Hey, good morning, everyone. I think we're gonna go ahead and get started here. So are we good at the back there? All good? All good. Hey, good morning, Brent Ashton from Covalon Technologies Ltd. Really excited to be here today to tell you a little bit about the Covalon story, where we're at, where we're heading, and jump right in with the classic forward-looking statements. I won't read this in its full, but hopefully, you can quickly read, and we'll go from there and jump right in to talk about the company and so, you know, as you can see here on the slide, really a big focus in the med tech sector around helping prevent infection, reduce pain, and promote healing.
We'll go a little deeper into some of the areas and the clinical challenges that exist and the Covalon solution that helps to solve them, and just really excited to be able to tell you the story here and go from there, and I thought I'd start with a little bit around our investment thesis. As you think about the company, these are things I'm not gonna go deep on this page because these are all things you're gonna see throughout the presentation today. I lumped the first two together, right? There's some really sizable customer challenges that we have solutions for, that are differentiated, they're protected, and the play is in very attractive segments. Some favorable trends, so some tailwinds at our back from clinical trends and procurement and economic trends.
You'll see some really strong underlying fundamental financials, and really a strong growth opportunity, both on the product side and on the geographic side as well. We'll talk a little bit about the turnaround that is underway here. You know, I talked about that at the last point there, the turnaround by a really experienced leadership team. It's really my privilege. I think we've probably got some members of the team listening back in Mississauga, but to lead this team and the broader one, Covalon team that goes behind it. A lot of experience at both large and small med tech companies. Just a little bit about myself.
So you see here, I kind of have split my time between Canada and the United States. I was born here in Canada, so equally comfortable. You know, our company is based in Mississauga, the majority of our sales in the United States, so equally comfortable on both sides of the border. Over 15 years of deep med tech experience at two U.S.-based global companies, both 3M Healthcare, which is now a spinoff called Solventum, and then Becton Dickinson, or BD. And really strong. You can see the domain experience there, and it really lines up well with Covalon's focus around vascular access and wound care and the surgical suite. Joined here at Covalon in 2024, earlier this year in January.
You know, one of the questions I often get is, you know, "Why Covalon? Why, why make the jump to a smaller company?" I was really fortunate. I had some great experiences at 3M and at BD, amazing learnings, and I really wanted to take those learnings and apply them to a company that was in spaces that I knew well, and the opportunity to derive a bigger impact, so to speak. I've known Covalon for about a decade. They first came on my radar when I was at 3M, leading 3M's vascular access business, and I'm just incredibly excited to have joined Covalon, and make that bigger impact to patients and the clinicians that serve them, to our customers, to our shareholders and investors, so thank you, and to the Covalon team.
You ` know, I did see a very real opportunity to significantly improve the impact both that we serve externally and really grow revenues over that multiyear horizon quite significantly. We're in the early stage of the journey for sure. We've had some early success. We'll talk a little bit about that today, and we're likely gonna see some quarter-to-quarter variability for sure, but the long-term outlook remains really promising and very excited to tell you the story here. With that, I'll move on. You know, kind of alluded to some of the focus here around wound care, vascular access, what we call perioperative consumables, so think surgical procedures. We also have a medical device coatings business, and that's one that, you know, we've shifted.
The company made a decision about a year ago, I think it was the right one, to shift more of the focus towards the wound care and the vascular access piece, and it's really paying dividends early, and I think it'll continue to. So digging deeper into the advanced wound care space, and instantly eyes, you know, shoot up to a really challenging picture here. And I do this for a reason, right? This is the reality of the space we serve. Not all wounds are this tough to solve, but across, you know, my experience here at Covalon and then prior with 3M, I've had the privilege of being in wound clinics all over the world, and I can tell you, this isn't the worst of the worst either. I've seen a lot worse.
This issue is a really big problem. It's really kind of falls under the radar for a lot of reasons, but does affect millions of Americans and people around the world every year. Huge cost to treat, massive quality of life issue. The complications from this are horrendous. You can imagine if you had a loved one or a friend with a wound like this. Infection is rampant and can lead to some really bad outcomes. For sure, you know, challenging quality of life, but it can also lead to amputation and death. So the good news is, at Covalon, we have a solution that we know is really strong at helping to jumpstart the wound healing....
And so when we think about chronic wound healing, these are wounds that just aren't gonna heal on their own, right? If you nick your finger, the body will kick in, and you'll, you know, be back in good shape in no time, you know, hours or days. These are chronic wounds that just are not gonna heal on their own, and they need that jump start to happen. And so, we have a product, a collagen product, that is really, really strong at helping to jumpstart that wound healing and get the patient back on their way.
