MEDICAL TEXTILE

By:

Noura Salah Elbushra

Supervised by: Dr. Imad Abd Alla Adam

MEDICAL TEXTILE

Introduction: Combination of textile technology and medical sciences has resulted into a new field called medical textiles. New areas of application for medical textiles have been identified with the development of new fibers and manufacturing technologies for yarns and fabrics. Development in the field of textiles, either natural or manmade textiles, normally aimed at how they enhance the comfort to the users. Development of medical textiles can be considered as one such development, which is really meant for converting the painful days of patients into the comfortable days.
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Medical Textiles is one of the most rapidly expanding sectors in the technical textile market. Medical Textiles are the products and constructions used for medical and biological applications and are used primarily for first aid, clinical and hygienic purposes. It consists of all those textile materials used in health and hygienic applications in both consumer and medical markets. As such it comprises a group of products with considerable variations in terms of product performance and unite value. Because of the nature of their application many medical products are disposable items. The increased use of textiles in composite applications will provide major growth fiber consumption in terms of volume
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Constituent element of Medical Textile products:-

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Characteristics of materials for medical use The major requirements for biomedical polymers : Non toxicity Nonallergenic response The ability to be sterilized Mechanical properties Strength Elasticity Durability Biocompatibility As biomedical materials may be contaminated with bacteria, sterilization is important for biomedical polymers. The sterilization technique can be physical or chemical.
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FOCAL POINTS OF MEDICAL TEXTILE:

Textile has always been a part of healthcare. Combination of Textile Technology and Medical Sciences has resulted into MEDICAL TEXTILES. Medical Textiles are one of the faster growing sectors of the global Technical Textile industry Recently only application of textiles has started going beyond the usual wound care incontinence pads plasters etc. Latest innovation so that, wide variety of woven non woven knitted forms of textile increasingly finding their way into a variety of surgical procedures. As healthcare industry is growing enormously in Bangladesh the demand for the medical textile is also on the rise.

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Why textile implants ? Biocompatible materials Material combinations 2D- and 3D-structures Mechanical characteristic adapted to the environment Adjustable macroscopic structure Specific surface design Controllable degradation

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The use of textile materials for medical and healthcare products can be classified into following main areas
- Barrier material (for infection control) - Bandaging & pressure garment - Wound care material - Hygiene material - Implantable material (sutures, art. Joints etc) - Extra Corporal devices (like art. Kidney etc)

Requirements of textile material for medical applications

Biocompatible Good resistance to alkalis, acids and micro-organisms Good dimensional stability Elasticity Free from contamination or impurities Absorption / Repellency Air permeability.
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Medical Textile Products & Application:

Surgeons wear, wound dressings, bandages, artificial ligaments, sutures, artificial liver/kidney/lungs, nappies, sanitary towels, vascular grafts/heart valves, artificial joints/bones, eye contact lenses and artificial cornea and the like are some of the examples of medical textiles

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Surgical Fabrics
Surgical Wrappers
Surgical Gowns Surgical Drapes

Surgical Wrappers
What are surgical wrappers used for?

Surgical wrappers are primarily used to protect the contents of surgical packs from becoming contaminated, allowing for aseptic presentation of pack contents.

Surgical Drapes
Fenestrated Non-Fenestrated

A fenestration is a fixed opening incorporated into the design of the surgical drape to facilitate access to the operative site operative site

Fibres used for medical and healthcare application

Textiles materials that are used in medical applications include fibres, yarns, fabrics and composites. Depending upon the application, the major requirements of medical textiles are absorbency, tenacity, flexibility, softness and at times biostability or biodegradability. Fibres used in medical field may vary from natural fibre such as cotton, silk, regenerated wood fluff (absorbent layer), to, manmade fibres like polyester, polyamide, polyethylene, glass etc.

