Medical Textiles

Textiles used for medical purposes. Products include textile

material used in: Hygiene
Health
Personal Care
Surgical Applications
Knitted, Woven and Nonwovens
Classification of Medical Textiles:
Non-Implantable Materials- Wound Dressings,
Bandages, Plaster, Gauze, Wipes, Swabs
Implantable Materials- Sutures , Artificial
Ligaments, Veins and Arteries, Skin Replacement,
Orthopedic Pads, Vascular Grafts
(PET being unreactive and non-toxic is ideal as
tubing used to repair damaged blood vessels in
heart bypass operations.
PET tube can be inserted into the weakened
section of a blood vessel.
Its also used as a skin substitute for people
suffering severe burns.)
Extra Coporeal Devices- Artificial Heart, Kidney,
Joint, Mechanical Lung, Hollow Fibers for Dialysis
Machines.
Hygiene/ Healthcare- Wipes, Babies Diapers
(nappies), Adults sanitary products (Adult Diapers),
Operating Gowns and Drapes, Bedding,
Sterilization Packs.

 Textile materials that have been specifically engineered

to meet the needs of medical and surgical applications
which require the combination of:
Strength
Flexibility
Moisture and Air Permeability

Materials used include Monofilament and Multifilament

Yarns, Knitted, Woven and Nonwoven Fabrics and
Composite Structures.
Applications range from a single thread suture to a
complex composite structure needed for bone
replacement. Simple cleaning wipes to advanced
barrier fabrics in operating rooms.
Specialized areas of application include: Non-implantable Materials: Wound Dressings,
Bandages, Plasters etc.
Implantable Materials: Sutures, Vascular Grafts,
Artificial Ligaments, Artificial Joints etc.
Extra Corporeal Devices: Artificial Kidney, Liver
and Lung.
Healthcare/ Hygiene Products: Bedding,
Clothing, Surgical Gowns, Wipes, Mask, Swab etc.
Majority of Healthcare Products manufactured are
disposable but the remainder are reused.

 Existing and newer fibers and fabric forming techniques

have lead to the advancement of medical and surgical
textiles.
Fiber properties determine the product and its ultimate
application, whether the requirement is Tenacity,
Flexibility, Softness, Inertness, Absorbency or
Biodegradability.

Fibers used
1. Commodity Fibers
Fibers that have to be used in Medicine and Surgery
depend on whether they are Natural or Synthetic,
Biodegradable or
Non-biodegradable.
Fibers used have to be Non-Toxic, Allergenic and
Carcinogenic
and sterilized without impairing any of their physical
or chemical properties.
Commonly used Natural Fibers: Cotton, Silk and
Regenerated Cellulosics like Viscose Rayon; these are
used in Non-Implantable Materials and Healthcare/
Hygiene Products.
Commonly used Synthetic Fibers: Polyester (PES),
Polyamide (PA), Polytetrafluoroethylene (PTFE),
Polypropylene (PP), Carbon, Glass etc.
Then comes the issue of BiodegradabilityBiodegradability in this context refers to fibers that are
absorbed by the body within 2-3 months after implanting
them. These include Cotton
Viscose Rayon
Polyurethane
Alginate
Collagen
Fibers that take more than 6 months to degrade
(considered Non-biodegradable) include Polyester (PES)
Polypropylene (PP)
Polytetrafluoroethylene (PTFE)

 Carbon
2. Specialty Fibers
Naturally occurring polymers like Collagen, Alginate,
Chitin and Chitosan are used for Modern Wound
Dressings.
Collagen
Obtained from Bovine Skin, a protein thats
available in Fiber form or Hydrogel (Gelatin)
form.
Used as Sutures as they are as Strong as Silk
and Biodegradable fibers.
The transparent gelatin form is gotten when
collagen is cross-linked in 5-10% aqueous
solution. This has a high oxygen permeability
and can be processed into soft contact lenses.
Electrospun Collagen nanofibers can be used to
make Scaffolds for Tissue Engineering.
Alginate (Calcium Alginate)
Alginic Acid, main constituent of Seaweedusually Laminarie- exisits in the form of Cacium
Alginate salt which is a fiber used for its
healing properties.
Used for Wounds and Dressings.
Non toxic, Biodegradable and *Haemostatic
(Arresting the flow of blood within the vessels)
Alginate dressings trapped in the wound are
easily biodegraded.

