disease and suitable textile materials

R.DevendirakumariR.Devendirakumari13mat0113mat01

Apparel TechnologyApparel TechnologyKumaraguru College of TechnologyKumaraguru College of Technology

Covai-49Covai-4910/15/14 R.Devendirakumari (13MAT01) 1

IntroIntroTextile 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.

Materials usedmonofilament and multifilament yarnsWovenknitted, andnonwoven fabrics, and composite structures. 10/15/14 R.Devendirakumari (13MAT01) 2

Applications:Single thread suture to the complex composite structures for bone replacement, and Simple cleaning wipe to advanced barrier fabrics used in operating rooms.

10/15/14 R.Devendirakumari (13MAT01) 3

Non-implantable materials Wound dressings, Bandages, PlastersGauzesLintWadding, etc.

Implantable materials SuturesSoft-tissue implantsOrthopaedic implantsCardio vascular implants

Extracorporeal devicesArtificial kidneyArt Liver, and Art Lungs

Healthcare/

hygiene products Surgical clothingSurgical coversBeddingClothingIncontinence diaper/sheetCloths/wipesSurgical hosiery

Medical Textile Materials

1. Non-implantable materials1. Non-implantable materials

IntroductionThese materials are used for external applications on the body and may or may not make contact with skin.


I.I. Wound careWound careA number of wound dressing types are

available for a variety of medical and surgical applications.

The functions of these materials are to provide

Protection against infection, Absorb blood and exudate, Promote healing and, Apply medication to the wound.


Common wound dressings are consisting of 3 layersabsorbent layer held between a wound contact layer and aflexible base material. The absorbent pad absorbs blood or liquids and provides a cushioning effect to protect the wound. The wound contact layer should prevent adherence of the dressing to the wound and be easily removed without disturbing new tissue growth. The base materials are normally coated with an acrylic adhesive to provide the means by which the dressing is applied to the wound.The use of collagen, alginate, and chitin fibres has proved successful in many medical and surgical applications.

wound dressing concept


When alginate fibres are used - interaction between the alginate and wound creates a sodium calcium alginate gel.

The gel is hydrophilic, permeable to oxygen, impermeable to bacteria, and contributes to the formation of new tissue.

Other textile materials

gauze, lint, and Wadding.

•Gauze: is an open weave, absorbent fabric that when coated with paraffin wax.•Uses- burns and scalds. •In surgical applications - absorbent material when used in pad form (swabs); yarns containing barium sulphate X-ray detectable.

scald


Lint: is a plain weave cotton fabric.

Uses - protective dressing for first-aid and mild burn applications.

Wadding: is a highly absorbent material that is covered with a nonwoven fabric.

To prevent wound adhesion or fibre loss.


Wound dressings. (a) and (b) wound dressings

(a) (b)


II. BandagesII. BandagesBandages are the final medical requirement. woven, knitted, or nonwoven and are either elastic or

non – elastic materials are used.The most common applicationBandages is to hold dressings in place over wounds. Lightweight knitted or simple open weave fabrics made

from cotton or viscose that are cut into strips then scoured, bleached, and sterilised.

Elasticated yarns are incorporated into the fabric structure to impart support and conforming characteristics.

Knitted bandages can be produced in tubular form in varying diameters on either warp or weft knitting machines. 10/15/14 R.Devendirakumari (13MAT01) 12

Different types of bandages and their application.Different types of bandages and their application.

(a) Elasticated flat bandage, (b) tubular finger bandages,10/15/14 R.Devendirakumari (13MAT01) 13

Woven light support bandages - sprains or strains and the elasticated properties are obtained by weaving cotton crepe yarns that have a high twist content.

Similar properties can also be achieved by weaving two warps together, one beam under a normal tension and the other under a high tension.

When applied under sufficient tension, the stretch and recovery properties of the bandage provides support for the sprained limb.


