Global Surgical Incision Closures Industry

  • October 2013
  • -
  • Global Industry Analysts
  • -
  • 245 pages

This report analyzes the worldwide markets for Surgical Incision Closures in US$ Million by the following Product Segments: Stapler Products (Internal Stapler, Skin Staplers, Surgical/Ligature Clips, & Vascular Clips), Suture Products (Absorbable Sutures, & Non Absorbable), Tape Closures, and Tissue Sealants.

The report provides separate comprehensive analytics for the US, Canada, Japan, Europe, Asia-Pacific, Latin America, and Rest of World. Annual estimates and forecasts are provided for the period 2010 through 2018. Also, a six-year historic analysis is provided for these markets. Market data and analytics are derived from primary and secondary research. Company profiles are primarily based on public domain information including company URLs.

The report profiles 55 companies including many key and niche players such as -
3M Healthcare
Abbott Laboratories
Advanced Medical Solutions Group Plc
Aesculap AG & Co. KG
Baxter International, Inc.
Covidien Ltd.

Table Of Contents




I. INTRODUCTION, METHODOLOGY and PRODUCT DEFINITIONS
Study Reliability and Reporting Limitations I-1
Disclaimers I-2
Data Interpretation and Reporting Level I-2
Quantitative Techniques and Analytics I-3
Product Definitions and Scope of Study I-3
Stapler Products I-3
Internal Staplers I-3
Skin Staplers I-4
Surgical/Ligature Clips I-4
Vascular Clips I-4
Sutures I-4
Absorbable Sutures I-4
Non-Absorbable Sutures I-4
Hemostats I-4
Tape Closures I-4
Tissue Sealants/Adhesives I-4


II. EXECUTIVE SUMMARY

1. INDUSTRY OVERVIEW II-1
Surgical Incision Closures - A Prelude II-1
Current and Future Analysis II-1
Maximizing on the ‘Minimal’ Market II-2
Next Generation Closure Technologies Offer Lucrative
Opportunities II-2
Tissue Sealants: Gaining in Popularity II-2
Why Use Adhesives and Sealants Over Sutures and Staples? II-3
Gauging the Economic Benefits of Hemostats and Sealants II-4
Suture Products: Largest Market II-4
Staplers: Compete with Sutures II-5
Tapes/Strips: Simplifying Closures II-5
Tissue Adhesives: On the Growth Curve II-5
Biomaterials and Synthetic Materials Mark Metamorphosis II-6
Advanced Wound Closure Devices: Comparing the US and European
Markets II-6

2. COMPETITIVE SCENARIO II-7
Table 1: Leading Players in the Global Wound Closure Devices
Market (2012): Percent Share Breakdown of Revenues for
Covidien Ltd., Ethicon, Inc., Baxter International. Inc., and
Others (includes corresponding Graph/Chart) II-7
Product Mix of Leading Players in the Traditional Surgical
Incision Closures Market. II-7

3. MARKET TRENDS and DRIVERS II-8
Technological Advancements Drive the Market for Wound Closure
Devices II-8
Developing Markets Hold Lucrative Potential for Wound Closure
Devices II-8
Wound Closure Device Market Gains from Increase in Cosmetic
Surgeries II-9
High Strength Surgical Devices Garners Growth II-9
Key Reasons for the Use of Sealants, Wound Closure and Other
Surgical Inclusion Devices II-9
Surgical Glue - The Future of Wound Closure Devices II-10
Companies Focus on Non-Invasive Closure Products II-10
Absorbable Sutures to Race Ahead over Non-Absorbable Sutures II-10
Barbed Sutures - The Next Generation Sutures II-11
Innovative Products Stabilize Growth in the Staplers Market II-11
Hemostatic Agents: In Close Competition with Sutures Technology II-12
Hemostats Pose Threat to Tissue Sealants II-12
Topical Skin Adhesives Gain Acceptance in Radiological
Applications II-12
Adhesives and Sealants to Witness Rapid Gains in
Cardiovascular Procedures II-13