 Dry Strength is comparable to that of Viscose

but Wet Strength is low (Low Wet Tenacity)
Metal content of the alginate is high due to ten
percent calcium which gives it a specific
gravity of 1.75.
Highly absorbent (Absorbance achieved via.
Strong hydrophilic gel formation). It maintains
a physiologically moist microenvironment that
promotes healing and formation of granulation
tissue. This makes dressing changes virtually
painless!
The effects of calcium alginate on cell
proliferation (propagation, production) and
migration is due to the release of Ca2+ ions.
Chitin
A polysaccharide obtained from crab and
shrimp shells.
Excellent antithrombogenic (Thrombogenicity
is the tendency of a material in contact with
blood to produce a thrombus, or clot)
properties. It can be absorbed by the body and
promote healing.
Chitin Nonwoven Fabrics serve as artificial skin,
adhering to the body and stimulate new skin
formation which accelerates cellular
regeneration and reduces pain.
Chitosan

 Treating Chitin with alkali solution gives

Chitosan that can be spun into filaments of
similar dry strength to that of Viscose Rayon.
Chitosan, developed for Slow Drug-Release
Membranes.
Polycaprolactone (PCL) and Polypropiolactone
(PPL)
o Can be mixed with cellulosic fibers to produce
highly flexible and cheap biodegradable
Nonwovens.
o Melt Spun Fibers made from Polylactic Acid
(PLA) have similar heat and strength properties
like Nylon (PA) and are also biodegradable.
Poly (D, L- Lactide- co-glycolide)
Synthetic polymer (of the ester family)
Nanofibers of high surface area and
porosity used for biologically functional
tissue scaffolds.
Commonly used biodegradable polymer in
tissue engineering, electrospinning of this
fiber gives high porosity, pore size, pore
volume produced for tissue scaffolds.
This nanofiber scaffold provides enough
space for cell accommodation and easy
passage for nutrient intake and metabolic
waste secretion.
Its Youngs Modulus and Strain at Failure
can be controlled/ tailored for scaffolds by

varying the fiber orientation and solution

concentration during electrospinning.
Non-toxic. Used for controlled drug
release.
Used for biodegradable sutures, bone
fixation nails and screws.

Non-Implantable Materials

Used for external applications on the body which may or

may not come into contact with skin.
Eg.
Product

Fiber Type

Form of
construction

Wound Care:
Absorbent Pad

Cotton, Viscose

Nonwoven

Wound Contact
Layer

Silk, Viscose, PA,

PE

Knitted, Woven,
Nonwoven

Base Material

Viscose, Plastic
Film

Woven, Nonwoven

Cotton, Viscose,
PA, Elastomeric
Yarns

Knitted, Woven,
Nonwoven

Bandages
Simple Inelastic/
Elastic

Light Support

Cotton, Viscose,
Elastomeric Yarns

Knitted, Woven,
Nonwoven

Cotton, PA,
Compression

Knitted, Woven

Elastomeric Yarns

Orthopedic

Cotton, Viscose,
PES, PP, PU Foam

Woven, Nonwoven

Plasters

Cotton, Viscose,
PES, PP, Plastic
Film, Glass

Knitted, Woven,
Nonwoven

Gauzes

Cotton, Viscose

Woven, Nonwoven

Lint

Cotton

Woven

Wadding

Cotton, Viscose,
Linters, Wood Pulp

Nonwoven

Wound Care
Wound dressings, for different medical and surgical
applications, protect against infections, absorb blood and
exudate (mass of cells and fluid thats seeped out of the
blood vessels or an organ), speeds up healing.
In some cases, medicine can be applied to the wound with it.
Common wound dressings are composite materials
composite materials with an absorbent pad that absorbs
blood or liquids and provides cushioning to protect the
wound. This wound contact layer needs to be easily
removable without disturbing the new tissue growth.

 Base materials are usually coated with PAC adhesive to allow

the dressing to be applied to the wound.
Using Collagen, Alginate and Chitin fibers help with the
healing process. Eg. When Alginate fibers are used in the
wound contact layer, interaction between the alginate and
the wound creates a Sodium- Calcium Alginate Gel. This gel
being hydrophilic and permeable to oxygen but
IMPERMEABLE TO BACTERIA helps to form new tissue.