You can see, you know, some features around absorbing a lot of its weight, and the antimicrobial effectiveness of the product in our silver version, for those wounds, almost half of which are infected. When we think about the wound care space, and Covalon, a couple of things. I'll touch on the top two. It's a fair bit of content to go through, so I won't cover everything, but we're really proud of our technology. We have some good patents in place that protect both the composition, that I'll talk about in a bit, as well as the manufacturing method, and so we feel that's really critical.
And the company, a little over a year ago, implemented some insourcing of manufacturing on the wound care products, on the collagen, and that's showing up, and that's driving. It's giving us greater agility, but also improving our margins, which is key. You can see some of the market dynamics, the US market, where our greatest focus is. Big market, growing fast, but we're taking share. We're growing much faster than the market. Obviously, you know, some world large multinational global competitors, but we're winning. And how are we winning? Well, our composition. We have a very unique composition that includes both CMC and EDTA, and I'm not gonna turn this into a clinical presentation, but it's got a really multipronged approach to how we heal.
Great history of serving millions of patients, and so I think that gives clinicians, our customers, our customer's customers, the confidence in the product. And we really, you know, come in a nice place. So we feel we have a really good technical solution at a price point that fits our, a sweet spot, kind of between the market leader, which would be 3M, now Solventum, and products that are a little more commoditized towards the bottom. So we've carved out a really great spot in that middle. Moving on to the vascular access piece. You know, you can see here a picture.
This is a premature baby, and there's a lot more going on here than just the vascular access, but the vascular access is a really critical part. So think of vascular access as you've probably had friends, families, family members, loved ones, that had to have a catheter inserted. Two main types: you know, one that drops more into the heart and infuses drugs, critical-to-life drugs. There's also peripheral catheters at kind of your wrist and hand. And a big problem, right? You're introducing a hole in the body to gain access, and one of the complications of that is bloodstream infections, and you do not wanna get one, so hopefully none of you have ever had one. They're not fun. Best case, you're gonna get a whole lot of drugs.
You're gonna have another week or two, probably, in the ICU at the hospital, and that's the best case. It's gonna cost a lot to treat that. Worst case is you're gonna die, and that happens about 15%-20% of the time. These are entirely preventable, but horrible outcomes, and we have some good solutions we'll talk about in a second. Another thing that's definitely increasing in awareness from our customers, from the clinicians that serve patients, is around medical adhesive-related skin injury, and we've all probably experienced this to some degree.
If you've ever had an IV or a product put on that had a good adhesive to make the product stick to the skin, when you go to remove it, oftentimes that's removing layers of the skin and causing challenges and possible as a source of infection and other things. So that's becoming. I'd say in the last 10 years, that's really increased in relevance to customers. They wanna get the job done, but they don't wanna have to take the product off and ruin the patient's skin. And so, you know, our solutions, we have some great solutions. One is our VALGuard product, where we protect against gross contamination.
If you picture the baby on the previous slide, for those of you that have had young kids, you're probably familiar with the term like a blowout, where, you know, the diaper doesn't contain everything it needs to, and you got a whole mess on your hands. And you can't really see it in this slide, but that's exactly what happened in this zoom-in. So, you know, the patient had these, these IV lines, and, some poop made its way into the line. And, you know, you don't have to be a, a, you know, Harvard-educated doctor to know that's probably not a good thing, with, you know, bacteria and bugs and, and it's, it's a cause of these bloodstream infections, and our product helps protect against that. We've also got some IV securement dressings, our IV Clear and our CovaClear, CovaClear IV.
The IV Clear has an antimicrobial, and it's actually a dual-action antimicrobial that makes it fairly unique, and helps to prevent against infections as well. And then you've got the CovaClear IV and IV Clear both have this silicone adhesive, so sticks and secures the IV in place, while at the same time, when you go to remove it, it doesn't tear off layers of skin. And so, you know, again, differentiated, patented technologies. You know, one thing in this, based on our business model and our go-to-market model, this is an area where we're working and seeing a lot of support from what are called key opinion leaders, so these are experts in their field around the world, doctors, nurses, infection preventionists that are really focused around trying to solve the problems, the clinical problems, right?