(c) tubular elasticated net garment

(d) tubular support bandages10/15/14 R.Devendirakumari (13MAT01) 15

Nonwoven orthopaedic cushion bandages Maade by polyurethane foams, polyester, or polypropylene fibres and contain blends of natural or other synthetic fibres. Nonwoven bandages are lightly needle-punched to maintain bulk and loft. Cushion bandage materials includes a fully needle punched structure which possesses superior cushion properties compared with existing materials. 10/15/14 R.Devendirakumari (13MAT01) 16

Compression bandages Treatment and prevention of deep vein thrombosis, leg ulceration, and varicose veins

Classification of Compression bandages extra-highHighmoderate, and light compression.

Woven and contain cotton and elastomeric yarns or warp and weft knitted in both tubular or fully fashioned forms.

Orthopaedic cushion bandage:Used under plaster casts and compression bandages to provide padding and prevent discomfort. 10/15/14 R.Devendirakumari (13MAT01) 17

anti-embolism stockings.

Hip spica lumbar/abdominal support


Lymphatic System DisordersThe lymphatic system is part of the body's

immune system. It consists of nodes, vessels andfluid.


Lymph - a fluid that contains white blood cells that defend against germs.Lymph vessels - vessels that carry lymph throughout your body. They are different from blood vessels.Lymph nodes - glands found throughout the lymph vessels. Along with your spleen, these nodes are where white blood cells fight infection.lymphedema -The lymphatic system clears away infection and keeps your body fluids in balance. If it's not working properly, fluid builds in your tissues and causes swelling, called lymphedema. Other lymphatic system problems can include infections, blockage, and cancer.


http://www.nlm.nih.gov/medlineplus/spleendiseases.html

http://www.nlm.nih.gov/medlineplus/lymphedema.html



http://www.nlm.nih.gov/medlineplus/lymphoma.html

Causes of lymphatic obstruction include:Infections InjuryRadiation therapySkin infections such as cellulitis (more common in obese patients)Surgery & Tumors (swelling)


http://health.nytimes.com/health/guides/disease/cellulitis/overview.html

Treatment for lymphedemaTreatment for lymphedemaCompression garments (usually with multilayered bandages)Wearing compression stockings. Elastic compression garments Inelastic garments Compression bandaging, also called wrapping andShort-stretch bandages to the involved .Areas (arms, legs, or feet ).


Venous System disordersBlood flows from the heart through the

arterial system, and back to the heart through the venous system.

In the legs, the venous system is composed of three elements:

Deep veins, which carry ~95% of the blood volume

Superficial veins, which carry ~5% of the blood volume

Perforator veins, which connect the superficial veins to the deep veins


Overview of Vein Valves - Healthy and Damaged


Problems and SymptomsProblems and SymptomsStandingObesityEven pregnancy, since these all increase stress on the

system. Over time, this increased pressure can reduced

circulation. Fatigue, aching and swelling of the legs and feet can be a

result.


Some Problems due to venous in-suffiency include:

Varicose Veins Leg Pain Leg Swelling Leg ulcers Higher risk of a pulmonary embolism

Chronic Venous Insufficiency◦ Leg Pain and swelling ◦ Discoloration of the lower leg, often ◦ causing brown patches◦ Venous ulcers ◦ Dermatitis

Deep Vein Thrombosis (DVT):


Benefits of Compression Garments Compression hosiery helps

counteract this by applying a firm continuous graduated pressure to the muscles and veins in legs.

Maximum pressure at the ankle to encourage blood to flow up the leg, decreasing compression as it moves higher on the leg.

40% of men and 50% of women.

Graduated Compression


Compression hosiery

Compression hosiery quickly relieves the pain and swelling associated with venous disorders, while at the same time preventing more serious problems, such as blood clots in the deep veins.


Mild Compression (8-15 mmHg)Relief of tired, aching legs, minor swelling in the ankle and legs and to alleviate pain associated with very mild varicose veins.

Moderate Compression (15-20 mmHg)Mild to moderate leg swelling Tired, aching legs and mild leg pain .Superficial or early varicose veins.Post-operative for less severe procedures.Helps to reduce Deep Vein Thrombosis (DVT) in normal-risk patients, especially during periods of long travel.

Firm Compression (20-30 mmHg) Severe leg disorders including:Moderate swelling or edema, leg pain, varicose veins.Reduces Deep Vein Thrombosis (DVT) especially during periods of long travel .Prevention of re-occurrence of venous ulcerations in the leg.

