MEDICAL TEXTILES

C. Jayanthi M.Mirudhula E.Vijayalakshmi D.Annamalai

Lecturer / Textile Lecturer / Textile Lecturer / Textile Technology Managing
Technology Technology Thiagarajar Polytechnic Director
Thiagarajar Polytechnic Thiagarajar Polytechnic College, Salem Balaji Meditech
College, Salem [email protected]
College, Salem – 636005 Gugai,Salem
[email protected] mirudhula19991999@gm
m
ail.com

ABSTRACT

Increasingly intimate combination of Textile Technology and Medical Sciences has made an
emerging multidisciplinary field with tremendous potential. Medical Textiles represent
structures designed and accomplished for a medical application. The number of applications is
diverse, ranging from a single thread suture to the complex composite structures for bone
replacement and from the simple cleaning wipe to advanced barrier fabrics used in operating
rooms. Textile materials and products, that have been engineered to meet particular needs, are
suitable for any medical and surgical application where a combination of strength, flexibility
and sometimes moisture and air permeability are required. The medical textile industries have
diversified with new materials and innovative designs. Recently, application of textiles has started
going beyond the usual wound care, incontinence pads, plasters etc., Latest innovation i.e., wide
variety of woven, non-woven, knitted forms of textile increasingly finding their way into a variety
of surgical procedures. As the healthcare industry is growing enormously in India, the demand
for the Medical Textile is also on the rise. Medical textiles are a major growth area within the
technical textile sector and the range of applications for such products continue to grow and
increase in diversity with every new development. The introduction of new materials, the
improvement in production techniques and fibre properties, and the use of more accurate and
comprehensive testing have all had significant influence on advancing fibres and fabrics for
medical applications. As more is understood about medical textiles, there is every reason to
believe that a host of valuable and innovative products will emerge.

Keywords:

Medical, textile, technology, surgical, application

Introduction :

Medical Sciences has made an emerging multidisciplinary field with tremendous potential.
Medical Textiles represent structures designed and accomplished for a medical application. The
number of applications is diverse, ranging from a single thread suture to the complex composite
structures for bone replacement and from the simple cleaning wipe to advanced barrier fabrics
used in operating rooms.

Definitions :

 David Rigby Associates, “The Medical Textile application area, embraces all those
technical textiles used in
health and hygiene applications.”
 A/c to Textile Terms and Definitions, “Med tech is a general term which describes a textile
structure which has been designed and produced for use in any of a variety of medical
applications, including implantable applications.

Basic requirement of textile in medical field :

 Conformance to technical specifications

 Sterile
 Anti allergic
 Anti-bacterial
 Environment friendly
 Economical
 Elasticity
 Air permeability
 Good dimensional stability
 Biocompatible

Advantages of textiles in medical field

 Cross infection is reduced
 Protection of care providers
 Cost effective
  WHO recommends disposable Personal Protective
Equipments
 The comfort level is higher (eg. Gowns)
 Engineered to have high barriers to blood and other body fluids
 Are flexible, soft and comfortable

Types of medical textiles

 Surgical Masks: It is a medical device covering mouth, nose and chin and providing a barrier
to minimize the direct transmission of infective agent from staff and patient. The degree of
protection effected by mask depends on filtrations capacity and fit of masks to the wearer
face.
Surgical: The surgical products include surgical gowns and surgical masks. Requirements of
these are absorbency, breathability, softness, tenacity and bio degradability. In surgical gown
the comfort is achieved by the combination of shape or size of garment and ability to maintain
satisfactory environment within the garment.
Extra Corporeal Devices: These are extra corporeally 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.

Textile materials for extra corporeal devices

Extra corporeal fibres are those used in mechanical organs such as Hemodialyser (artificial
kidney), artificial liver and mechanical lung. Historically, regenerated cellulose fibres in the form of
cellophane have been utilized to retain waste products from blood. Japan is the world leader in
fibre technology to make ‘Hollow Fibre’ for the artificial kidney. Over the past 20 years, cellulosic
membranes have improved considerably due to the ability form:

 Thinner membranes
 Controlled pore size
 Improvement of surface properties
Other medical applications of the modified cellulose include hemodialysis membranes (Vit E
modified cellulose) and cellulose di-acetate membranes (Chaudhary and Bokar, 2009).
 Artificial kidney :