4. PRODUCT ANALYSIS II-14
Surgical Stapler Products II-14
Stapler Products: Replacement for Manual Suturing II-14
Sutures Products II-15
Sweeping Changes in the Kinds of Suture Material Used II-15
Applications of Sutures II-15
Sutures Classification II-16
Absorbable and Non-Absorbable Surgical Suture II-16
Monofilament and Multifilament II-16
Absorbable Suture Materials II-16
Surgical Gut or Catgut II-16
Chromic Gut II-16
Fast-Absorbing Gut II-16
Polyglycolic Acid II-17
Polyglactin II-17
Polydioxanone II-17
Polytrimethylene Carbonate II-17
Polyglecaprone II-17
Uses of Absorbable Sutures II-18
Characteristics of Absorbable Sutures II-18
Non-absorbable Suture Materials II-18
Silk II-18
Nylon II-18
Polyester II-19
Polypropylene II-19
Polybutester II-19
Uses of Non-Absorbable Sutures II-19
Characteristics of Non-Absorbable Sutures II-19
Synthetic Absorbable Sutures Dominate Suture Markets II-20
Tissue Sealants II-20
Fibrin Sealants II-20
Tapes II-21
Comparison of Advantages and Disadvantages of Different
Surgical Closure Devices/Procedures II-21
Hemostats II-21
List of Select Hemostat Products Available II-22

5. PRODUCT LAUNCHES/DEVELOPMENTS II-23
UCL Hospitals Develops Novel Surgical Clip II-23
ZipLine® Medical Launches a Noninvasive Skin Closure Device II-23
ZSX Medical to Introduce Zip-Stitch Clips II-23
IonMed to Introduce BioWeld1 II-23
Micro International to Introduce Permaseal II-24
AD Surgical Unveils Polyester and Cable Nylon Non-absorbable
Sutures II-24
Theragenics Introduces PLUS Range of Antibacterial Sutures II-24
Advanced Medical Solutions Obtains FDA Approval for its New
Product II-25
Covidien Obtains FDA 510(k) Clearance for iDriveâ„¢ Ultra
Powered Stapling System II-25
AccessClosure Unveils MynxGrip Vascular Closure Device II-26
Covidien Unveils AS Meniscalâ„¢ Repair Device II-26
Covidien Introduces V-Locâ„¢ Knotless Suturing Reloads II-26
Covidien Introduces Endo GIAâ„¢ Radial Reload II-27
Covidien Introduces the Endo GIAâ„¢ Black Reload Stapler II-27
Ethicon Unveils Range of STRATAFIXâ„¢ Knotless Tissue Control
Devices II-27
Medline Industries Launches Octylsealâ„¢ Tissue Adhesive II-28
Omnia Launches PTFE Sutures II-28
Teleflex Introduces Weck Efxâ„¢ Endo Fascial Closure System and
Range of Weck® Access Devices II-28
Covidien Launches Endo Stitchâ„¢ automated suturing device II-29
Covidien Introduces V-Loc PBT Wound Closing Device II-29
Baxter Launches Artiss Fibrin Sealant II-29
Ethicon Launches SECURESTRAPâ„¢ Absorbable Strap Fixation Device II-29
Cardica Receives Patent for Microcutterâ„¢ Technology II-30
Covidien Receives FDA Approval for DuraSeal Exact II-30
Fraunhofer IPT Develops Laser Suturing Tool II-30

6. RECENT INDUSTRY ACTIVITY II-31
TPG Growth Acquires Sutures India II-31
Theragenics Inks Definitive Merger Agreement with Juniper
Investment II-31
Abbott Acquires OptiMedica II-31
Teleflex Acquires Microlaparoscopy Technology of InnoLap Surgical II-31
Smith and Nephew to Acquire Healthpoint Biotherapeutics II-32
Innocutis Medical and Incisive Surgical Inks Exclusive
Marketing Agreement II-32
Titan Medical and Mayo Foundation for Medical Education and
Research Sign Exclusive Patent License Agreement II-32
AMS to Acquire RSORBA Wundversorgung II-33
EES Acquires SterilMed II-33
Sanofi-Aventis Acquires Genzyme II-33
Medtronic Takes Over Salient Surgical Technologies and PEAK
Surgical II-33

7. FOCUS ON SELECT PLAYERS II-34
3M Healthcare (US) II-34
Abbott Laboratories (US) II-34
Advanced Medical Solutions Group Plc (UK) II-34
Aesculap AG and Co. KG (Germany) II-35
Baxter International, Inc. (US) II-35
Covidien Ltd. (Ireland) II-36
Autosuture (US) II-36
Syneture (US) II-37
USS Sports Medicine (US) II-37
CP Medical, Inc. (US) II-37
Derma Sciences, Inc. (US) II-37
Ethicon Endo-Surgery, Inc. (US) II-38
Smith and Nephew plc (UK) II-38
Teleflex Medical (US) II-39

