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The market for nonwoven medical dressings, sponges and bandages.

consultant Donald Patience looks at nonwovens potential in several medical sponge and dressing markets; segments offer substantial growth opportunity for nonwovens

One of the medical markets least penetrated by nonwovens with good growth potential is dressings, sponges and bandages. Today, this market is dominated by woven cotton gauze in several thread counts and yarn sizes that comply with U.S. or European Pharmacopeia standards for construction and purity.

This mature, slow growing market utilizes more than 750 million square yards of fabric valued as finished product in excess of $400 million. Nonwoven penetration was estimated in 1990 to be approximately 10% of the total hospital, alternate site and consumer markets. This relatively low penetration has been due to the following reasons, which can differ by supplier:

- Lack of fabrics with satisfactory physical and aesthetic attributes.

- Perceived insufficient profit motivation by a few major suppliers to develop suitable nonwovens and production capability (not the case with all suppliers).

- Protection of woven textile investments and capital intensive facilities (by some suppliers).

- The difficulty in changing medical professionals' habit of using woven textile products. Doctors and nurses have developed procedures and techniques for using woven gauze products and tend to be reluctant to change if there are no significant perceived cost or performance advantages to the new nonwoven materials.

There are four significant suppliers of nonwoven medical dressings, sponges and bandages in the U.S. They are Johnson & Johnson, Kendall Healthcare, Baxter Hospital Supply and Professional Medical Products. These medical nonwoven products include general use sponges, dressing, drain, IV, laparotomy sponges and conforming bandages.

Nonwovens have achieved major market shares in the large surgical packs and gowns and CSR wrap markets. They are also important in wipes, shoe and head coverings and masks. Significant penetration has not yet been achieved against the traditional woven gauze general purpose and operating room sponges, although nonwoven general purpose and specialty sponges have shown volume increases in recent years.

Hospital market estimates for the various brands, sizes and put-ups of general purpose and specialty nonwoven sponges have shown a relatively steady market that began to signal a growth increase in 1989 and 1990.

There is currently only one operating room nonwoven sponge in the market and although this laparotomy pad has been sold for many years, it has not yet achieved penetration of significance. When the nonwoven pad was introduced to the hospital market, it was made with a rayon nonwoven that was apertured using a process that was a predecessor of spunlacing and used low velocity water jets and a pattern screen with considerable chemical binder applied to the fabric to provide adequate wet strength.

Once again, the difficulty of competing with woven textiles is apparent in the failure of this long time nonwoven entry into the operating room sponge market to obtain a significant share position. Product and fabric design are critical for operating room products and present opportunities for innovation and development.

Where Nonwovens Potential Lies

The products with major potential to be converted to nonwovens are general purpose gauze sponges used for most wound cleaning and dressing requirements. This hospital market consists of gauze sponges varying in size from 4x4 inches to 3x3 inches and 2x2 inches and using 8, 12 and 16 ply of U.S.R Type VII cotton gauze.

Nonwoven general use sponges are made in the same gauze sponge sizes but only in three and four ply. These rayon/polyester spunlaced fabric sponges are purported to have better strength, absorbency and scrubbing texture than gauze sponges with less linting and improved wound release characteristics.

Specialty nonwoven dressings include those designed specifically for wounds with drains or IV sites and wounds requiring high absorbency and fast wicking. These sponges are available in 4x4, 4x3 and 2x2 inches, six ply and prepackaged sterile.

The operating room sponge market is still essentially a woven gauze business. All sponges used in the O.R. contain an x-ray detectable element in case a sponge or pad is inadvertently left in a body cavity and must be located by taking an x-ray. Sponge sizes are 4x4 and 4x8 inches in 12, 16 and 24 ply of U.S.P. Type VII cotton gauze. Larger sponges are called laparotomy pads or sponges and are normally 12x12, 18x18, 18x4 and 36x8 inches of four ply U.S.P. gauze.

The hospital bandage roll market is also a gauze business with only a few share points in nonwoven products. This woven bandage roll market consists of the six ply gauze "Kerlix" bandage and the two ply slack mercerized "Kling" products.

Spunlaced nonwovens provide "textile-like hand" and have physical attributes that produce a "gauze-like" fabric. These characteristics have made it the most utilized nonwoven process for general purpose sponges, dressings and bandages to date.

However, the position of spunlaced does not preclude the use of other fabrics currently available or yet to be developed. The successful use of the spunlaced process requires significant capital investment, technology and operating skill. In the U.S., Du Pont, Chicopee and Veratec practice a mix of high and medium energy entanglement processes and are the major suppliers, although not the only companies with spunlaced ability.