Extra Firm Compression (30-40 mmHg) Severe swelling or edema, varicose veins.Prevention of reoccurrence of venous ulcerations in the leg.Chronic venous insufficiency.Distended, tortuous veins of the legs associated with pregnancy. Post deep vein thrombosis (DVT) Relief of chronic leg fatigue and heaviness .

Compression Category Descriptors


ScarScarring is a healing process of the skin in

response to damage sustained. Scarring is a bodily reaction to injury, during

which the skin thickens, hardens and reddens.Complications Caused by ScarringPain, itching and discomfortHypersensitivity to clothes or touchReduced range of joint motion due to

“shortening” of the skin tissue covering the jointThe unaesthetic appearance of thick, red scarsReduced quality of life and diminished body

image.10/15/14 R.Devendirakumari (13MAT01) 31

Types of ScarsTypes of ScarsHypertrophic ScarsThese scars the wound repair process.do not grow outside the confines of the original wound. Normally red, thick and may be painful or itchy. Keloid ScarsKeloids are original margins of the wound. people with dark skin, and people of oriental decent are more often affected. Growth with rounded margins, and may originate from ear piercing as well as from injury.


Pressure Garment Reduce Pressure Garment Reduce ScarringScarringPressure garments help prevent the

development of hypertrophic and keloid scars by applying mechanical pressure to the affected area.

The pressure garment counteracts the thickening of the scar tissue and thus scarring is minimized.

To reduce the blood circulation to the scarred area which in turn reduces thickening of irregular tough scar tissue & Recovering skin from additional injury.10/15/14 R.Devendirakumari (13MAT01) 33

Scar Disappear Completely


(a) Cervical collar (b) foam padded arm sling

Surgical hosiery and other products made from non-implantable materials.

(c) adjustable wrist brace (d) anti-decubitus boots.10/15/14 R.Devendirakumari (13MAT01) 35

2. Extracorporeal devices2. Extracorporeal devices

Extracorporeal devices are mechanical organs that are used for blood purification and include the

Artificial kidney (dialyser), The artificial liver, and The mechanical lung.


Extracorporeal devicesExtracorporeal devices


ARTIFICIAL KIDNEY

Hollow fibres have replaced coil or laminate in dialyser devices. which consists of 4,000 to 20,000 hollow filaments having an

external diameter of 200 to 300 micrometer. Blood flows inside of the fibres and the dialysate flows outside

of the fibres.

Hemofiltration the term 'Artificial kidney' is often applied to the whole system including the pumps and control circuitry for the dialysate mixing and delivery, and for the blood preparation and monitoring, pumping, deaerating and return to the body.


ARTIFICIAL LIVERARTIFICIAL LIVERMade of hollow viscose to

separate and dispose patients’ plasmas and supply fresh plasma.

MECHANICAL LUNGMade with a hollow

polypropylene fibre or a hollow silicone membrane.

Used to remove carbon dioxide from patients’ blood and supply fresh oxygen.


3. Implantable materials3. Implantable materials

IntroductionThese materials are used in effecting repair to the body whether it be wound closure (sutures) or replacement surgery.(vascular grafts, artificial ligaments, etc.).


Implantable materialsImplantable materials


I. SuturesI. SuturesSutures for wound closure are

either monofilament or multifilament threads

Categorised as either biodegradable or nonbiodegradable.

1. Biodegradable sutures are used mainly for internal wound closures.

2. Non-biodegradable sutures are used to close external wound closures.


II. Soft-tissue implantsII. Soft-tissue implantsThe strength and flexibility

characteristics of textile materials are suitable for soft-tissue implants.

To replacement of Tendons, ligaments, and cartilage in

both reconstructive and corrective surgery.

Artificial tendons are woven or braided porous meshes or tapes surrounded by a silicone sheath.

Natural tendon can be looped through the artificial tendon and then sutured to itself in order to connect the muscle to the bone.