Other materials used for wound dressing include- Gauze (An open weave absorbent fabric coated with
paraffin wax for treating burns. In surgery, gauze, being
absorbent, is used in pad form (swabs)--- Yarns
containing Barium Sulfate incorporated into the swab
makes it X-ray detectable).

- Lint, being a plain weave cotton fabric is used as a

protective dressing for first- aid and treating mild burns.

- Wadding , is a highly absorbent material covered with a

nonwoven fabric to prevent wound adhesion or fiber
loss.

Bandages
Different types of Bandages and their Application:
Elasticated Flat Bandage
Tubular Finger Bandage
Tubular Elasticated Net Garment
Tubular Support Bandage
Orthopedic Casting Bandage
Pressure Cloves
Pressure Garment
Hip Spica
Abdominal Support
Anti-Embolism Stockings

Performs different functions depending on the final

medical requirement.

Knitted, Woven, Nonwoven [Either Elastic or Nonelastic)

Most common application: To hold dressings in place over wounds
Such Bandages are lightweight knitted or simple
open-weave fabrics made of cotton or viscose which
are cut into strips, scoured, bleached and sterilized.
Elastic yarns are incorporated into the fabric
structure to give support.
Knitted bandages can be made in tubular form (of
different diameters) - either warp or weft knitted.
Woven light support bandages are used for
sprains and
elasticity properties are gotten from
weaving cotton crepe yarns of high TPI. (OR, another
option being to bring about a Seer-Sucker effect by
weaving with two warp beams, one being under
normal tension and the other under a higher
tension).
If the bandage is applied under sufficient tension, the
stretch and recovery properties of the bandage give
the support needed for the sprained area.

Compression Bandages are used for treating or

preventing Deep Vein Thrombosis, Leg Ulcers and
Varicose Veins.

They are designed to exert a requirement amount of

compression on the leg when applied at a constant
tension.
Compression Bandages are based on the amount of
compression they can exert to the ankle and
include: Extra-High Compression
High Compression
Moderate Compression
Light Compression
Either woven with Cotton and Lycra yarns on warp
and weft knitted in either tubular or open width (fully
fashioned) forms.
Orthopedic Cushion Bandages are used under
Plaster Casts and Compression Bandages which
provides padding and
less discomfort.
Nonwoven Orthopedic Cushion Bandages are made
from Polyurethane (PU) foams, Polyester (PES) or
Polypropylene (PP) fibers.
Nonwoven bandages are lightly Needle Punched for
adding bulk and loft.
Cushion Bandage Materials use fully engineered
Needle Punched Structures which possess good
cushioning properties compared to existing
materials.

Bandages:
Bandages are designed to perform different functions based on
the type of wound to be treated and the medical requirements.
They can be Knitted, Woven or Nonwoven.

Types of Bandages:
Ability of a bandage to fulfill one or more than one functions
depends on its:
Elastic Properties
Thickness
Weight

 Conformability

Compression Bandages
- Mainly employed for treating Venous Leg Ulcers and
Varicose Veins
- Reduces Venous Hypertension which results from
Valvular- Insufficiency.
- Application of external compression by means of a
bandage increased the velocity of blood flow within the
veins by providing support to the muscles.
- Venous return is faster and more efficient if the
compression bandage is applied such that pressure
graduates from the ankle to the knee.

- Fibers used: Lycra or Elastane, which is light, strong,

comfortable and washable.
- Knitted or Woven, designed such that they provide
compression.
- Classified as elastic or non- elastic. Elastic compression
bandages are categorized according to the amount of
pressure generated on the ankle of an average leg.
- Compression can be exerted to the leg either by a
single layer bandage or multilayer bandage.