The most commonly used fibers are staple polyester and rayon in the form of an unbonded web. The staple fiber normally ranges in denier from 1.2-1.5 and has a length of 0.8-1.5 inches. Mixtures of the staple fibers for sponge and dressing products typically range from 50-70% rayon and 30-50% polyester and it is possible to entangle wet laid long fiber-containing webs, continuous filament webs, melt blown fabrics and blends of all three. Staple fibers can also be entangled with scrims, wovens, foams and wood pulp.

The properties of hydroentangled fabrics depend to a significant extent on the web formation and their forming mechanism. Ideally, the web former should be high speed and capable of producing a randomly oriented uniform structure. Patent literature describing typical web forming equipment shows a high speed rotor or lickerin that separates fibers from a feed mat then individualizes the fibers and delivers them into a high velocity air stream where the fibers are collected on a screen.

The design and pattern of the entangled fabric is determined by the screen that allows the water to be removed from the entangle site. Major screen design characteristics are the warp and fill diameters, weave pattern and the screen material. Most sponge and dressing nonwovens are entangled on open screens to form apertured fabrics that have some resemblance to plain woven cotton gauze. The degree of fiber entanglement is proportional to the energy utilized and is reflected in the tensile strength, surface integrity, elongation and initial fabric modulus. Most of the tensile strength is developed during the early phase of the entanglement treatment, while surface integrity and initial modulus reflect the final process steps. The energy distribution between the two sides of the web also affects the surface integrity.

Bandages, dressings and sponges made from spunlaced nonwovens strive to achieve two-sided entanglement to minimize differences in surface integrity characteristics and create a fabric that is as close to the two identical sides of plain weave cotton gauze as the spunlaced process is capable of delivering.

Hydroentangled fabrics made on high energy process equipment achieve high levels of entanglement with subsequent excellent functional strength and surface integrity. Other processes that operate at lower pressures and energy intensities may require small amounts of binder or surface bonding agent to achieve suitable strength, elongation and surface integrity for use as dressings, bandages and sponges.

The water intensive spunlaced process requires elaborate filtration systems to remove fiber finish and debris to permit the water to be recycled. Cellulosic fibers generate a relatively high amount of fiber debris while synthetic fibers do not. It has been purported that cotton fiber alone or blended with polyester would enhance the properties of dressing and bandage products. Numerous nonwoven samples of cotton and cotton/polyester blends have been made but these blends have not yet been made available in the sponge products market.

To date, rayon has been used universally in blends with polyester and this combination of synthetic fibers results in an aesthetically pleasing product that is uniform in appearance, smooth in texture and more easily processed than natural fiber. The added difficulty of processing cotton due to the length variability and increased debris could be offset by the more stable sourcing and cost of cotton versus rayon and the desirable physical properties of cotton that include increased wet strength, resiliency and hand. These attributes tend to impart to the nonwoven fabric characteristics that are closer to the natural fiber cotton gauze.

Although spunlaced fabrics without binder are preferred to other types for use as dressings and sponges, there continues to be yardage of apertured rayon fabrics used as the outer layer of "Topper," "Cover" and other cellulose wadding and rayon filled sponges, combine dressings and abdominal pads. This apertured fabric has been used for years on filled sponges and absorbent sponges and pads. The hydroformed apertured nonwovens required considerable chemical binder to provide functional strength and stability and thus trade off wet strength, hand and texture.

Although nonwoven dressings have been available for many years, the development of the spunlaced fabrics has provided a nonwoven fabric of suitable technical characteristics to challenge woven gauze. The competition between woven and nonwoven fabrics will continue for these major medical markets.


The Nonwovens Handbook, B.M. Lichstein, editor; INDA 1988 M. Tauri: "The Outlook For Spunlaced Nonwovens," NONWOVENS INDUSTRY, November, 1988 A. Watzl: "New Machinery Concepts For Spunlaced Nonwovens," INB Nonwovens, January 1990

About the author:

Donald Patience is a consultant in the medical device field, based in Wilmington, NC. He has been an R&D director in the woven and nonwoven dressings market for more than 40 years. The above information is taken from a special "Profiles" report on the prospects for nonwoven sponges and dressings completed in cooperation with John R. Starr, Inc.

The study quantifies the segment's growth and provides updated forecasts through the mid-late 1990's, broken down by type of sponge, bandage or dressing, market segment/distribution channel and type of nonwoven fabric. The report is available for $2000 from John R. Starr, Inc., P.O. Box 649, Osterville, MA 02655; (508)428-0070.
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Author:Patience, Donald
Publication:Nonwovens Industry
Date:Aug 1, 1992
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