Textile for Medical Science

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.

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 have 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.

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

follows:
Current Issues
Sr
Fibre Application in medical field
No.
Surgical clothing gowns, Beddings,
1 Cotton Sheets, Pillow cover, Uniforms,
Surgical hosiery
2 Viscose Caps, Masks, Wipes
Gowns, Masks, Surgical cover drapes,
3 Polyester
Blankets, Coverstock
4 Polyamide Surgical hosiery
5 Polypropylene Protective clothing
6 Polyethylene Surgical covers, Drapes
7 Glass Caps mask
8 Elastomeric Surgical hosiery

A number of crucial issues regarding medical products in general and

healthcare and hygiene products in particular have been identified and
debated amongst clinicians, environmentalist, drug companies etc. for a
long time. The issues such as

Natural against chemical or manufactured fibres

Disposable against reusable or durable fabrics
Antibacterial or antimicrobial fibres against finishes or coatings for
infection control
Methods of disposal of clinical waste i.e. landfills against incineration
and other forms of medical and clinical waste disposal
There is general move towards an increased use of natural polymers that
are biocompatible, biodegradable and nontoxic

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

Medical textiles can be classified as follows:

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.

1. 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.

2. Surgical masks:-They should have higher filter capacity, high level

of air permeability, lightweight and nonallergic.
Healthcare and hygiene products :

Product application Fibre type Fabric type

Cotton, Polyester,
Surgical clothing Nonwoven,
Viscose rayon,
gowns Woven
Polypropylene
Viscose rayon,
Nonwoven
Caps masks Polyester, Viscose,
Nonwoven
Glass
Polyester, Nonwoven or
Surgical covers Polyethylene Woven
Drapes cloth Polyester, Nonwoven or
Polyethylene Woven
Beddings, Cotton, Polyester Woven, Knitted
Blankets, Sheets Cotton Woven
Pillow covers Cotton Woven
Cotton, Polyester
Clothing uniforms Woven
Polyester,
Protective clothing Nonwoven
Polypropylene
Incontinence
Polyester,
Diaper sheet
Polypropylene Nonwoven
Coverstock
Wood fluff Nonwoven
Absorbent layer
Superabsorbents Nonwoven
Outer layer
Polyethylene fibre
Cloths/ Wipes Viscose rayon Nonwoven
Polyamide,
Nonwoven
Surgical hosiery Polyester, Cotton,
Knitted
Elastomeric yarns

1. Surgical caps: - These are made from nonwoven materials based

on cellulose.
2. 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 ,
which gives a very high surface area for contact with the fluid. Typically
fibre will absorb 95% of its ultimate capacity in 15 seconds.

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.

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
1. The most important factor is porosity, which determines the rate at
which human tissue
will grow and encapsulate the implant.
2. Small circular fibres are better encapsulated with human tissue than
larger fibres with
irregular cross sections.
3. The fibre polymer must not release toxic substances, and fibre should
be free from
surface contaminants such as lubricants and sizing agents.
4. Biodegradable

Why textile implants?

v Biocompatible materials
v Material combinations
v 2D- and 3D-structures
v Mechanical characteristic adapted to the
v environment
v Adjustable macroscopic structure
v Specific surface design

Polyamide is most reactive material losing its overall strength after only
2 years as a result of biodegradation.
E.g. Sutures, soft tissue implants, orthopaedic implants, cardiovascular
implants etc.

Vascular prosthesis

The first artificial vascular graft was produced from polyamide fibre in
1956. Polytetraflouroethylene (PTFE) fibre soon replaced polyamide and
then polyester fibre was introduced. The implants are made from variety
of synthetic materials. The main fibres include polyester, PTFE.
Polypropylene, polyacrylonitrile. However polyester and PTFE are most
common vascular prosthesis currently available.