Orthopedic Bandages
- Treatment of Venous Leg Ulcers.
- A padding of at least 2.5 cm thickness is placed
between the limb and compression bandage to
distribute pressure evenly at the ankle as well as calf
region.
- Wadding help protect vulnerable areas of the leg from
high compression levels needed along the rest of the
leg.
- Longer a compression bandage system has to be in
place, greater the amount of padding needed.
- Commercial Padding Bandages are Needle Punched
Nonwovens, Thermal Bonded and either PES alone or a
blend of PES/Viscose.
- An Ideal Orthopaedic Bandage has to meet the
following: Light weight

 Soft and Cushioning to the limb

Prevent any sort of tissue damage
Good absorption and wicking
Tear easily by hand
Comfortable, no irritation and non-allergenic with
the skin on prolonged contact.
Adhesive Bandages
Has an absorbent pad (Often medicated with antiseptic)
covered with woven fabric, plastic or latex rubber which
has an adhesive.
Plaster is applied such that the pad covers the wound
(but doesnt stick to it), and the fabric or plastic sticks
to the surrounding skin to hold the dressing in place
and prevent dirt entering the wound.
Adhesive bandages provide support rather than
compression. The adhesive coating ensures the
bandage doesnt slip or become displaced.
They are used for providing support in the treatment of
sprains or strains.
The material is a heat- bondable, absorbent, Nonwoven
fabric that gives loft and absorbency in the pad area..
The bandage material is of low density, high
absorbency and they are thermal bonded nonwoven
fabric comprising of absorbent cellulosics and staple
length PES-PE conjugate fibers.

Light Support Bandages

Short or Minimal Bandages.
Manufactures from Cotton or Cotton & Viscose.
Used to prevent formation of Oedema and gives support for
managing mild sprains and strains.
Limited extensibility and elasticity, allowing them to be put
firmly over a joint with minimal pressure.
This makes them suitable for treating venous ulcers where
arterial impairment is prevented since low residual pressures
compromise arterial inflow.

Retention Bandages
Used to retain dressings or other materials in
contact with the wound.
They are not to apply pressures so arent used for
leg ulcers or control of oedema.
Light weight cotton products with sufficient (but
minimal) extensibility for a good degree of
conformability.
More recent lightweight knitted and woven
bandages with elastomeric yarns used called
contour or conforming stretch bandages are
cheaper and easier to use than the original
products.

Extracorporeal devices

 Mechanical organs used for blood purification. Eg.

Artificial Kidney (Dialyser)
Artificial Liver
Mechanical Lung
Function and performance of these devices depends on the
fiber and textile technology used.

Extracorporeal Devices
Product
Artificial Kidney
Artificial Liver

Mechanical Lung

Fiber Type

Function

Hollow Viscose Fiber, Remove waste from

Hollow PES Fiber
a persons blood
Hollow Viscose

Separate and
dispose of the
patients plasma and
supply fresh plasma

Hollow PP, Hollow

Silicone, Silicone
Membrane

Remove CO2 from

the patients blood
and supply fresh
blood

Artificial Kidney works by circulating the blood through a

membrane, either a flat sheet or a bundle of hollow viscose
fibers or regenerated cellulose fibers in the form of
cellophane that retains unwanted waste materials.
Multilayer filters of Needle Punched Nonwoven Fabrics of
different densities are used to quickly and efficiently remove
waster materials.

 Artificial liver uses hollow fibers or membranes similar to

artificial kidneys to carry out their function.
Mechanical lug uses microporous membranes of high gas
permeability but low liquid permeability and functions like a
natural lung would, allowing oxygen to come into contact
with the patients blood.

Implantable Materials
Materials used in repairing the body whether though- Would closures (sutures)
- Replacement surgery (vascular grafts, artificial
ligaments etc.)
Implantable Materials

Product

Fiber Used

Fabric
Construction

Sutures
Biodegradable

Collagen, PolyLactide,
Polyglycolide

Non- Biodegradable

Braided
Monofilament,

PES, PA, PP, PTFE,

Steel
Soft Tissue
Implants

Monofilament,

Braided

Artificial Tendon

PES, PA, PE, PTFE,

Silk

Woven, Braided

Artificial Ligament

PES, Carbon

Braided

Artificial Cartilage

LDPE

Nonwoven

Artificial Skin

Chitin

Contact Lenses (Eye) Collagen, Silicone,

Polymethyl
Methacrylate
Orthopaetic
Implants
Artificial Joint
Bones

Silicone, Polyacetal,
PE

Cardiovascular
Implants
Vascular
Grafts

Heart Valves

PES, PTFE

Knitted Woven

PES

Knitted, Woven

Most important is Biocompatability, whether the textile is

accepted or rejected by the body.
Factors that affect how the body reacts to an implant: Porosity- Determines the rate at which human tissue
will grow and encapsulate the implant.