8. GLOBAL MARKET PERSPECTIVE II-40
Table 2: World Recent Past, Current and Future Analysis for
Surgical Incision Closures by Geographic Region - US, Canada,
Japan, Europe, Asia-Pacific (excluding Japan), Latin America
and Rest of World Markets Independently Analyzed with Annual
Sales Figures in US$ Million for Years 2010 through 2018
(includes corresponding Graph/Chart) II-40

Table 3: World Historic Review for Surgical Incision Closures
by Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-41

Table 4: World 15-Year Perspective for Surgical Incision
Closures by Geographic Region - Percentage Breakdown of Dollar
Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding
Japan), Latin America and Rest of World Markets for Years
2004, 2013 and 2018 (includes corresponding Graph/Chart) II-42

Table 5: World Recent Past, Current and Future Analysis for
Stapler Products by Geographic Region - US, Canada, Japan,
Europe, Asia-Pacific (excluding Japan), Latin America and Rest
of World Markets Independently Analyzed with Annual Sales
Figures in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) II-43

Table 6: World Historic Review for Stapler Products by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-44

Table 7: World 15-Year Perspective for Stapler Products by
Geographic Region - Percentage Breakdown of Dollar Sales for
US, Canada, Japan, Europe, Asia-Pacific (excluding Japan),
Latin America and Rest of World Markets for Years 2004, 2013 and
2018 (includes corresponding Graph/Chart) II-45

Table 8: World Recent Past, Current and Future Analysis for
Stapler Products by Product Segment - Internal Stapler, Skin
Staplers, Surgical/Ligature Clips, and Vascular Clips Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2010 through 2018 (includes corresponding
Graph/Chart) II-46

Table 9: World Historic Review for Stapler Products by Product
Segment - Internal Stapler, Skin Staplers, Surgical/Ligature
Clips, and Vascular Clips Markets Independently Analyzed with
Annual Sales Figures in US$ Million for Years 2004 through
2009 (includes corresponding Graph/Chart) II-47

Table 10: World 15-Year Perspective for Stapler Products by
Product Segments - Percentage Breakdown of Dollar Sales for
Internal Stapler, Skin Staplers, Surgical/ Ligature Clips, and
Vascular Clips Markets for Years 2004, 2013 and 2018 (includes
corresponding Graph/Chart) II-48

Table 11: World Recent Past, Current and Future Analysis for
Internal Stapler Products by Geographic Region - US, Canada,
Japan, Europe, Asia-Pacific (excluding Japan), Latin America
and Rest of World Markets Independently Analyzed with Annual
Sales Figures in US$ Million for Years 2010 through 2018
(includes corresponding Graph/Chart) II-49

Table 12: World Historic Review for Internal Stapler Products
by Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-50

Table 13: World 15-Year Perspective for Internal Stapler
Products by Geographic Region - Percentage Breakdown of Dollar
Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding
Japan), Latin America and Rest of World Markets for Years
2004, 2013 and 2018 (includes corresponding Graph/Chart) II-51

Table 14: World Recent Past, Current and Future Analysis for
Skin Stapler Products by Geographic Region - US, Canada,
Japan, Europe, Asia-Pacific (excluding Japan), Latin America
and Rest of World Markets Independently Analyzed with Annual
Sales Figures in US$ Million for Years 2010 through 2018
(includes corresponding Graph/Chart) II-52

Table 15: World Historic Review for Skin Stapler Products by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-53

Table 16: World 15-Year Perspective for Skin Stapler Products
by Geographic Region - Percentage Breakdown of Dollar Sales
for US, Canada, Japan, Europe, Asia-Pacific (excluding Japan),
Latin America and Rest of World Markets for Years 2004, 2013 and
2018 (includes corresponding Graph/Chart) II-54

Table 17: World Recent Past, Current and Future Analysis for
Surgical/Ligature Clips Products by Geographic Region - US,
Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin
America and Rest of World Markets Independently Analyzed with
Annual Sales Figures in US$ Million for Years 2010 through
2018 (includes corresponding Graph/Chart) II-55