Arteriovenous leg ulcer with exposed tendons; (a) Before treatment; (b) Shave excision; (c)

MatridermTM on the wound; (d) Split-skin mesh graft; (e) One year later with stable healing


Ligaments: Braided polyester artificial ligaments are strong and exhibit resistance to creep from cyclic loads.

Braided composite materials containing carbon and polyester filaments are suitable for knee ligament replacement.

3D-braids 10/15/14 R.Devendirakumari (13MAT01) 45

To replace damaged knee ligaments (anterior cruciate ligaments) should not only possess biocompatibility properties but must also have the physical characteristics needed for such a demanding application.

Anterior cruciate ligament prostheses.


CartilageCartilageCartilage is a flexible connective tissue found in many areas in the bodies of humans and other animals, including thejoints between bones, the rib cage, the ear, the nose, the bronchial tubes and the intervertebral discs. It is not as hard and rigid asbone but is stiffer and less flexible than muscle.

There are two types of cartilage

1.Hyaline cartilage is hard and dense and found where rigidity is needed.

2.Elastic cartilage is more flexible and provides protective cushioning.


Low density polyethylene 1.To replace facial, 2.Nose3.ear, and 4.throat cartilage; the material is particularly suitable for this application because it resembles natural cartilage in many ways.Carbon fibre reinforced composite structures are used to resurface the defective areas of articular cartilage within synovial joints (knee, etc.) as a result of osteoarthritis. 10/15/14 R.Devendirakumari (13MAT01) 49

III. Orthopaedic implantsIII. Orthopaedic implantsOrthopaedic implant materials are used for hard tissue

applications.To replace bones and joints. Fixation plates that are implanted to stabilise fractured

bones. Fibre-reinforced composite materials may be designed

with the required high structural strength and biocompatibility properties needed for these applications.

Replacing metal implants for artificial joints and bones. To promote tissue in growth around the implant a

nonwoven material made from graphite and PTFE (e.g. Teflon) is used, which acts as an interface between the implant and the adjacent hard and soft tissue.


Artificial BoneHip replacement

Total Knee Replacement


Composite structures composed of poly(d, l-lactide urethane) and reinforced with polyglycolic acid have excellent physical properties.

The composite can be formed into shape during surgery at a temperature of 60 °C and is used for both hard and soft tissue applications.

Braided surgical cables composed of steel filaments ranging from 13–130mm are used to stabilise fractured bones or to secure orthopaedic implants to the skeleton. 10/15/14 R.Devendirakumari (13MAT01) 52

IV. IV. Cardiovascular implantsCardiovascular implants

Vascular grafts are used in surgery to replace damaged thick arteries or veins 6mm, 8mm, or 1 cm in diameter.

Used in surgery to replace damaged arteries.

Woven or knitted PET or PTFE.Crimped to prevent kinks.Velour surface promotes tissue

growth.Collagen impregnation to prevent

blood leakage.


Vascular prosthesisVascular prosthesis

During implantation the surgeon can bend and adjust the length of the graft, which, owing to the crimp, allows the graft to retain its circular cross-section.


4. Healthcare/hygiene products4. Healthcare/hygiene products


Textile materials used in the operating theatre include surgeon’s gowns, caps and masks, patient drapes, and cover cloths of various sizes.


ReferencesReferencesHandbook of technical textiles “Edited by A R

Horrocks and S C Anand” ‘Published by Woodhead Publishing Limited in association with The Textile Institute’. Abington Hall, Abington Cambridge CB1 6AH England.

www.elastictherapy.com/benefits.htmlhttp://www.comar-medical.com/scarinfo-en.htmlhttp://www.comar-medical.com/clothing-en.htmlhttp://www.jcasonline.com/article.asp?issn=0974-

2077;year=2011;volume=4;issue=3;spage=176;epage=182;aulast=Wollina

http://textileaid.blogspot.in/2014/06/medical-textile-use-of-technical.html

http://biotextiles.wordpress.com/acl-prostheses/10/15/14 R.Devendirakumari (13MAT01) 58

disease and suitable textile materials

Technology

devendirakumari 13mat01lint

wound adhesion

wound dressing concept

wound contact layer

base materials

materials usedmonofilament

absorbent fabric

protective dressing