 Small Circular fibers- These are better encapsulated

by human tissue better that large fibers of irregular
cross section
Toxicity- Has to be inert. No toxic substances can be
given off by the fiber. Fibers must be free from surface
contaminants like lubricants or sizing chemicals.
Polymer Properties- Especially biodegradability,
determines the success of implantation.

Sutures
Wound Closures (Sutures) are either monofilament or
multifilament threads (Biodegradable or Non-Biodegradable)
Biodegradable sutures are used for internal wound closures

Non-biodegradable sutures are used to close exposed

wounds and are removed once the wound is sufficiently
healed.

Soft- Tissue Implants

(Tendon: A flexible inelastic cord of strong fibrous collagen tissue
attaching a muscle to the bone)
Soft tissue implants are made of strong and flexible textile
materials.
Surgical applications include:
Replacement of tendons
Replacement of Ligaments

 Cartilage (firm flexible connective tissue) for both

reconstructive and corrective surgery.
Artificial Tendons are woven or braided porous meshes or
tapes surrounded by a silicon sheath.
During their implantation, the natural tendon can be looped
through the artificial tendon and then sutured to itself to
connect the muscle to the bone.
Textile materials used to replace damaged knee ligaments
should obviously have the physical properties needed for
this application, other than just biocompatibility.
Braided PES artificial ligaments are strong and have good
creep properties under cyclic loading.
Also, Braided Composites of Carbon+PES are suitable for
replacing damaged knee ligaments.
Two types of Cartilage found within the body:
Hyaline Cartilage, hard and dense, found where rigidity
is needed
Elastic Cartilage, flexible and provides cushioning properties.

LDPE can replace facial, nose, ear and throat cartilage! Since
LDPE resembles natural cartilage in many ways.
Carbon Fiber Reinforced Composite structures are used to
resurface or repair defected cartilage areas like Knee Joints
(Due to Osteoarthirisis).

Orthopaedic Implants
Materials used for hard tissue applications Eg. Bone and Joint
Replacement.
Fixation Plates implanted to stabilize fractured bones.
Fiber Reinforced Composite Materials (of high Strength and
Biocompatibility) are replacing Metal Implants for Artificial
Bones and Joints.
For promoting tissue ingrowth around the implant, a
Nonwoven Mat made of Graphite and Teflon (PTFE) is used
that acts as an interface between the implant and hard +
soft tissue.
Composites of Poly (D,L-Lactide Urethane) reinforced with
Polyglycolic Acid have good physical properties for this. This
composite can be formed into the correct shape DURING
surgery at a temperature of 60C.
It can be used for both Hard and Soft Tissue.
Braided Surgical Cables (Made of Steel Filaments of
thickness
13-130microns) are used to stabilize
fractured bones OR secure orthopaedic implants to the
skeleton!
PTFE is used for hip joint replacements.

Cardiovascular Implants
Vascular grafts are used in surgery to replace thick arteries
or veins (6, 8 or 11mm in diameter).
Made of PES (Dacron), PTFE (Teflon), Knitted or Woven
Structures for such Vascular Prosthesis/ Grafts.
Straight or Branched Grafts can be created using Weft or
Warp Knitting.
PES vascular grafts are heat set into a crimped configuration
that improves handling features.
During implanting them, the surgeon can easily bend and
adjust the length of the graft due to this CRIMP, which allows
the graft to retain its circular cross- section.
Knitted grafts have porous structure that allows the graft to
easily become encapsulated by growing tissue but this
porosity is disadvantageous especially during blood leakage
(hemorrhage) through the interstices of the graft
immediately after implantation!