Table 18: World Historic Review for Surgical/Ligature Clips
Products by Geographic Region - US, Canada, Japan, Europe,
Asia-Pacific (excluding Japan), Latin America and Rest of
World Markets Independently Analyzed with Annual Sales Figures
in US$ Million for Years 2004 through 2009 (includes
corresponding Graph/Chart) II-56

Table 19: World 15-Year Perspective for Surgical/ Ligature
Clips Products by Geographic Region - Percentage Breakdown of
Dollar Sales for US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets for
Years 2004, 2013 and 2018 (includes corresponding Graph/Chart) II-57

Table 20: World Recent Past, Current and Future Analysis for
Vascular Clips Products by Geographic Region - US, Canada,
Japan, Europe, Asia-Pacific (excluding Japan), Latin America
and Rest of World Markets Independently Analyzed with Annual
Sales Figures in US$ Million for Years 2010 through 2018
(includes corresponding Graph/Chart) II-58

Table 21: World Historic Review for Vascular Clips Products by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-59

Table 22: World 15-Year Perspective for Vascular Clips
Products by Geographic Region - Percentage Breakdown of Dollar
Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding
Japan), Latin America and Rest of World Markets for Years
2004, 2013 and 2018 (includes corresponding Graph/Chart) II-60

Table 23: World Recent Past, Current and Future Analysis for
Suture Products by Geographic Region - US, Canada, Japan,
Europe, Asia-Pacific (excluding Japan), Latin America and Rest
of World Markets Independently Analyzed with Annual Sales
Figures in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) II-61

Table 24: World Historic Review for Suture Products by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-62

Table 25: World 15-Year Perspective for Suture Products by
Geographic Region - Percentage Breakdown of Dollar Sales for
US, Canada, Japan, Europe, Asia-Pacific (excluding Japan),
Latin America and Rest of World Markets for Years 2004, 2013 and
2018 (includes corresponding Graph/Chart) II-63

Table 26: World Recent Past, Current and Future Analysis for
Suture Products by Product Segments - Absorbable Sutures and
Non-Absorbable Markets Independently Analyzed with Annual
Sales Figures in US$ Million for Years 2010 through 2018
(includes corresponding Graph/Chart) II-64

Table 27: World Historic Review for Suture Products by Product
Segments - Absorbable Sutures and Non-Absorbable Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-65

Table 28: World 15-Year Perspective for Stapler Products by
Product Segments - Percentage Breakdown of Dollar Sales for
Absorbable Sutures and Non-Absorbable Markets for Years 2004,
2013 and 2018 (includes corresponding Graph/Chart) II-66

Table 29: World Recent Past, Current and Future Analysis for
Absorbable Sutures by Geographic Region - US, Canada, Japan,
Europe, Asia-Pacific (excluding Japan), Latin America and Rest
of World Markets Independently Analyzed with Annual Sales
Figures in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) II-67

Table 30: World Historic Review for Absorbable Sutures by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-68

Table 31: World 15-Year Perspective for Absorbable Sutures by
Geographic Region - Percentage Breakdown of Dollar Sales for
US, Canada, Japan, Europe, Asia-Pacific (excluding Japan),
Latin America and Rest of World Markets for Years 2004, 2013 and
2018 (includes corresponding Graph/Chart) II-69

Table 32: World Recent Past, Current and Future Analysis for
Non-Absorbable Sutures by Geographic Region - US, Canada,
Japan, Europe, Asia-Pacific (excluding Japan), Latin America
and Rest of World Markets Independently Analyzed with Annual
Sales Figures in US$ Million for Years 2010 through 2018
(includes corresponding Graph/Chart) II-70

Table 33: World Historic Review for Non-Absorbable Sutures by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-71

Table 34: World 15-Year Perspective for Non-Absorbable Sutures
by Geographic Region - Percentage Breakdown of Dollar Sales
for US, Canada, Japan, Europe, Asia-Pacific (excluding Japan),
Latin America and Rest of World Markets for Years 2004, 2013 and
2018 (includes corresponding Graph/Chart) II-72

Table 35: World Recent Past, Current and Future Analysis for
Hemostat Closures by Geographic Region - US, Canada, Japan,
Europe, Asia-Pacific (excluding Japan), Latin America and Rest
of World Markets Independently Analyzed with Annual Sales
Figures in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) II-73

Table 36: World Historic Review for Hemostat Closures by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-74