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The various applications of different fibre in medical field are shown as follows:

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Classification of Medical Textiles These are the textile products for medical applications include materials as fibres, yarns, woven, knitted, nonwoven, PTFE felts and mesh etc. Depending upon the usage, they are classified as: a. Healthcare and Hygiene products b. Extracorporeal devices c. Implantable materials d. Non-implantable materials

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a.Healthcare & hygienic products :

An important area of textile is the healthcare and hygiene sector among other medical applications. The range of products available for healthcare and hygiene is vast, but they are typically used either in the operating theatre or in the hospital wards for hygienic, care and safety of the staff and patients. They could be washable or disposable.

a.1 Operating theatre

This includes surgeons gown, caps and mask, patient drapes and cover cloth of various sizes. Surgical gown: - It is essential that environment of operating theatre is clean and strict control of infection is maintained. A possible source of infection to the patient is the pollutant particle shed by the nursing staff, which carries bacteria. Surgical gowns should act as barrier to prevent release of pollutant particles into air. Traditional surgical gowns are woven cotton goods that not only allow the release of particles from the surgeons but also a source of contamination generating high levels of dust (lint). Disposable non woven surgical gowns have adopted to prevent these sources of contamination to patients and are often composite materials of nonwoven and polyethylene films. Surgical masks:-They should have higher filter capacity, high level of air permeability, lightweight and nonallergic.
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Healthcare and hygiene products :

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Surgical caps: - These are made from nonwoven materials based on cellulose. Surgical drapes and covercloths: - These are used to cover patients or to
cover working areas around patients. It should be completely impermeable to bacterial and also absorbent to body perspiration and secretion from wound.

a.2 Hospital ward

This includes beddings, clothing, mattresses covers, incontinence products, clothes and wipes.e.g. In hospital cross infection should be prevented and hence traditional woolen blankets replaced by cotton leno woven blankets. Incontinence products for patients are available in both diaper and flat sheet forms with later used for bedding. Cloths and wipes are made from tissue paper or nonwoven bonded fabrics, which may be soaked with an antiseptic finish.

Super absorbent fibers for healthcare and hygiene products

They absorbs upto 50 times their mass of water, whereas the conventional wood pulp and cotton linter absorbents absorb approximately 6 times their mass of water. The superabsorbent fibres offer advantage as compared to superabsorbent powders due to their physical form, or dimensions, rather than their chemical structure. Whilst they do absorb fluids to a similar level as powder, they do, however, do it faster. This is due to the small diameter of the fibres ( 30), which gives a very high surface area for contact with the fluid. Typically fibre will absorb 95% of its ultimate capacity in 15 seconds. MEDICAL TEXTILE 20

b. Extracorporeal devices
These are extracorporeally mounted devices used to support the function of vital organs, such as kidney, liver, lung, heart pacer etc. The extracorporeal devices are mechanical organs that are used for blood purification and include the artificial kidney (dialyser), the artificial liver, and the mechanical lung. The function and performance of these devices benefit from fibre and textile technology.

b.1 Artificial kidney

Tiny instrument, about the size of a two-cell flashlight. Made with hollow hair sized cellulose fibres or hollow polyester fibres slightly larger than capillary vessels. Fabric, which is used to remove waste products from patients blood.

b.2 Artificial liver

Made of hollow viscose to separate and dispose patients plasmas and supply fresh plasma.

b.3 Artificial heart

An 8-ource plastic pump lined with decom velour to reduce damage to blood and is a chambered apparatus about the size of human heart Silastic backing makes the fabric impervious to emerging gas that is not desirable in the blood.

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b.4 Mechanical lung

Made with a hollow polypropylene fibre or a hollow silicone membrane. Used to remove carbon dioxide from patients blood and supply fresh oxygen.

C. Implantable materials
Textile fibres, yarns, fabrics, composites and 3-D shaped fabrics from woven, knitted, nonwoven, braided and embroidery play a vital role in the manufacture of various implants, including the replacement of diseased or non-functioning blood vessels and segments of aorta or other big arteries. It is even feasible to produce vascular prosthesis as fine as 2-3mm in diameter. These materials are used in effecting repair to the body whether it is wound closure (sutures) or replacement surgery (vascular grafts, artificial ligaments etc) Biocompatibility is of prime importance if textile materials are to be accepted by the body and four key factors will determine how the body reacts to the implants The most important factor is porosity, which determines the rate at which human tissue will grow and encapsulate the implant. Small circular fibres are better encapsulated with human tissue than larger fibres with irregular cross sections. The fibre polymer must not release toxic substances, and fibre should be free from surface contaminants such as lubricants and sizing agents. Biodegradable
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d.1 Surgical dressing:these are employed as coverings, adsorbent, protective and supports for injured or diseased part. They are different types Primary wound dressing Absorbent Bandages Protective Adhesive tapes

d.2 Primary wound dressing

Placed next to the wound surface Nonwovens with a binder content of 60% and made of cellulose fabrics are being Used.

