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For close to 200 years, there’s been little change to a product that’s essential while dressing wounds—gauze, which is made from cotton. Now, a Bengaluru-based medtech startup has created rolled gauze with chitosan, a polymer derived from the shells of shrimp, crabs and other crustaceans. Chitosan has unique properties to bind with blood cells and stop bleeding in minutes.

“Chitosan doesn’t just absorb, it stops bleeding, reduces pain, and helps wounds heal faster. This is the next generation rolled gauze, and will go into all ambulances and casualty centres," says Leo Mavely, founder and CEO of Axio Biosolutions, which will launch its gauze at a conference in Ahmedabad later this week. This is Axio’s third product for wound care.

It all began in 2007 when Mavely, a bio-engineer, was an incubatee at Ahmedabad’s Nirma Labs. He knew that 40% of road accident deaths result from bleeding, and there are 400 such deaths every day in India, a problem he wanted to solve.

At Ahmedabad’s hospitals, he came face-to-face with the most common cause of maternal deaths worldwide—postpartum haemorrhage or excessive bleeding after childbirth. His search for an affordable, easy-to-use, fast-acting material to stop such bleeding in time led him to chitosan.

Mavely also met Border Security Force soldiers after he learnt that one in two deaths in the combat zone is due to bleeding. “The immediate need for a solution came from them. I felt if we could save the life of one soldier, that was a big enough impact," he says.

FOR THE ARMED FORCES

He founded Axio Biosolutions with a team of three in 2007 and spent the next three years developing a product called Axiostat, filing for patents, and publishing papers in journals. Made of chitosan, it looks like a sponge and can be pushed into a bleeding wound. The chitosan reacts with blood, and seals blood vessels in two minutes. At the hospital, doctors pour a saline solution and the dressing dissolves into a gel-like substance that can be peeled off.

The Department of Science and Technology funded the early product development. A seed funding round of $2,00,000 came in 2010, and a year later, Axiostat got Indian regulatory approval. It had a pilot run with the BSF in Chhattisgarh. During the surgical strike at the Line of Control in 2016, it helped save the life of a soldier who had stepped on a landmine. “It blew away his foot, but the bleeding stopped in minutes with our product," Mavely says.

Today, all units of India’s frontline defence forces carry two of Axio’s products in field medical kits. That’s barely a quarter of its business; the rest being the larger wound care market. But there were many hoops to jump through before it got past the door.

“Doctors were sceptical. That’s because India always had generic alternatives but not innovative products," Mavely says. It didn’t fit in with the expectation that an Indian product had to be a cheaper alternative to something already deployed in the West.

So, even though it already had Indian regulatory approval, Axio applied for the European CE mark and got it by the end of 2013. It also got ISO 13485 approval. “That’s when we got the product into the market."

In hospitals, the use cases are wide. For example, during an angioplasty, there’s a lot of bleeding after the catheter is removed. Typically, a nurse will apply pressure to the wound with gauze for about 45 minutes to stop the bleeding. “Our product variant brings that time down to about three minutes," Mavely says.

This product line got US FDA clearance last year, one of the few India-made products in the wound care space to get this approval. Axio sells its wound care products in 20 countries, mostly in Europe and West Asia, besides India. It also works with the armed forces in six other countries.

MASSIVE MARKET

In 2015, Axio raised a series A funding round of $2.1 million from Accel Partners and IDG Ventures. The investors then joined a $7.4 million round in 2018 along with Ratan Tata’s UC-RNT Capital.

Last year, Axio launched its second product, MaxioCel, an absorbent dressing for diabetic foot ulcers and burns. Thus far, the main challenge has come at the procurement stage. Government tenders still generally go to the lowest bidder, regardless of innovation or quality of the product.

Axio is not without competitors as the wound care market is huge. The Crimson Report pegged the global market for wound care at $30 billion by 2024. Coloplast, Convatec, Molnlycke, Smith & Nephew, and Acelity are behemoths in the space. But Mavely is bullish: “We have created a new category called chitosan wound dressing, and while it isn’t cheap, it’s affordable."

Malavika Velayanikal is a contributing editor with Mint. Write to her at malavikaworks@gmail.com

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