Table 37: World 15-Year Perspective for Hemostat Closures by
Geographic Region - Percentage Breakdown of Dollar Sales for
US, Canada, Japan, Europe, Asia-Pacific (excluding Japan),
Latin America and Rest of World Markets for Years 2004, 2013 and
2018 (includes corresponding Graph/Chart) II-75

Table 38: World Recent Past, Current and Future Analysis for
Tape Closures by Geographic Region - US, Canada, Japan,
Europe, Asia-Pacific (excluding Japan), Latin America and Rest
of World Markets Independently Analyzed with Annual Sales
Figures in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) II-76

Table 39: World Historic Review for Tape Closures by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-77

Table 40: World 15-Year Perspective for Tape Closures by
Geographic Region - Percentage Breakdown of Dollar Sales for
US, Canada, Japan, Europe, Asia-Pacific (excluding Japan),
Latin America and Rest of World Markets for Years 2004, 2013 and
2018 (includes corresponding Graph/Chart) II-78

Table 41: World Recent Past, Current and Future Analysis for
Tissue Sealants by Geographic Region - US, Canada, Japan,
Europe, Asia-Pacific (excluding Japan), Latin America and Rest
of World Markets Independently Analyzed with Annual Sales
Figures in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) II-79

Table 42: World Historic Review for Tissue Sealants by
Geographic Region - US, Canada, Japan, Europe, Asia-Pacific
(excluding Japan), Latin America and Rest of World Markets
Independently Analyzed with Annual Sales Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) II-80

Table 43: World 15-Year Perspective for Tissue Sealants by
Geographic Region - Percentage Breakdown of Dollar Sales for
US, Canada, Japan, Europe, Asia-Pacific (excluding Japan),
Latin America and Rest of World Markets for Years 2004, 2013 and
2018 (includes corresponding Graph/Chart) II-81


III. MARKET

1. THE UNITED STATES III-1
A.Market Analysis III-1
Outlook III-1
Surgical Incision Market - Overview III-1
Advanced Wound Closure Devices on Strong Growth Path III-1
Rising Elderly Population Indicate More Room for Growth III-2
Table 44: Increase in Number of Surgeries in the US
(2001-2010, 2010-2020) (in %) (includes corresponding
Graph/Chart) III-3
Market for Surgical Sealants III-3
Fibrin Sealants III-4
Table 45: Leading Players in the US Fibrin Sealants Market
(2012): Percentage Share Breakdown by Value Sales for
Baxter International, Haemacure/Angiotech, and Others
(includes corresponding Graph/Chart) III-4
Low Awareness, Rigid FDA Approvals Restrain Hemostats
Tissue Sealants Growth III-4
Sutures - Holding Their Own III-5
Synthetic Absorbables Gain Popularity III-5
Table 46: Leading Players in the US Suture Products Market
(2012): Percentage Share Breakdown by Value Sales for
Ethicon Inc, Covidien, and Others (includes corresponding
Graph/Chart) III-5
Surgical Stapling Market III-5
Table 47: Leading Players in the US Stapler Products Market
(2012): Percentage Share Breakdown by Value Sales for
Ethicon Endo-Surgery, Covidien, 3M Healthcare and Others
(includes corresponding Graph/Chart) III-6
Ligature Clips III-6
Table 48: Leading Players in the US Ligature Clips Market
(2012) Percentage Share Breakdown by Value Sales for
Covidien, Ethicon, Teleflex Medical, Aesculap and Others
(includes corresponding Graph/Chart) III-6
Adhesive Strips III-7
Table 49: Leading Players in the US Strips Market (2012) -
Percentage Share Breakdown by Value Sales for 3M
Healthcare, Derma Sciences, and Others (includes
corresponding Graph/Chart) III-7
Product Launches/Developments III-7
Recent Industry Activitys III-12
Key Players III-14
B.Market Analytics III-18
Table 50: US Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-18

Table 51: US Historic Review for Surgical Incision Closures
by Product Group/Segment - Stapler Products (Internal
Staplers, Skin Staplers, Surgical/Ligature Clips and
Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-19

Table 52: US 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-20

2. CANADA III-21
A.Market Analysis III-21
Recent Industry Activity III-21
B.Market Analytics III-22
Table 53: Canadian Recent Past, Current and Future Analysis
for Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-22

Table 54: Canadian Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-23

Table 55: Canadian 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/ Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-24