Woven grafts may solve this problem but lower porosity

suppresses tissue growth! And woven grafts are stiffer than
knitted vascular grafts.
To reduce this blood leakage problem, knitted grafts
developed with internal and external velour surfaces fill
these interstices of the graft!
Another method can be to seal or pre-clot the graft with the
patients blood before implanting------- this however is time
consuming and its feasibility depends on the patients blood
chemistry and surgeons skills.
Pre-sealed grafts have zero porosity when implanted
although after getting implanted become porous allowing
tissue ingrowths.
Vascular Graft is either impregnated with Collagen or Gelatin
so that after around 14 days, it degrades to allow tissue
encapsulation.
Artificial blood vessels with an inner diameter of 1.5mm have
been made with Porous PTFE (Teflon) tubes. This tube has an
inner layer of Collagen and Heparin to prevent blood clots
Also the outer biocompatible layer has another layer of
collagen with the tube itself maintaining some strength.
Artificial Heart Valves which are Caged Ball Valves with
metal struts are basically covered with PES (Dacron) fabrics
for suturing the valve with the surrounding tissue.

Healthcare/ Hygiene Products

Used in the operating room or the hospital ward for hygiene,
care and safety of staff and patients.
Healthcare/ Hygiene Products

Product

Surgical
ClothingGowns

Fiber

Fabric
Construction

Cotton, Viscose,
PES,PP

Wove, Nonwoven
Nonwoven

Caps

Viscose

Masks

Viscose, PES, Glass

Nonwoven

Surgical Covers:Drapes

PES, PE

Woven, Nonwoven

Cloths

PES, PE

Woven, Nonwoven

Blankets

Cotton, PES

Knitted, Woven

Sheets

Cotton

Woven

Pillow covers

Cotton

Woven

Uniforms

Cotton, PES

Woven

Protective Clothing

PES, PP

Nonwoven

Incontinence
(Lacking- self
restraint)
Diaper/ Sheet:-

PES, PP

Nonwoven

Wood fluff,
Superabsorbents

Nonwoven

Bedding:-

Clothing:-

Coverstock

Absorbent Layer
Outer Layer

PE

Nonwoven

Cloth Wipes

Viscose

Nonwoven

Surgical Hosiery

Cotton, PES, PA,

Elastomeric Yarns

Knitted

 Textile Materials are used in surgeons gowns, caps,

masks, patient drapes, cover cloths of different sizes to
reduce the spreading of bacteria and infection.
Possible source of infection is the pollutant particles
shed by staff, which carries bacteria. Surgical gowns
help act as a barrier for the release and spreading of
these pollutant particles. Gowns being Woven Cotton
Goods. They dont allow the release of particles from
surgeons however itself acts as a source of
contamination (eg, dust particles or lint generated).
This is why surgical gowns are disposed of right away
once used. Another solution being to use composite
materials containing Nonwoven and PE films.

Surgical masks have a very fine middle layer of glass

fibers or synthetic microfibers covered on both sides
with acrylic bonded parallel laid or wet- laid Nonwoven.
They need to have high filtering capacity, air
permeability, lightweight and non-allergenic.
Surgical caps are parallel laid or spun laid Nonwovens
made with cellulosics.
Surgical drapes (cloths used to cover the patient) and
Cover cloths (cloth used to cover working areas around
the patient).
Nonwovens with film backed on one or both sides are
used for these applications. The film is completely
impermeable to bacteria and the Nonwoven is

absorbent to body perspiration and secretions from the

wound. (Hydrophobic finish gives the bacteria barrier
characteristics)
Eg. Loop raised warp knitted PES fabric with laminated
back to back microporous PTFE films in the middle for
permeability, comfort and yet resistance to
microbiological bacterial contaminants.

Bedding, clothing, mattress covers, cloths and wipes

Traditional woolen blankets replaced cotton leno woven
blankets due to better thermal properties and yet easily
washable and sterilizable yarns.
In isolation wards and intensive care units, disposable
protective clothing is worn to minimize cross-infections.
These articles being made of composite fabrics of
Tissue reinforced with PES or PP spun-laid web.

Incontinence products (diapers and sheets)- disposable

diaper being a composite of an inner covering layer
(Coverstock), an absorbent layer and an outer layer.
Inner covering layer being longitudinally oriented PES
web treated with hydrophilic finish OR a spun laid PP
Nonwoven material.
Weft and Warp knitted Pile or Fleece fabrics made of
PES serve as composites with foams and PVC sheets for
use as incontinence mats.
Cloths and Wipes are made from Tissue Paper or

Nonwoven bonded fabrics, soaked in antiseptic finish.