Infection, that MARSI, that medical adhesive-related skin injury. We're seeing some really strong support in how they amplify the problem and potential solutions, which would include Covalon's products, so really excited about that. You can see some of the market dynamics. Again, big, big space, decent growth, right? Mid-single-digit market growth. Covalon clearly taking share. You can see some of the competitors, again, some familiar faces around 3M, now Solventum and Medline, but also some global companies, and you know, I talked a little about some of those favorable competitive trends, and I would say across the board, for these competitors here, there's a huge distraction factor going on.
3M has gone through their spin-off, and so they're focused on a lot of different things, and including the wound care business as more of a focus and some alternative technologies. Medline went through a transition from family ownership to private equity and gearing up likely for a public offering. Smith & Nephew and J&J, really not focused. They have products in this space, not as focused as Covalon or some of the other companies are. And so we really like the competitive environment, and we see a ton of upside opportunity as we continue to grow. How do we do that? We've got a really novel products here with really strong value propositions that we take into what we term, you know, high return on investment call points.
So pediatric hospitals, the intensive care unit, oncology, these are all spots where when we focus, we win because we have a really strong value prop that really resonates with those customers. And then we've implemented a... It's a very basic, very simple sales strategy, but it's working, and sometimes keeping it, you know, what is it, KISS? Keep It Simple, Stupid. Keep It Simple, Smart guy, whatever. It works. And so it's here on the screen today. It starts with retaining customers. Can't you know, if the bucket is leaky, you're gonna run into challenges. And proud that when we look at our top fifty customers in the U.S., in the vascular access space, top fifty customers, hospitals, from a year ago, we've retained forty-nine of them, so 98%.
And the one customer we did lose was a conscious decision to do a bit of a SKU rationalization. It didn't make sense to continue manufacturing a couple of the SKUs that customer was buying. So that was a strategic, it was the right decision. And so we see real good stickiness with our products, literally and figuratively, I guess. As well, you know, growing our existing business. This is a really key part to our strategy, and it's really two-pronged. So one is, you know, if we get a product in, so we've got VALGuard in at a hospital, well, how do we get them to then use and adopt IV Clear? And then how do we get them using CovaClear? So going from one product at a hospital to two to three or more.
Then secondarily, but equally important, you know, if we get a product in, so VALGuard is being. Actually, IV Clear is probably a better example. We've got IV Clear. It's being used in the ICU. How do we then get that same product used in oncology? How do we get that used then in the bone marrow transplant unit? So expanding the usage of the same product, and that strategy has been really critical. We've seen, among our existing customers, that same top 50 customers from a year ago. We've seen over 50% revenue growth within existing customers, which is certainly not easy to accomplish, and I'm really proud of the work the team has done to do that. Then, of course, you've also got to add new customers.
Over the past nine months, we've added about 62 new customers, and that represents about 15% of our growth. So we see this as a strong lever for future growth as well. Just a snapshot. You know, we've had a lot of success with some very name-brand hospitals, both pediatric and acute care or more adult-focused hospitals around the U.S., here in Canada, and outside of North America, and just building relationships, continuing to advance them, but strong recognition, right? Getting sick sucks, period. You hate to have to go to a hospital, but if you do, these are some of the hospitals that you would want to go to. They're leading the world in care, and they recognize the value that Covalon brings.
So I alluded on the investment thesis around the turnaround, and since coming in, just wanted to highlight some of the areas that we've been really focused on. One has been around right-sizing the commercial team. So previously, we had a larger team, probably wasn't the right makeup, and some kind of bifurcated leadership. And so, about a year ago, and then some further actions, call it six, seven months ago, we took to really right-size that team, just make sure it was one team, very focused, strong leadership under our SVP of growth, and driving to the right activities. And so we've consolidated down, and now we're going to, we've got the right profile, the right leadership. Sorry, and we're gonna expand from there. Second is around implementing new process and rigor.
I'm fortunate in my past to see world-class examples of how to work certain elements of the business and implementing them. I've thrown a lot of change at the team, and I'm really encouraged because they've accepted it, they've embraced it, and they're driving in new and really significant improvement ways. Third is around establishing the strong quality and compliance culture, and this is at the foundation of every successful med tech company that I've ever worked at, seen, partnered with, and it's an area that I'm really excited about with Covalon, and how we're adapting and evolving on that front. It kind of parallels with the fourth one here around bringing this broader new culture to life.
So really a focus on thinking bigger, thinking differently, more customer focused, prioritizing and strong execution, so some elements there. And then last but not least, have definitely been repairing some key relationships. We've had, you know, as a company, we've had some rocky times in the past, and between customers, suppliers, and the investor community as well, it's really been energizing to engage and be able to talk about what we're doing to change, what we're doing to turn things around, and where we're going in the future. And so, you know, really pleased that we've reversed nine quarters prior to this year, nine quarters of losses with back-to-back quarters of profitability. That'll show up here in the next couple of slides.