3. JAPAN III-25
A.Market Analysis III-25
Wound and Tissue Management Market to Witness Growth III-25
B.Market Analytics III-26
Table 56: Japanese Recent Past, Current and Future Analysis
for Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-26

Table 57: Japanese Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-27

Table 58: Japanese 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-28

4. EUROPE III-29
A.Market Analysis III-29
Wound Closure Devices Market in Europe III-29
Tissue Sealant Market in Europe III-29
Gaining from Increasing Surgical Volumes III-30
Increase in Demand for Synthetic Absorbable Sutures III-30
Product Launch III-30
B.Market Analytics III-31
Table 59: European Recent Past, Current and Future Analysis
for Surgical Incision Closures by Geographic Region -
France, Germany, Italy, UK, Spain, Russia and Rest of Europe
Markets Independently Analyzed with Annual Sales Figures in
US$ Thousand for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-31

Table 60: European Historic Review for Surgical Incision
Closures by Geographic Region - France, Germany, Italy, UK,
Spain, Russia and Rest of Europe Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2004 through 2009 (includes corresponding Graph/Chart) III-32

Table 61: European 15-Year Perspective for Surgical Incision
Closures by Geographic Region - Percentage Breakdown of
Dollar Sales for France, Germany, Italy, UK, Spain, Russia
and Rest of Europe Markets for Years 2004, 2013 and 2018
(includes corresponding Graph/Chart) III-33

Table 62: European Recent Past, Current and Future Analysis
for Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-34

Table 63: European Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-35

Table 64: European 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-36

4a. FRANCE III-37
Market Analysis III-37
Table 65: French Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/ Ligature Clips and Vascular Clips), Suture
Products (Absorbable Sutures and Non-Absorbable Sutures),
Hemostats, Tape Closures and Tissue Sealants Markets
Independently Analyzed with Annual Sales Figures in US$
Thousand for Years 2010 through 2018 (includes corresponding
Graph/Chart) III-37

Table 66: French Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/ Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-38

Table 67: French 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-39

4b. GERMANY III-40
A.Market Analysis III-40
Largest European Market for Surgical Incision Closures III-40
Product Launch III-40
Aesculap AG and Co. KG - Key Player III-40
B.Market Analytics III-41
Table 68: German Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-41

Table 69: German Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-42

Table 70: German 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/ Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-43

4c. ITALY III-44
A.Market Analysis III-44
Product Launch III-44
B.Market Analytics III-45
Table 71: Italian Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-45

Table 72: Italian Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-46

Table 73: Italian 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/ Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-47

4d. THE UNITED KINGDOM III-48
A.Market Analysis III-48
Product Launch III-48
Key Players III-48
B.Market Analytics III-50
Table 74: UK Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-50

Table 75: UK Historic Review for Surgical Incision Closures
by Product Group/Segment - Stapler Products (Internal
Staplers, Skin Staplers, Surgical/Ligature Clips and
Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-51

Table 76: UK 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-52

4e. SPAIN III-53
Market Analysis III-53
Table 77: Spanish Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-53

Table 78: Spanish Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-54

Table 79: Spanish 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-55

4f. RUSSIA III-56
Market Analysis III-56
Table 80: Russian Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-56

Table 81: Russian Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-57

Table 82: Russian 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/ Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-58

4g. REST OF EUROPE III-59
A.Market Analysis III-59
Product Launches III-59
Covidien Ltd. (Ireland) - A Key Player III-61
B.Market Analytics III-62
Table 83: Rest of Europe Recent Past, Current and Future
Analysis for Surgical Incision Closures by Product
Group/Segment - Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets Independently Analyzed with Annual Sales Figures in
US$ Thousand for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-62

Table 84: Rest of Europe Historic Review for Surgical
Incision Closures by Product Group/Segment - Stapler
Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2004 through 2009 (includes corresponding Graph/Chart) III-63

Table 85: Rest of Europe 15-Year Perspective for Surgical
Incision Closures by Product Group/ Segment - Percentage
Breakdown of Dollar Sales for Stapler Products (Internal
Staplers, Skin Staplers, Surgical/Ligature Clips and
Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets for Years 2004, 2013 and 2018 (includes
corresponding Graph/Chart) III-64