The cloth or wipe is used to clean wounds for wound
dressing afterwards or to treat mild burns or rashes.
Surgical Hosiery with slight compression characteristics
are used for- Light support for the limb
- Treating venous disorders
- Knee and elbow caps--- normally shaped during
knitting on circular machine (may also contain
elastomeric threads) are worn for support,
compression during active sports or protection.
Advances in fiber science resulted in new breed of wound
dressings which contribute to the healing process.
Advanced composite materials containing combination of
fibers and fabrics have developed for applications
concerning biocompatibility and strength.
Nonwovens are used in all areas of medical and surgical
textiles. Short production cycles, high flexibility and
versatility and low production costs are reasons why
Nonwovens are popular in medical textiles.

Coverstock: A lightweight nonwoven material used to contain and

conceal off the underlying core material. Eg. Facing materials that
cover the underlying absorbent core of diapers, sanitary napkins,
adult incontinence products

New Millennium Fibers:

Filtration using Nonwovens:

Liquid, for example, blood, body fluids and water

Air inwards and operating theatres
Anaesthetic gases
Odor removal, dressings, ostomy
Anti-allergic bedding

Alginate dressings are constructed from interwoven strands of calcium

alginate mixed, in some brands, with varying proportions of sodium alginate.
Normally they are presented as a flat sheet of a few mm thickness, although
ribbons or ropes are available. Some brands may have a backing fixed to the
alginate mass for structural strength.
On contact with wound exudate the fibres turn to a gel trapping moisture
at the wound surface to create a moist environment. This also makes them
easy to remove at dressing changes. This mode of action makes them unsuitable
for dry or necrotic wounds, even when soaked with saline. Some concern has
been expressed that under some conditions fibres that do not fully gel may
act as a foreign body in the wound. This may increase the length of the
inflammatory stage.
Reinforced wound dressings refer to the type of
alginate dressings that contain a web of continuous non-gelling materials,
which when wetted will act as a firm structure to the dressings to facilitate
a complete and clean removal.

Wound care management is an extremely complex medical operation and

no single dressing can provide for all eventualities. The successful wound
dressing must satisfy several criteria:
1. Seal the wound and prevent introduction of external stresses and loss of
energy
2. Remove excess exudates and toxic components
3. Maintain a high humidity at the wound-dressing interface
4. Provide thermal insulation
5. Act as a barrier to microorganisms
6. Be free from particulates and toxic wound contaminants

7. Be removable without causing trauma at dressing changes.

Wound healing and polysaccharide fibers

Chitin (poly-1,4,2-acetamido-2-deoxy--D-glucose) is the second most
abundant natural polymer, existing widely in the cell walls of fungi and
crustacean shells. Chitin fibers has been suggested as a material which can
accelerate wound healing, but due to its chemical and physical nature is very
difficult to dissolve. New solvent systems have now been developed which
allow fibers to be produced from chitin, but these have yet to make an impact
on the market.
Another useful material is carboxymethyl cellulose (CMC) which can
be produced chemically from cellulose, the most abundant carbohydrate in
nature. It has the merit that it can be produced in a variety of molecular
weights and can then be integrated with other materials such as alginate to
produce synergistic behavior in terms of physical properties.

Hyaluronan a new medical fiber

This connective tissue polysaccharide is now central
to the understanding and treatment of many intractable diseases.
Previously regarded as the matrix which acted as a
shock absorber in the body, it has now been found to bind into cells via
specific receptor sites, and to instruct the cell how to behave. It is, therefore,
at the centre of normal and disease-related cell proliferation.
Among the reported new developments are its uses and potential in the
following areas:

breast cancer
as a switch to control cell-cancer behavior
as an anti-cancer material
in corneal wound healing
cartilage maintenance
repair of lung injury
healing of chronic wounds
engineering of new tissues
treatment of diabetic foot ulcers
kidney diseases in relation to diabetes
in the control of eye surgery