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A dressing should possess the following properties:

Healing properties, regulated mainly with the substances which are applied to or added to the dressing. Causing no mechanical injury of a granulating wound. Decreased adherence surface. Eliminating a possibility of loose fibers getting caught in the wound. Stable and spatial structure Easy penetration of wound secretion to the absorbing dressing. Not- interrupted process of wound healing - as only the outer gauze compress is changed. Painless changing of the dressing.

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d.3 Absorbent
Similar to wound pads used in surgery. Manufactured from well bleached, carded and cleaned cotton fabrics. Absorbent lint is cotton of plain weave, warp nap raised on one side, by a process known as linting EPI 36, PPI 32, used as an external absorbent and protective dressing and for the applications of oilments and lotions, as antiseptic adsorbent and protective dressing in first aid treatment. Surgical and other gauze provide absorbent materials of sufficient tensile strength for surgical dressing. They are made of cotton gauze loosely woven. Now-a days nonwovens are used.

d.4 Bandages
These are narrow cotton or linen, plain weave cloth of low texture, either woven or knitted. There are different types Cotton and rubber elastic net bandages- for sprains and strains Cotton rubber elastic net bandages- net fabric of lace construction. Plaster of Paris bandages- cotton cloth is impregnated with a mixture of calcium sulphate Orthopedic cushion bandages. Crepe bandage- elastic in nature due to special weave allows it to stretch twice its Length.
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Various types of bandages along with their function are mentioned below:
Simple Bandage Hold dressings in place. Elasticated Bandage: Impart support and conforming. Light support Bandage: management of sprains or strains. Compression Bandage: Treatment and prevention of deep vein thrombosis, leg ulceration. Orthopedic Bandage: Used under plaster casts, provide padding and prevent discomfort. Gauze: Serves as absorbent material. Lint: Used as protective dressing for use in mild burn applications. Wadding: prevent wound adhesion.

d.5 Protective eye pad

Scientifically shaped to lit over the eye used in outpatient clinic and industrial department.

d.6 Adhesive tapes

It is narrow, plain weave fabric having a coating of adhesive paste. It is used with other pads to conform them on the injury.

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Plasma applications in medical textiles

Cleaning Sterilization Surface modification for - Better adhesion of growing cells - Attachment of growth promoters - Attachment of bioactive molecules for antimicrobial action Stain repellency of medical gowns, hospital clothing

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We have thus so far seen what is the current scenario and

what are the future requirements of Medical Textiles.

Medical Textiles are one of the dynamically expanding

sectors and development of same is to convert pain full days of patients into comfortable days.
As medical procedures continue and transform, the demand for textile materials is bound to grow and grow.

References: 1.I.V.Walker ,proceedings of Medical Textile Conference,1999,Bolton Institute, U.K. Publishing Co., Cambridge,12-19. 2. G.Fisher .Technical Textile Int., July/Aug 2003, 19. 3. D.G.B.Thomas, Textiles 1975, Feb.7. 4. magic-magnet.com/products/accessary2.htm. 5. www.journalofwoundcare.com 6. H.M.Taylor, Textile, Dec., 1983, 77 7. Dr.V.K.Kothari, Journal of the Textile Association Nov.-Dec.2006.vol.67 p 181-185 8. http;//www.ita.rwth-aachen.de 9. J Luneschloss and W. Albrecht Non-woven Bonded Fabrics, p 404-452 10. N.Arun Man Made Textiles in IndiaSep.2000, Vol.XLIIIp411-415 11. www.fibre2fashion.com

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