Kidney, filter waste materials out of the blood and produce urine to secrete toxins from
body. The kidneys also maintain normal concentrations of body fluids, which play a key
role in homeostasis. In the natural kidney, ultrafiltration of the blood occurs through
the glomerular capillaries leading to the removal of waste products and the purification of
blood. In an artificial unit a membrane-dependent-ultrafiltration achieves essentially the
same result. Hemodialysis is indispensable for people suffering from kidney disease. The
material used in dialysis membranes are regenerated cellulose, cellulose triacetate,
acrylonitrile copolymer, poly (methyl methacrylate), ethylene-vinyl alcohol copolymer,
polusulfone and polyamide which can be grouped as cellulose and synthetic polymer
systems. Pore sizes of membranes vary between 1 - 3 nm for conventional membranes and
4 - 8 nm for large pore membranes. The function of the artificial kidney is achieved by
circulating the blood through a membrane, which may be either a flat sheet or a bundle of
hollow regenerated cellulose fibres in the form of cellophane that retain the unwanted
waste materials. Multilayer fibres composed of numerous layers of needle-punched fabrics
with varying densities may also be used and are designed to remove the waste materials
rapidly and efficiently. The synthetic polymer substitute being experimented with is a
polyethylene glycol-polyethylene terephthalate block copolymer membrane which can
selectively filter.

 Mechanical lung: Mechanical lungs use microporous membranes that provide high
permeability for gases (both O2 and CO2) but low permeability for liquid flow and functions
in the same manner as the natural lung allowing oxygen to come into contact with the
patient's blood. During the flow, oxygen, which is maintained at a high partial pressure,
displaces carbon dioxide, thus effecting purification. In this device, oxygen flows around
hollow fibres at extremely low pressure. Blood flow inside of the fibre. The oxygen permeats
the micropores of the fibre and comes in contact with the blood. The pressure gradient
between the blood and oxygen is kept near zero to prevent mixing of oxygen and blood.
Red blood cells capture oxygen by diffusion process. The mechanical lung was first
developed as a device to replace lung function during heart surgery is now, and
extensively used for this purpose in the USA (about 250,000 per year) and Japan
(20,000 per year). A newer form of artificial lung can also be used as a supplementary
respiratory device over a longer term to assist the breathing of patients suffering from acute
lung or heart failure, or older people with weak lung function. The best membrane material
 available and in extensive use is silicone, which not only has a high permeability to gases
and low permeability to water but can also be autoclaved. Mitsubishi Rayon Co (Japan) has
developed a microporous polypropylene hollow fibre for the manufacture of an artificial
lung, and is currently supplying the fibre to medical device manufacturers. Here gases
freely pass through the pores of PP hollow fibres, but not the blood, because of the
hydrophobicity of PP membrane. As a result, the artificial lung of the gas-bubble type is
rapidly being replaced with the membrane type. PP hollow fibre exhibits good compatibility
with blood and excellent gas permeability.

 Artificial liver: The artificial liver utilises hollow fibres or membranes similar to those used for
the artificial kidney to perform their function. Organ cells are placed around the fibres and
blood flows inside the fibre. Blood nutrients pass through the fibre wall to the oxygen cells and
enzymes pass from the cells to the blood. The metabolism of the liver is very complicated
which poses problems for the artificial liver. This can be solved by using a double lumen
structure with a hollow fibre within a hollow fibre. Blood runs outside and in contact with liver
cells and blood, and after purification it runs inside the fibre. Unlike the heart, lung or kidneys,
which have one primary function, the liver has multiple functions essential to maintain life
including carbohydrate metabolism, synthesis of proteins, amino acid metabolism, urea
synthesis, lipid metabolism, drug biotransformation and waste removal. Therefore the
preferred artificial liver support system would perform these various liver functions.
Hepatocytes carry out many vital biological functions, such as synthesis and catabolic
reactions, detoxification and excretion. Due to their ability to restore a tissue-like
environment, hollow fibre bioreactors (HFBs) show great potential among different systems
used to culture hepatocytes. Currently the major use of Hepatocyte Hollow Fibre
Bioreactors is as bio artificial livers to sustain patients suffering from acute liver failure, but
they can also be used to synthesise cell products and as cellular models for drug metabolism
and transport studies. The artificial liver utilises the functions of separating, disposing & supply
of fresh plasma in hollow viscose fibres or membranes similar to those used for artificial
kidney to perform their function. The principal goal of the Extracorporeal liver assist device
(ELAD) is to circulate a patient's plasma extracorporeal through a bioreactor that contains
metabolically active hepatocytes. Such devices are expected to increase life of patient,
improve the care and quality of life of patients and to reduce care costs.

