical differences, this is still significantly lower than in the U.S. EDANA says.

“The mission of EDANA’s MEDECO (medical devices committee) is therefore to promote the benefits of single-use nonwovens products to decision makers, influencers and end-users in surgery, wound management and infection control,” says Wiertz.

Fiber Technology to Limit HAIs

A development-stage company is offering a proven antimicrobial technology to make surgical privacy curtains bacteria resistant, cutting down on hospital acquired infections, a problem that is responsible for 100,000 deaths per year in the U.S. alone. This technology, intrinsic to the fiber, has been developed by PurThread, a Durham, N.C. company founded by former head of Foss Manufacturing, Steve Foss. Beyond medical applications, the technology has potential in consumer, military and industrial applications.

A recent study proved the efficacy of the technology and was published in the journal, Infection Control and Hospital Epidemiology. This first-of-its-kind study was conducted by the University of Iowa Carver College of Medicine. It found that standard control curtains were eight times more likely to be contaminated with the superbug vancomycin resistant enterrococus (VRE) than experimental PurThread privacy curtains, which only had one positive VRE culture during the entire study. Additionally, the median time to first contamination of PurThread curtains took seven times longer than control curtains. On average it took only two days for control curtains to become contaminated with potentially pathogenic bacteria, while PurThread curtains withstood contamination an average of 14 days.

“From the beginning, our goal was not just to come up with another attempt at a palpable treatment but instead to develop something that is intrinsic to the fibers,” says Bill O’Neill, vice president of clinical operations, PurThread. “Whatever the product is, we want to develop a long-term solution.”

In total the University of Iowa study evaluated the privacy curtains in 30 rooms that admitted many patients with active infections (21 surgical intensive care units (ICU) rooms and nine medical ICUs). Fifteen rooms were randomly selected to have a new, standard curtain installed, while the remainder were fitted with experimental PurThread curtains, identical in look and feel.  All 30 curtains were swabbed to collect samples for culturing twice a week for four weeks.

“The study demonstrates PurThread’s commitment to the highest standards of scientific rigour and clinical integrity as it develops this promising new technology,” says Kathryn Bowsher, vice president of clinical and regulatory strategy at PurThread Technologies. “The contamination variation, in this study, between PurThread experimental curtains and control curtains shows the antimicrobial materials being developed by PurThread can have a measurable and meaningful impact in a clinical setting. The scientific literature shows that a cleaner patient environment contributes to a reduction in the transmission of healthcare associated pathogens, and this study strengthens our efforts to develop medical textiles that reduce bioburden contamination and contribute to a more hygienic patient environment.

Freudenberg Offers Cutting Edge Technology

Freudenberg has been a pioneer in the development of nonwoven products for medical applications—starting with Ostomy filters as early as the 70s. In addition, Vilmed nonwovens were the first nonwovens used to replace wovens for wound pads. Today, the company continues to be an innovative leader and has joined forces to deliver with its strategic partner JVC (Japan Vilene Company) cutting edge technology.

“The medical industry is a field of high strategic importance to the Freudenberg Group and in particular Freudenberg Nonwovens,” says Henk Randau, general manager, industrial nonwovens North America.

The company develops unique nonwoven solutions for Transdermal Delivery Systems, Advanced Wound Care, Active Wound Care and Ostomy applications. Recently the success of hydroactive nonwovens has proven the importance of cutting edge nonwovens technology for the wound care industry.

“The market for medical devices is steadily growing,” says Randau. “The growth rates of segments like Traditional Wound Care, Advanced Wound Care and Stoma are showing moderate but also very stable growth rates over the years. The business with Transdermal Delivery Systems is growing strongly as the benefits of this technology, which originates in Japan, are spreading to the U.S. and Europe. However budget cuts and general cost pressures in the European healthcare sector are a challenge for the industry to come up with cost effective solutions. Customers in emerging countries ask for cost effective solutions, which provide good performance while in the U.S. and Europe high performance is premium. There is also a trend towards more effective product solutions for complex indications such as chronic wounds, which help to reduce the total cost of treatment. We also see an increasing trend of self-treatment products.”

Moving forward meeting regulatory requirements and receiving approval by authorities like the FDA will be the biggest challenges, according to Randau. “We will continue to strengthen our core business by being the preferred development partner for key projects of our customers,” he says. “Creating platform technologies for the Advanced Wound Care segment is a priority as is setting the foundation for future growth by investments, acquisitions and strategic alliances.”

As the market is mainly driven by an aging world population and increasing prosperity in emerging countries, Randau says it is vital to “continue to educate the end consumer by supplying knowledge that diverse indications need to be treated differently and with regard to what is the best approach.”