The major requirements of a good vascular graft include

v Non-fraying
v Flexibility
v Durability
v Biocompatibility
v Stability to sterilization
v Resistance to bacteria/viruses

Knitted polyester vascular prosthesis has become the standard

vascular graft for replacement of arterial vessels of 6mm and greater.
However while this has many features required by a surgeon, such as
ease of handling, saturability, and conformability, it has one major
disadvantage; it is not blood-tight. The knitted structure, by its nature,
is porous, which is what is required for rapid incorporation by tissue in
growth from the host. At the time of surgery the surgeon has to
percolate the graftusingsome of the patients own blood, which is taken
before heparinisation- a time consuming process which can be difficult
to carry out satisfactorily. This prevents its use when patients are
heparinised such as cardiopulmonary bypass and in emergency
aneurismal surgery when percolating is not possible.

The potential for localized delivery of antibiotics from braided surgical

sutures

It is an attempt to address the problem of nosocomial infections

associated with braided sutures; they have proposed the incorporation
of a resorbable antibiotic coating. The sutures coating has been
 engineered to release its active ingredients locally during the first few
days following surgery. Two broad spectrum antibiotics with superior
Gram-positive activity, moxifloxacin and Clindamycin were selected
and each incorporated at two leves of loading into a reasonable

Epsilon-caprolactum glycolide copolymer which was then coated onto

polyester braided sutures. In vitro exposure experiment to phosphate
buffered saline (PBS) were undertaken at room temperature for a
period of 5 days in order to determine the duration and efficacy of the
released antibiotic against a standard strain of Staphylococcus
aurous. The results from zone of inhibition tests demonstrated that
both antibiotics provided effective prophylytic bacteripostatic
properties for periods of upto 2 days.

A suture should be chosen with the following properties of importance: -

v Tensile strength
v Stiffness
v Easy handling properties
v Good knotting security

d.Non-implantable materials

These materials used for external applications on the body and may or
may not make contact with skin. They are made from co-polymer of
two α amino acids.

This includes wound care, bandages, plasters, pressure garments,

orthopaedic belts etc.
d.1 Surgical dressing:-

these are employed as coverings, adsorbent, protective and supports for

injured or diseased part. They are different types
v Primary wound dressing
v Absorbent
v Bandages
v Protective
v Adhesive tapes

d.2 Primary wound dressing

v Placed next to the wound surface

v Nonwovens with a binder content of 60% and made of cellulose
fabrics are being
v Used.
A dressing should possess the following properties:

v Healing properties, regulated mainly with the substances which

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

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.

Various types of bandages along with their function are mentioned

below:

1. Simple Bandage Hold dressings in place.

2. Elasticated Bandage: Impart support and conforming.
3. Light support Bandage: management of sprains or strains.
4. Compression Bandage: Treatment and prevention of deep vein
thrombosis, leg ulceration.
5. Orthopedic Bandage: Used under plaster casts, provide padding and
prevent discomfort.
6. Gauze: Serves as absorbent material.
7. Lint: Used as protective dressing for use in mild burn applications.
8. 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.

Medical textile global scenario:

It is the 5th in the textile market size with respect to other twelve
textile application
Recently a survey of medical textiles conducted by the tata economy
consultancy services has estimated the market size in terms of value
17093 (Rs Mn) in 2005 and it would be 302018 (Rs Mn)
Market size of medical textile in India in the value terms (Rs Mn) 2005
is 338. It is estimated up to 575 (Rs Mn) 2010
The forecast for the world medical textile consumption in volume and
value terms for 2010 is 2380 tonnes and 8238 (Mn USD) respectively

Consumption of different categories of medical textiles:

SR Medical Textile Product

Market potential (Rs Mn)
2005 2010
1 Sanitary Napkins 4819 8519
2 Incontinence diapers 605 1070
3 Surgical dressing 5828 10302
4 Health care textiles 1491 2635
5 Sutures 3160 5587
6 Medical devices & 1190 2104
Implants

CONCLUSION

Textiles are more and more developing into interdisciplinary high-tech

products with interesting changes in the market. Medical Textile
Competence Centers are being established to make the most of
knowledge, expertise and existing collaboration with medical
researchers, microbiologists, physiologists and textile scientists. Each
country has its own regulations and standards for medical textiles. As
medical procedures continue to develop, the demand for textile
materials is bound to grow.