Woodlands Health

Enming Yong

Wounds represent an under-appreciated clinical and economic burden to healthcare systems with reductions in quality of life to those affected. Up to 6% of the population may be affected by chronic non-healing wounds and care may consume more than 5% of national healthcare budgets.

With aging populations in Asia and an increase in the prevalence of chronic diseases like diabetes mellitus and peripheral vascular disease, in addition to the episodic and recurring nature of wound care management, the wound care market in Asia is expected to grow at a compound annual growth rate (CAGR) of 8% from 2021 to 2026. Of note, the advanced wound therapeutics segment is poised to grow more rapidly at 12% CAGR to $4.9 billion by 2024. These therapeutics may include topical negative pressure dressings (e.g. V.A.C.®) which may be used for open wounds or surgical incisions, topical oxygen therapies (e.g. Granulox®), electric stimulation (e.g. Accel-Heal®), skin substitutes like acellular dermal matrixes (e.g. Integra®) or autologous blood clot therapy (e.g. Actigraft®).

Emerging trends for healthcare systems include the re-organisation of medical units to take a multi-disciplinary team approach (with podiatrists, wound nurses, vascular, orthopaedics and/or plastics surgeons and endocrinologists) which has been shown to reduce diabetic foot ulcerations and lower extremity amputations. Health systems innovation through the formation of one-stop wound centres that are multidisciplinary, evidence-based and patientcentric expedites investigations and interventions, hence improving clinical outcomes, patient-reported outcome measures (PROM) and patient-reported experience measures (PREM), with resultant cost-effective health economic benefits. Increasingly, the provision of home or mobile wound care services may be powered by apps to link healthcare providers to patients, hence allowing the platforms to become the “Uber” of healthcare.

With the increasing use of technology in healthcare, digital health solutions also hold a lot of promise and there are opportunities to provide remote wound consults by telehealth, both in the outpatient and inpatient settings. Despite the presence of multiple wound imaging solutions within the market, there are currently no established players for wound imaging in Asia, especially catering to the multi-ethnic Asian population with different skin tones. With increasing adoption of electronic medical records (EMR) across Asia, for multi-ethnic patient populations spread across a large geography with various socio-economic circumstances, there is an urgent need from wound care professionals to be able to accurate assess wounds across time periods while being able to share wound related information between providers at different levels of care.

"With increasing research interest and funding on wound care in Asia, especially with regards to the understanding of wound fluid biomarkers, the next wound innovation frontier is on related biosensors and development of smart wound dressings and wearable devices to monitor wound healing, detect and respond to changes in the wound environment"

Unique value propositions will include the interoperability of wound imaging software with existing EMR systems while providing analytics and incorporating clinician decision support systems (CDSS). A data-driven approach using artificial intelligence in wound assessment can help to assess the type of wound with possible aetiology, size and depth of wound for healing trajectory and wound bed with peri-wound segmentation analysis for accurate description. This will allow for standardised and longitudinal wound documentation with prompt diagnosis, while accurately predicting wound healing trajectories and recommending dressing products with appropriate clinical management that are personalised for the patient. These wound imaging analytic systems may also be smartphone based and patientowned, which will help empower, educate and engage patients and their caregivers, thus improving overall health literacy and patient activation.

With increasing research interest and funding on wound care in Asia, especially with regards to the understanding of wound fluid biomarkers, the next wound innovation frontier is on related biosensors and development of smart wound dressings and wearable devices to monitor wound healing, detect and respond to changes in the wound environment. The potential use of nanotechnology will help improve the sensitivity and specificity of such biosensors. Within Singapore, the Agency for Science, Technology and Research (A*STAR) has established a Skin Research Institute of Singapore (SRIS), with goals to improve skin health and reduce the burden of skin diseases for Asian populations and globally, through a multidisciplinary approach to research and innovation by linking scientists with clinicians and engineers. Coupled with the multiethnic population and emerging research capabilities of clinical and academic institutes, this represents an exciting opportunity for a thriving bench-to-bedside translational research and innovation eco-system in Asia in the next decade and beyond.

In conclusion, the wound care market in Asia is dynamic, rapidly growing and poised for disruption. Emerging trends and opportunities for wound care in Asia include having a team-based approach in clinical management, health systems innovation through the establishment of evidence-based and patient-centric wound care centres, adoption of digital health solutions and translational innovations from biomarkers to smart biosensors.