Support surfaces: An unknown market ready to be tapped

Monday, April 30, 2007

The line graph for the support surfaces market should curve dramatically upward as huge numbers of geriatric patients flow into the long-term care and homecare environments over the next few decades. And while they'll be prone to a wide assortment of disease states, many will share the same co-morbidity: decubitus pressure ulcers.
Wound care market observers say HME providers should see demand for all sorts of related products soar as the number of patients with diabetes, incontinence, morbid obesity, COPD, osteoporosis, congestive heart failure, stroke and other chronic conditions swells. Ironically, one of the most critical products they will need is practically unknown to most in the general public: preventative and therapeutic support surfaces.
A recent report from the Washington, D.C.-based National Pressure Ulcer Advisory Panel estimates the national cost to treat pressure ulcers is currently between $1.6 billion and $6.8 billion annually and those amounts are expected to grow exponentially with the boomer wave.
"Given the rapidly increasing number of adults in the United States achieving elder status, effective prevention and care of pressure ulcers is imperative," the NPUAP report stated. "Pressure ulcer prevention and treatment has become an important health policy issue. Healthy People 2010, our government's plan for health policy, contains a goal to significantly reduce pressure ulcer incidence during this decade."
To help reach this goal, NPUAP is spearheading an initiative for standardizing guidelines for support surface testing. The objective is to develop uniform terminology, testing methods and reporting standards for support surfaces.
"Choosing from the many alternatives (of available support surfaces) is complicated by the lack of information about characteristics and the inconsistent manner in which this information is reported," the NPUAP reports. "A means to measure and compare support surface characteristics will facilitate the process."
Abbey Daniels, CEO of Coral Springs, Fla.-based SenTech Medical Systems, believes the initiative is a positive step for the support surfaces industry.
"It sets our future direction," she said. "I've always been a strong advocate for standardization--it eliminates the marketing fluff that only serves to confuse. It allows us to focus on more important issues, like tissue integrity and how the components of a support surface affect the tissue and wound."
Sizing up surfaces
Although the manufacturing sector hasn't produced a breakout innovation in several years, the support surfaces market still boasts a diverse and sophisticated array of preventative and therapeutic high-tech mattresses. They fall into three basic categories: mattress overlays, mattress replacement systems and complete bed systems.
Overlays go on top of an existing mattress, are up to five inches thick and can be filled with foam, air or gel. They are used primarily for Stage I or Stage II ulcers.
"If you have multiple Stage II wounds and overlays don't work, you then move into the mattress replacement group," said Maxine Rankin, a registered nurse and clinical training and reimbursement specialist for the Holliston, Mass.-based Invacare Supply Group.
The mattress replacement category usually consists of an 8-inch mattress that goes on a bedspring and is either low air loss or alternating pressure. The third category includes air-fluidized beds with ceramic glass beads in a Gore-Tex lining with an air pump that blows the beads around.
The technical knowledge required fto provide support surfaces may not be as high as respiratory or rehab, but it does mandate a certain amount of clinical training, product expertise and familiarity with the nature of wounds, Rankin said.
"The amount of knowledge needed depends on the product," she said. "Not much is needed for overlays, but mattress replacements have different levels of complexity--some are plug-and-run while others have individual air bladders that can get punctured. It is also essential to know how to fix the pumps on some systems."
Mattress sizes are stratified across various age groups and body types, from pediatric to geriatric to bariatric. As with other HME product segments, bariatric versions of support surfaces are now commonplace, Rankin said.
Holistic market approach
Last year SenTech Medical helped form a new consortium of support surface manufacturers under the name of Anodyne Medical Device. It includes Los Angeles-based Anatomic Concepts and Corona, Calif.-based AMF Support Surfaces.
Daniels serves as COO of the corporation and says its purpose is to approach the market in a way that hasn't been tried before.
"Historically, this is an industry made up of small independent niche companies who specialize in different areas, such as high-end power surfaces, gel and foam products," she said. "We want to bridge the gap across the little pods. No one has come up with a cohesive offering. We're looking at it from an engineering standpoint to combine technologies in a way that can reduce costs. We want to change the way support surfaces are seen."