1. An overview of reusable surgical textiles in the North American market
Dan Sanchez
Vice President
Medcrest Textiles Division
Medline Industries, Inc.

2. Textiles is our Heritage
Medline History
Textiles is our Heritage
Started almost 100 years ago as a textile company
Medline pioneered many textile innovations that are now widely-used in healthcare today:
Colored scrubs, printed patient gowns, knitted sheets
Largest U.S. Provider of Healthcare Textiles in the USA
Approximately 36% healthcare market share in the U.S.
Over 19,800 textile customers
#1 or #2 healthcare market position in every major category

3. 40+ years of consecutive growth 4th generation family leadership
Medline Sales History
$4 Billion in sales
6000+ employees
Number one privately held manufacturer and distributor of health care products in the U.S.
40+ years of consecutive growth
4th generation family leadership
1000 person dedicated sales force
Steady International Growth

4. Historical Development of the Reusable Market
Until the 1950’s “Muslin” material was the accepted reusable surgical material
The belief was it would stop airborne microbes & was a T140, 100% Cotton material
The fabric was white in color and produced glare which tired the surgeons eyes –
Medline introduced color into the Operating Room by coloring the gowns and drapes green to reduce glare

5. Historical Development of the Reusable Market
In 1952 William C. Beck reported “muslin material may have been considered an acceptable bacteriological barrier when dry, but lost whatever barrier capability it possessed once it became wet”.
New fabrics were developed with a higher thread count and chemical finishes such as “Quarpel” were applied
However not much changed at the hospital level for about a decade as they continued to use Muslin fabrics
At the same time disposable fabrics were being developed and their use began to increase

6. Historical Development of the Reusable Market
In the late 1980’s Reusable Surgical Textiles finally improved substantially
100% polyester materials were developed that provided a very good barrier to fluids and strike through
In the early 1990’s Gore was introduced as a Liquid Proof and Breathable fabric for surgeons gowns
Unfortunately the barn door was left open and the horse was gone!

7. Disposable Surgical Textiles
During the 70’s and 80’s the use of disposable surgical textiles surged higher
The U.S. government reimbursed hospitals for single use items on a cost plus basis
Hospitals used disposables to generate revenue
Reusable Surgical Textiles were not reimbursable
The technology for disposables was better than the reusable's

8. Organisation of The Reusable Market
As of 2004, through a survey it was estimated disposables had captured 84% of the market for surgical textiles in the USA
Disposables promised the product would be perfect every time
Whereas, with reusable's you would need to have faith the laundry had processed, inspected and repaired the textile item appropriately
Sadly, many laundries were not meeting expectations

9. Organisation of The Reusable Market
U.S. ~ 20 Million Surgical Procedures Annually
Gowns
~ 85% Disposable – 15% Reusable
Primarily Level 3 and 4 (using AAMI Guidelines)
Drapes
~ 85% Disposable Table Covers and Mayo Stand Covers – 15% Reusable
~ 95% Disposable Patient Drapes – 5% Reusable

10. Organisation of The Reusable Market
Canada ~ 2 Million Surgical Procedures Annually
Gowns
60% Disposable – 40% Reusable
Reusable's are ~ 80% Level 4
Balance is a mix of Level 3 and Level 2
Disposables are ~ 75% Level 3, 25% Level 4
Drapes
70% Disposable – 30% Reusable

11. Organisation of The Reusable Market
Mexico – number of procedures unknown
Gowns and Drapes are about 60% Reusable
~ 50/50 split between cotton and microfiber
Rapidly transitioning to disposable gowns and drapes

12. Medline’s Position In The Reusable Market
31% Market Share
Primarily Gowns, Wrappers, Table Covers and Mayo Stands
Canada
30% Market Share
Mexico
Very little Reusable sales

13. Medline’s Position In The Reusable Market
Complete Delivery on a Rental Basis
Sterile Recoveries
Can cover about 70% of the USA
About $100 M in revenue
Comprised of reusable's textiles, stainless steel and disposable sterile packs
Primarily Level 4 and 3; some level 2
Other Laundries with Sterilization Capability
HLS – Illinois
MUHL – Wisconsin
Comtex – Ohio
Crown Laundry – Alabama
Mayflower - Maryland

14. Promotion of Reusable's
Dedicated Textile Sales Representatives to sell textiles in the USA and Canada
Implementing “Hybrid” programs to provide a mix of Reusable's and Disposables – this will increase our reusable sales by 10 to 30%
Creating a sustainability catalog that draws from every division (20) within Medline
Providing support to build Pack Rooms and provide guidance in meeting FDA regulations within laundries

15. Promotion of Reusable's
Continue to educate on the AAMI Guidelines:

16. The Position of Reusable's vs. Disposables
Reusable Surgical Textiles have the ability to provide a cost effective alternative to Disposables
The U.S. Government is reducing its funding for hospitals
Hospitals must find ways to cut cost and save money
Adding a pack room to the laundry and converting to reusable's is one potential savings

17. The Position of Reusable's vs. Disposables
Cost Savings Analysis:
Product
Gown pack cost
Gowns used per year*
Annual Spend
XL Ultra Level 3 - KC 95121
$2.57
12,900
$33,153
XL Fabric Reinforced (no level)
$2.71
2,556
$6,927
Total
$40,080
Medline Reusable Level 3
$1.93
$24,883
Medline Reusable Level 4
$2.67
2556
$6,826
$31,710
Annual Savings moving to Reusable Gowns
$8,370
% Savings moving to Reusable Gowns
20.9%

18. The Position of Reusable's vs. Disposables
Reusable's are also primarily synthetic and do not produce lint which coincides with the objective of AORN in the USA and ORNAC in Canada
Many hospitals have established “Green” committees to try and become more environmentally friendly
We must support their efforts with documentation on our sustainable products

19. Summary
Reusable Textiles have dramatically changed in the past 100 years from Muslin to high tech synthetic materials
Disposables filled the vacuum we provided when our product did not have the required barrier properties
Government helped to reinforce the transition to disposables
We must prove our products are cost effective and sustainable to win over new customers

20. Thank You!