MEDICAL & BIOMEDICAL TEXTILES

INTRODUCTION :
Medical textiles are textile products and constructions for medical applications. They are
used for first aid, clinical or hygienic purposes and rehabilitation.
Biomedical textiles are fibrous structures designed for use in specific biological
environments, where their performance depends on biocompatibility with cells and
biological tissue or fluids.
APPLICATIONS OF BIOMEDICAL TEXTILES:
Protective and heathcare te!tie": surgeons wear, operating drapes and staff
uniforms, etc.
E!terna device": wound dressings, bandages, pressure garments, prosthetic socks,
etc.
I#$anta%e #ateria": sutures, vascular grafts, artificial ligaments, etc.
&'(iene $rod)ct": incontinence pads, nappies, tampons, sanitary towels, etc.
E!tracor$orea device": artificial liver, artificial kidney, artificial lung, etc.
&ISTOR* :
The first recorded use of fibres in medicine was mentioned in !urgical "apyrus nearly #,$$$
years ago. %n the !usanta !ambita of the %ndian &iterature, written approximately ',($$
years ago, a variety of materials are mentioned including horse hair, leather strips, cotton,
animal sinews and fibrous tree bark. )s more research has been completed, textiles have
found their way into a variety of medical applications. %n addition to protective medical
apparel, textiles in fibre and fabric form are used as implants, filters and surgical dressings.
*ecent decades have witnessed ma+or development in medical textile production, the
materials they are made of the and the technology used to produce them.
DESI+N FACTORS:
The design of a biomedical textile is driven by its end function. The main factors include:
F)nction: the textile needs to fulfill the purpose for which it was designed, for
example swabs re,uire an absorbent textile, sutures may re,uire a biodegradable
textile, while hospital bedding should be comfortable and durable.
Bioco#$ati%iit': this refers to the reaction of the textile with blood and tissue in the
body. )n implantable device has more potential for reaction than an external device
and is, therefore, sub+ect to tighter regulations. -or example an artificial ligament is
permanent and is able to react with blood cells and the surrounding tissue, compared
to an external bandage that is temporary and only contacts the outer skin tissue.
Co"t: this will depend on the raw materials, manufacturing process and product end.
use/ surgeons gowns and swabs should have a low production cost while vascular
grafts and artificial skin will have a relatively high production cost.
Prod)ct a$$rova: each country has its own regulations and standards for medical
textiles. 0owever the 1uropean 2nion has introduced 3ommunity &egislation to
govern medical devices. The three directives are: )ctive %mplantable Medical
4evices, Medical 4evices 4irective and %n.5itro 4iagnostic Medical 4evices.
RA, MATERIALS:
5arious synthetic and natural fibres, each with uni,ue properties, are used to construct
biomedical textiles. -ibres are used in a variety of applications depending on the
characteristic re,uired/ for example 3arbon fibre known for its absorption properties is used in
wound dressings and absorption columns. 0owever it is used for its strength in artificial
ligaments and for its lubricity in orthopaedic cushioning. !ynthetic polymers, used extensively,
can be divided into permanent e.g. polyamide, polyester, polyethylene, polypropylene, "T-1
and polyurethane and biodegradable which are mainly used in sutures and tissue engineering
structures e.g. polycaprolactone, polyglycolic acid and polylactic acid. 6atural biological fibres
include: chitin 7from the cells of crustacea8 a polysaccharide renowned for its wound healing
properties and incorporated into wound dressings/ collagen 7a fibrous protein found in
connective tissue, tendons, etc.8 used in cell engineering structures, for example artificial skin/
and alginate fibres which can interact with the wound to form an absorbent gel, that acts as a
protective barrier and still allows the wound to breathe.
MANUFACTURIN+ PROCESS:
Biomedical textiles are manufactured from a wide range of processes. 1xtruded polymers can
be further processed or used as filaments or tapes in dental floss and toothbrushes. Braided
textiles are used for sutures and to replace damaged tendons and ligaments. 9oven and
knitted materials are used extensively in bandages, vascular grafts and hernia meshes. )
speciali:ed area of medical textiles is the extrusion of hollow fibre membranes used in
extracorporeal devices. 6on.wovens are primarily made from synthetic fibres and uses
include wound dressings, hygiene products and protective clothing.
RE-UIREMENTS OF BIOMEDICAL TEXTILE
The main attribute of a biomedical textile is that it should fulfill the purpose for which it was
designed. -or example, sutures may re,uire a biodegradable textile. )n artificial ligament is
permanent and is able to react more with blood cells and the surrounding tissues, compared
to an external bandage which is temporary and only contacts the outer skin tissue. )n
implantable device should be biocompatible. Biocompatibility testing evaluates the response
of the host system to the medical textile. *esults of this testing must be viewed along with the
benefits of this device.