Hyaluronan (HA) is a linear polysaccharide, with a fiber structure, which

consists of repeating disaccharide units of D-glucuronic and N acetyl-D
glucosamine
residues.
Hyaluronan occurs naturally in vitreous humor synovial fluid and umbilical
cord and in many animal tissues in smaller concentrations. It has been reported
that the molecular weight of naturally occuring hyaluronan varies within the
range 105 to 107. Hyaluronan can be produced from biological sources such
as bovine vitreous, umbilical cord and rooster comb. The highest molecular
weight of hyaluronan produced from animal sources commercially available
is about 5 106 and marketed under the trade name of Healon GV.
Other fibrous scaffolds for tissue engineering
The tissue engineering process starts with a scaffold and a supply of cells.
The cells could be the patients own cells, a donors cell or taken from a
tissue bank. These are seeded into a proposed scaffold. The cells themselves
attach to the scaffold and are cultured within a mini bio-reactor. Tissue
culture media provide nutrients for the cells and remove waste products. The
cells increase in number and lay down the new extracellular matrix to form
neo-tissue. If bio-resorbable fibers are used, then these will start to degrade.
At the end of culturing the tissue engineered may require preservation and
storage before used as an implant.
In addition to the polysaccharides the most important synthetic group
which have application as bio-resorbable scaffolds are poly(glycolic acid)

and poly(lactic acid). These have an established history as sutures or surgical

devices. One such tissue engineered and now on the commercial market is
DermograftTM, a joint venture between Advanced Tissue Services (USA)
and Smith and Nephew, used for the treatment of diabetic foot ulcers. These
wounds are difficult to heal and can often lead to serious complications. The
scaffold is produced from multifilament yarn, a 9010 co-polymer of
poly(glycolic acid) and poly(lactic acid). Specially shaped scaffolds are
produced for articular cartilage and meniscal cartilage.

Collagen: medical applications

Collagen is a major structural protein, forming molecular cables that strengthen
the tendons and vast, resilient sheets that support the skin and internal organs.
Bones and teeth are made by adding mineral crystals to collagen. Collagen
provides structure to our bodies, protecting and supporting the softer tissues
and connecting them with the skeleton. It is composed of three chains, wound
together in a tight triple helix, each chain being over 1400 amino acids long.
Collagen has found widespread medical uses. Urology, dermatology,
orthopaedics, vascular and general surgery utilize collagen in various forms
ranging from injectable solutions to sponge-like materials. In addition, collagens
extracted from animal species, primarily bovine, are used in the preparation

of a wide variety of commercial products including:

biological dressings
tissue culture applications
dermal injectables.

Collagen is an ideal biomaterial for the development of medical and other

commercial products because it is highly biocompatible, is readily available
at high purity, and can be manufactured in such diverse forms as pastes, gels,
films, sponges, and felt-like sheets using a variety of process methods. In
cosmetic treatments it is able to:
smooth facial lines and wrinkles
add definition to lip line borders
smooth smile lines
improve marionette lines
decrease frown lines
improve vertical lip lines
fill shallow acne scars
Collagen also plays an essential role in the wound healing process. Acting
as a tissue scaffold, it is used as a carrier vehicle for cells in tissue engineered
products for dermal wound repair and as a carrier vehicle for growth factors
in bone repair. Collagen fibers are one of the best scaffolds for cell migration
and proliferation. Collagen interacts with fibronectin and other adhesion
proteins to promote cellular in-growth which speeds up wound healing. Type
I collagen has been shown to attract fibroblasts in cell culture and appears to
cause directed migration of cells. Drugs, cells, and growth factors use collagen
as both the delivery vehicle and structural support for tissue development
and in-growth.
Polylactic acid (PLA) differs from the previously discussed
polyesters
because PLA is based on renewable resources and is a
biodegradable

polymer. It is otherwise known as polylactide. The chemical

structure of
PLA is shown below:

It is produced from any starch or sugar containing raw material

such as
corn, cereals, cassava, sugar cane, etc.
Depending upon the content of L and D isomers in
PLA, melting point ranges from about 150C to 210C.
Fibre elasticity and resiliency of PLA is similar to PTT or PBT and is
attributed
to the partial coiling of the backbone chain in the crystalline form.
Uses: Biomaterials, Scaffolds for Tissue Engineering and even
Healing of Bone Fractures ---- Due to Biodegradability, Biocompatibility, Non- toxic, High strength.