Freudenberg offers a full range of tailor-made nonwoven solutions for wound care—consumer, professional, advanced and active—Ostomy and Transdermal Patches. Its Vilmed nonwovens are characterized by biocompatible raw materials with various surface designs, which are soft and gentle to the skin.

Super Absorbent Solutions for Wound Care

Technical Absorbents Ltd. (TAL) has been conducting extensive promotion and educating the medical market about its core Super Absorbent Fibre (SAF) technology for a number of years. Primarily this has been aimed at the growing advanced wound care (moist) sector. It is focused on increasing the usage of SAF, based on the wide-ranging benefits it brings to product design and performance in such applications. As a result it is currently involved in a diverse range of projects along the supply chain from converters to end product manufacturers. 

Technical Absorbents is able to supply SAF – which can be tailored to suit specific requirements – and also SAF containing nonwovens, wovens, yarns and tapes.  Such a diverse product mix allows the company to provide exacting super absorbent solutions, and in some cases can simplify the product development process for customers.

“Technical Absorbents provides extremely high levels of innovation and product development expertise to the advanced wound care market with its SAF technology,” says Dave Hill, technical sales manager, Technical Absorbents. “Its basic functionality is its ability to absorb up to 200 times its own weight in water, and 60 times its own weight in saline, at an extremely fast absorption rate. Being a fiber-based superabsorbent technology, it can be precisely tailored into a diverse range of medical fabric formats that offer the potential for enhanced design and performance.”

Within wound care, SAF is the basis for soft, flexible wound care dressings. “These dressings which and retain wound exudates, creating the optimum environment to aid the healing process and prevent further bacterial growth,” says Hill. “It really is the essential basis for true absorbent media innovation within the medical sector. Product design is greatly improved using SAF-based absorbent media and affords significant benefits across both product manufacturing in terms of reduced conversion costs and simplification of product construction, leading to truly innovative design standards and performance.”

The company has noticed an increase in interest in its technology within the competitive medical nonwovens market, as manufacturers seek to launch the newest and most advanced products.

In terms of advanced moist wound care fabrics, manufacturers are looking to produce softer, more conformable materials that provide extremely high levels of exudates absorbency. Hill says SAF has an advantage here as its fibrous form means that it can be integrated extremely well with final fabric construction, without the need for containment systems. This allows for the creation of less bulky and compacted fabrics, yet still providing the necessary absorbency levels.

The wound care market in general definitely seems to be experiencing some growth, according to Hill. He says TAL also gets many enquiries about disposable garments and spill mats for operating rooms so these are obviously still experiencing growth.

“Moving forward, in terms of advanced wound care, the comfort and safety of the patient are keys in the development projects that TAL is involved in,” Hill says. “There is also an element of making products easier to apply and reducing the frequency of dressing changes required.”

Ahlstrom Expands Sterilization Range

Ahlstrom has introduced its expanded interleaved Sterile Barrier Systems (SBS) offering, Ahlstrom Reliance Tandem. This expansion introduces SMS (spunbond-meltblown-spunbond) technology into the company’s offering.

Ahlstrom’s sterile barrier systems are a trusted and an integral part of the central sterilization department in hospitals. Previously, the company’s interleaved offering consisted of crepe and wetlaid technologies. To help customers stay ahead, Ahlstrom now offers a complete interleaved portfolio with the introduction of SMS into its Ahlstrom Reliance Tandem portfolio. Ahlstrom Reliance Tandem uses its newest technology, SMS, in combination with its existing technologies to provide the optimal combination of sterile barrier system sheets for sequential wrapping.

Ahlstrom Reliance Tandem or interleaving is the concept of combining two layers of SBS sheets, each offering specialized performance for sequential wrapping. The two layers are used together to offer a high degree of flexibility in terms of performance, technology and cost for different applications.

In other news on the medical front, Ahlstrom inaugurated its new production facility in Longkou, Shandong Province, in eastern China. The plant is a joint venture together with Longkou Yulong Paper Co. Ltd., and produces medical papers used for sterilization wraps and masking tape base papers for the building industry in the Asian market.

“This joint venture in Longkou supports Ahlstrom’s growth strategy and strengthens our presence in Asia. Crepe paper used in the medical and building industries in Asia provides us interesting opportunities for growth in the area,” says Jan Lång, president and CEO.

The new plant in China is the result of a €21.9 million investment, of which €13.1 million was contributed by Ahlstrom, employs approximately 140 people and is located in the Zhu You Guan Industrial Park in Longkou.

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