 Health Care & Hygiene 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 hygiene, care and safety of the staff and patients.

 Implantable material: These materials are used in effecting repair to the body
whether it is wound closure

(sutures) or replacement surgery (vascular grafts, artificial ligaments etc.).

Manjunath and Karthik (2014) [6] described that vascular grafting is the use of transplanted or
prosthetic blood vessels in surgical procedures. As vascular grafts must have specific
characteristics, textile structures are usually the materials used for arterial replacement. The
most important aspects of an arterial graft are porosity, compliance and bio degradability. A
graft should be micro porous to provide a stable anchorage for vascular cells and stimulate
cell growth. Most textile grafts are constructed either of PET (Dacron) or PTEF (Teflon).

Singh et al. (2015) [8] stated that vascular implants belong to a specialised class of medical
textiles. The basic purpose of a vascular implant (graft and stent) is to act as an artificial
substitute for a diseased artery. However, the long-term healing function depends on its
ability to mimic the mechanical and biological behaviour of the artery. This requires a
thorough understanding of the structure and function of an artery, which can then be
translated into a synthetic structure based on the capabilities of the manufacturing method
utilised. Common textile manufacturing techniques, such as weaving, knitting,
braiding, and electros pinning, are frequently used to design vascular implants for research and
commercial purposes for the past decades. However, the ability to match attributes of a
vascular substitute to those of a native artery still remains a challenge. The synthetic implants
have been found to cause disturbance in biological, biomechanical, and hemodynamic
parameters at the implant site, which has been widely attributed to their structural design. They
reviewed the design aspect of textile vascular implants and compared them to the structure of a
natural artery as a basis for assessing the level of success as an implant. The outcome of
this work is expected to encourage future design strategies for developing improved long
lasting vascular implants.

 Non Implantable Materials: These materials used for external applications on the body and
may or may not make contact with skin. This includes wound care, bandages, plasters,
pressure garments, orthopedic belts etc.
Ideal wound dressing
 Maintain a moist environment at the wound/ dressing interface
 Absorb excess exudates without leakage to the surface of the dressing
  Provide thermal insulation and mechanical protection
 Sterile
 Provide bacterial protection
 Preserve an optimum pH value
 Absorb wound odour
 Be non-toxic and non-allergenic

(Karthik and Wasif, 2014) [4]

Wound dressing materials

Developments in wound care products

 Silver dressings: The use of silver to prevent and treat infection in both one of the earliest
forms of wound care. As silver does have such a favourable broad spectrum coverage,
especially in antibiotic resistant organisms, with little significant toxicity, there have a
number of new silver containing wound products developed to capitalize on its wound
healing benefits.
 Negative pressure wound devices: Advances in the actual device include smaller size,
allowing for portable units for home use, increased ability to remove large amount of
fluid, the ability of instill fluids in the wound for continuous irrigation, refinements in the
foam with more consistent pore sizes, different sponge materials including silver, and
increased safety and alarm systems.
 Advanced dressings: While plain gauze is still the most commonly used dressing in hospitals
today, new wound understanding and technology have produced advanced products that
help the body achieve the ideal moist, warm, protected wound healing environment.
Impregnated gauze improves upon this by adding zinc, iodine, or petrolatum to help
prevent desiccation and provide non adherent coverage.
 Skin substitutes: The advances in temporary and permanent coverage wounds have
made significant gains with advancing technology in biomaterials and tissue engineering.
Bioengineered skin substitutes, both biosynthetic skin substitutes and cultured autologous
engineered skin, are available to provide temporary or permanent coverage, with the
advantages of availability in large quatities and negligible risk of infection or immunologic
issues.
 Biobrane: It is a temporary dressing composed of knitted nylon mesh bonded to a thin
silicone membrane and coated porcine polypeptides. It is used in clean superficial and
middermal depth burns or as coverage for donor sites in split- thickness skin grafting.
 Trans Cyte: It is a biosynthetic dressing of a semipermeable silicone membrane on a
nylon mesh coated with porcine collagen and newborn human fibroblast cells. It is used as
a dressing in superficial burns that do not require skin grafting, or as a temporary cover for
excised burns prior to grafting.
 Derma graft: It contains neonatal fibroblasts on a bio absorbable polyglactin mesh. The
fibroblasts produce dermal collagen, glycosaminoglycans, growth factors and fibronectin to
support wound healing. It is a temporary or permanent cover used for excised burn wounds as
well as venous ulcers and pressure ulcers.