5. ASIA-PACIFIC III-65
A.Market Analysis III-65
Advanced Wound Closure Devices Growing in Prominence III-65
B.Market Analytics III-66
Table 86: Asia-Pacific Recent Past, Current and Future
Analysis for Surgical Incision Closures by Geographic
Segment - China, India and Rest of Asia-Pacific Markets
Independently Analyzed with Annual Sales Figures in US$
Thousand for Years 2010 through 2018 (includes corresponding
Graph/Chart) III-66

Table 87: Asia-Pacific Historic Review for Surgical Incision
Closures by Geographic Segment - China, India and Rest of
Asia-Pacific Markets Independently Analyzed with Annual
Sales Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-67

Table 88: Asia-Pacific 15-Year Perspective for Surgical
Incision Closures by Geographic Segment - Percentage
Breakdown of Dollar Sales for China, India and Rest of Asia-
Pacific Markets for Years 2004, 2013 and 2018 (includes
corresponding Graph/Chart) III-68

Table 89: Asia-Pacific Recent Past, Current and Future
Analysis for Surgical Incision Closures by Product
Group/Segment - Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets Independently Analyzed with Annual Sales Figures in
US$ Thousand for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-69

Table 90: Asia-Pacific Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-70

Table 91: Asia-Pacific 15-Year Perspective for Surgical
Incision Closures by Product Group/ Segment - Percentage
Breakdown of Dollar Sales for Stapler Products (Internal
Staplers, Skin Staplers, Surgical/Ligature Clips and
Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets for Years 2004, 2013 and 2018 (includes
corresponding Graph/Chart) III-71

5a. CHINA III-72
A.Market Analysis III-72
Current and Future Analysis III-72
Qingdao Kingston Medical Devices Co. - A Key Player III-72
B.Market Analytics III-73
Table 92: Chinese Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-73

Table 93: Chinese Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-74

Table 94: Chinese 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/ Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-75

5b. INDIA III-76
A.Market Analysis III-76
Recent Industry Activity III-76
B.Market Analytics III-77
Table 95: Indian Recent Past, Current and Future Analysis for
Surgical Incision Closures by Product Group/Segment -
Stapler Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2010 through 2018 (includes corresponding Graph/Chart) III-77

Table 96: Indian Historic Review for Surgical Incision
Closures by Product Group/Segment - Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets Independently Analyzed with Annual Sales
Figures in US$ Thousand for Years 2004 through 2009
(includes corresponding Graph/Chart) III-78

Table 97: Indian 15-Year Perspective for Surgical Incision
Closures by Product Group/Segment - Percentage Breakdown of
Dollar Sales for Stapler Products (Internal Staplers, Skin
Staplers, Surgical/Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets for Years 2004, 2013 and 2018 (includes corresponding
Graph/Chart) III-79

5c. REST OF ASIA-PACIFIC III-80
Market Analysis III-80
Table 98: Rest of Asia-Pacific Recent Past, Current and Future
Analysis for Surgical Incision Closures by Product
Group/Segment - Stapler Products (Internal Staplers, Skin
Staplers, Surgical/ Ligature Clips and Vascular Clips),
Suture Products (Absorbable Sutures and Non-Absorbable
Sutures), Hemostats, Tape Closures and Tissue Sealants
Markets Independently Analyzed with Annual Sales Figures in
US$ Thousand for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-80

Table 99: Rest of Asia-Pacific Historic Review for Surgical
Incision Closures by Product Group/Segment - Stapler
Products (Internal Staplers, Skin Staplers,
Surgical/Ligature Clips and Vascular Clips), Suture Products
(Absorbable Sutures and Non-Absorbable Sutures), Hemostats,
Tape Closures and Tissue Sealants Markets Independently
Analyzed with Annual Sales Figures in US$ Thousand for Years
2004 through 2009 (includes corresponding Graph/Chart) III-81

Table 100: Rest of Asia-Pacific 15-Year Perspective for
Surgical Incision Closures by Product Group/ Segment -
Percentage Breakdown of Dollar Sales for Stapler Products
(Internal Staplers, Skin Staplers, Surgical/Ligature Clips
and Vascular Clips), Suture Products (Absorbable Sutures and
Non-Absorbable Sutures), Hemostats, Tape Closures and Tissue
Sealants Markets for Years 2004, 2013 and 2018 (includes
corresponding Graph/Chart) III-82

6. LATIN AMERICA III-83
Market Analysis III-83
Table 101: Latin American Recent Past, Current and Future
Analysis for Surgical Incision Closures by Geographic
Segment - Brazil and Rest of Latin America Mar

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