So I'll talk two slides on kind of the financial outcomes, and the top two here are around growth. So you can see for the full company, some strong growth, and we're showing our year-to-date, 2024 as is the last one here. That's through three quarters, so our fiscal year is October first to September thirtieth , so coming up on the end here. So we'll add another quarter onto that bar. You can see where we've been at through Q3 in previous years. So strong growth, and really, the chart I would focus on would be the second one here around that U.S. product only. So that's our U.S. sales on the wound care products and the vascular access and surgical side. And as a comparator, we're seeing really strong growth.
So last year had a good, good year of growth at almost 60%, and this year even more. That's a really key focus, and certainly where we're gonna put a lot of effort going forward to continue to drive strong growth in the space. Margins have also improved. A couple of key drivers of that, one has been that insourcing of manufacturing that in addition to giving us better agility has given us some strong margin benefit, and then product mix effects. So with that greater focus on products that drive really good margins, we're seeing good outcome there. Also on the geography side, right?
So with that U.S. focus, our margins in the U.S. tend to outperform margins outside the U.S., and so that margin uptick strong, and we're in that sweet spot in med tech in kind of the high fifties to mid-sixties, and we'll see that continuing. Fourth element here is around operating expenses, and you can see here, you know, as we've been able to both increase revenue with less money, less investment. I think it's a classic scenario of doing more with less, and the right people and the right leadership.
And so excited about that drawdown of operating expenses as a percent to revenue, and hope to stabilize that kind of where it's at, and then hopefully grow even faster and add some more investment, but take the percentage down. And so you add all that up and it drives this net income turnaround. You can see here we're through three quarters, and I can't talk about Q4 yet, but through three quarters, you know, erased the previous years of losses and really positive income levels. And of course, with that comes strong cash.
We're in a fortunate position where we bottomed out from a cash position earlier this year, and have been rebounding, and then had the added benefit of some warrants that were issued five years ago that expired last week, and we had over 99% redemption from that warrant exercise. It brought in over CAD 5 million to the company, and so really strong cash position. Super quick, talk about some of the strategic priorities. So think of this as you know horizon one being what's the lion's share of our activity today. Horizon two, less so, but things we're working on, we'll spend more time on it next year and beyond, and then horizon three, beyond that.
So right now, super big focus on driving growth with what we have, what products we have, that new culture, and demonstrating the credibility and sustainability of our efforts and our team. Shifting to more and more time spent on that horizon two, it's product and technology focused, so product improvements, line extensions to drive incremental benefit from with our customers, looking differently at various technologies, building up that innovation engine and, you know, investing more heavily in the market development side of things. So think of that as like clinical evidence generation and dissemination, really proving out the efficacy of our products, how they work on patients and on the bench.
And then on the horizon three, looking at some broader things around new-to-the-world products and new to Covalon products, M&A activity, and international expansion. So with that, you know, capital structure, I won't go through each of these points, but a couple things to point out, really benefit from strong insider ownership, over 50%. Good cash position at CAD 16 million and no debt gives us a ton of flexibility. Very pleased with the early signs of the turnaround and how that's reflected in the share price. As I said before, in kind of my closer to my opening, you know, this is a multi-year journey, and we're really excited about the opportunity to significantly scale the revenues and the impact of the company. Which gets me to my summary.
Hopefully, you've seen here we are solving real challenging customer problems. We've had some success early, part of, we're building the foundation for the future and really excited about, the strong opportunities for impact going forward. So with that, I think I've got a couple minutes left for any questions that might exist. Yeah, go ahead. Yeah, the-- so the question was essentially, you know, we have strong competition, when a customer decides not to go with Covalon, why, why do they go? You know, I think oftentimes it's, it can be about price. That's, that's certainly one. There's, there's certainly products that are cheaper than ours that we don't feel delivers the value. And I think as well, you know, the medical field in general, driving change is tough.
It's probably a good thing as patients, not a good thing as a non-incumbent player, but driving that change is tough, and sometimes it's just even though they do believe that the product is better, they get concerned about driving change within their facility, so happy to talk more about that. That's a good one, but I think I need to yield to Mikey here.
Hey, thank you very much. Appreciate it, and of course, if you have any other questions, you can see him during the one-on-one session.