Lazar (2010) [5]stated that knitted fabrics and knitting technology play very important role on the
fields of technical
and medical textiles and their importance is ever greater. Experts estimate that their annual
consumption is increasing by 38 % in average and it can reach about 24 million tons in 2020.
Within this the consumption of each sector is increasing. Roughly one third of the
world’s fibre consumption is used for production of technical textiles

Disposable Medical Textiles: Disposable medical textiles are used for functional applications,
designed to be disposed off after use. They are bound by “use and throw” concept. Moreover,
specialty textiles are manufactured for healthcare purpose like isolation gown, disposable
trousers, liquid resistant laboratory coats, sleeve protector, shoe cover, disposable bed sheets
etc. These textiles are durable, lightweight and inexpensive. Woven and non-woven fabrics are
used in manufacturing single use textiles. The leading exporters of disposable textile products
are China, Turkey and United States.

Types of Disposable Medical Products

1. Baby Diapers: These are used to absorb and retain body fluids of infants in period
between birth and 24 months.
Diapers are essentially made by a sandwich of an absorbent pads between fabric sheets. The
technical textile component of the diaper is the non-woven fabric, which prevents fluid
leakage and gives diaper the desired shape.
2. Adult Incontinence Diapers: These are for people with loss of bladder control, which typically
applies to people in the age group of 70 years and more. These are typically made of the
absorbent material of cellulose with poly-beads to convert fluid to gel. The non-woven
material is placed on top for dry feeling.
3. Sanitary Napkins: These absorb and retain menstrual fluid; isolate menstrual fluids from the
body. The desired properties include no leakage, no unaesthetic appearance or colour, no
 odour, no poison, stay in place and comfortable.
4. Panty Shields: It protects the wearer’s panty from body
exudates. The important properties are sufficient absorption capacity, discretion,
comfortable to wear.
5. Tampons: These absorb and retain menstrual fluid inside the body. Desired properties are no
leakage, no odour,
easy to insert/remove, softness, stay in place, comfortable to wear.

Factors in World Trade of Medical Textiles

 Population growth rates, particularly in newly developing global regions,
 Changes in demographics, including the ageing of the population,
 Changes in living standards,
 Attitude to health risks; increased awareness of the risks to health from blood-borne
diseases and airborne pathogens,
 Ongoing enhancement in product performance,
 The growing dominance of purchasing which demands increasing value for money,
 The increasing share of nonwovens on the medical world market in relation to traditional
textile materials.

Recommendations for the development of this sector

 The government should take step to solve power crisis.
 The textile technologists of our country should come forward to encourage the
industrialist to set up medical textile manufacturing factory.
 Collaborate with medical textile manufacturing companies of USA, China etc.
 Try to develop educated, skilled manpower.
 Try to ensure proper safety and sound condition of the factories.

Conclusion
 Medical textiles are a major growth area within the
technical textile sector and the range of applications for such products continue to grow and
increase in diversity with every new development.
 The introduction of new materials, the improvement in production techniques and fibre
properties, and the use of more accurate and comprehensive testing have all had significant
influence on advancing fibres and fabrics for medical applications.
 As more is understood about medical textiles, there is every reason to believe that a host
of valuable and innovative products will emerge.
References
1. Chaudhary SN, Borkar SP. Textiles for extracorporeal devices. Indian Textile Journal. 2009;
65(1):34-39.
2. Dorugade VA. Medical textiles. International journal on Textile Engineering and Processes.
2015; 1(3):89-95.
3. Gotipamul RL, Lokesh KV. Medical textiles- extra corporeal medical textiles. Colourage.
2014; 61(11):90-95.
4. Karthik D, Wasif AI. Wound care materials. Colourage. 2014; 61(2):53-59.
5. Lazar K. Application of knitted fabrics in technical and medical textiles. 45th International
Congress IFKT, Ljubljana, Slovenia, 2010, 27-29.
6. Manjunath RN, Karthik D. Vascular graft: An overview.Colourage. 2014; 61(10):82-86.
7. Saravanan M. Surgical apparels. Colourage, 2014;61(2):60-63.
8. Singh C, Wong CS, Wang X. Medical textiles as vascular implants and their success to mimic
natural arteries. Journal of Functional Biomaterials. 2015; 6(2):500-525.