*e,uirements of an i#$ant:
The biological re,uirements of a satisfactory artificial implant may be stated as
follows:
"orosity, which determines the rate at which tissue, will grow and encapsulate the
implant.
!mall circular fibres are better encapsulated by human tissue than larger fibres with
irregular cross.sections.
6on.toxicity, where fibre polymer or fabrication techni,ues must be non.toxic and
fibres should be free of contaminants.
Biodegradability and bio.stability depending on the application. ) suitable artificial
surface for body cells to adhere to and grow on.
S)t)re" and i(at)re"
The term &igature denotes tying something such as blood vessel or a pedicle, whereas
suture denotes sewing by means of a needle and a thread made of suture material. !utures
are strategically located after a surgical operation primarily to hold the basic structural
elements in their re,uired sites and provide the necessary strength, retained over a period of
two weeks upwards, depending on the specific site. !utures are either monofilament or
multifilament threads used in surgery for wound closure. The ideal suture is a monofilament
with a smooth surface that can pass through the skin without being caught and can be
tightened into a single knot. The polybutylene terephthalate 7"BT8 suture is currently the most
popular because of its acceptable strength and smooth surface.
!utures are characteri:ed as biodegradable or non.biodegradable. Biodegradable sutures are
used mainly for internal wound closures. 6on.biodegradable sutures are used to close
exposed wounds and are removed when the wound is sufficiently healed. These may again
be of a natural or synthetic variety. The selection of the suture will depend on physical and
chemical characteristics and the biological culture of the tissue in which it is placed.
The absorbable natural sutures are 3atgut prepared from the intestine of government
inspected sheep. The great advantage of catgut is that it can be used even in the presence of
infection where a non.absorbable suture cannot be used. The disadvantages of catgut are
loss of tensile strength, doubted purity and cost. 3ollagen was invented to overcome the
disadvantages of catgut. The flexor tendons of beefs are converted into dispersed fibrils which
are extruded and reconstituted to form collagen sutures. The absorbable synthetic sutures are
"olyglycolic acid 7dexon8 which has the advantages of tensile strength, very little tissue
reactivity, knots well. The disadvantage however is that its tensile strength falls in ;( days.
3o.polymer is a suture which overcomes the disadvantage of polyglycolic acid in that its
tensile strength does not fall before #.< weeks.
The non.absorbable natural sutures are silk, waste silk, cotton, linen whereas the synthetic
ones are polyamide, polyester, polyethylene, polypropylene. 5icryl plus from 1thicon, is
claimed to be the worlds first and only suture incorporating an antibacterial agent. %t is
designed to reduce bacterial coloni:ation on the suture.
.a"c)ar i#$ant"
5ascular graft is an artificial vein or artery used to replace segments of the natural
cardiovascular system that are blocked or weakened. =rafts are implanted to bypass the
blockages and restore the circulation. These are replaced in surgery to replace damaged
thick arteries or veins from <mm, >mm or ;cm diameter. !traight or branched grafts are
possible by using either the weft or warp knitting technology. ?nitted vascular grafts have a
porous structure, which allow the graft to be encapsulated with new tissue. The disadvantage
is that this can cause hemorrhage 7blood leakage8 through the interstices directly after the
implantation. %n an attempt to reduce this risk, knitted grafts with internal and external velour
surfaces are used. )nother method is to seal or percolate the graft with the patients blood
after implantation. "orous Teflon exhibits good bio.compatibility and anticoagulant activity.
0owever, thin blood vessels, made from Teflon tubes lead to problems. The tube consists of
an inner layer of collagen, the tube itself providing strength. *esearch is targeted to produce
artificial blood vessels of less than @mm diameter. The main re,uirements are blood
compatibility, porous structure, re.absorbable, easy for tissue growth and avoid clotting.
So/t ti"")e i#$ant"
Biomedical materials are used in applications such as soft tissue compatible artificial
prostheses, artificial skin patches, artificial tendon and artificial corneas. %mportant properties
that affect cell attachment and tissue growth are chemical structure, electric charge,
hydrophilicity, hydrophobicity, roughness of the surface, micro heterogeneity and material
flexibility. !oft tissue compatible biological polymers are collagen, silk protein, cellulose, chitin
and chitosan. !oft tissue artificial materials include silicone rubber, polyurethane, hydro gels
and carbon fibre. !ilicone rubber is a cross linked polymer of poly 7dimethyl siloxane8. %t has
been used in artificial breasts, ears and noses.
&ernia re$air
Meshes find use in hernia repair and abdominal wall replacement, where mechanical strength
and fixation are very important. -ibres can be woven or knitted into a mesh with each side
designed with a specific porosity and texture to optimi:e its long term function. "olypropylene
mesh is an example of fabrics used in hernia repair. "olypropylene is resistant to infection
and is anti allergenic. =ore.Tex soft issue patch, which is used in hernia repair, is made of
expanded "T-1.
&ard ti"")e i#$ant"
0ard tissue compatible materials must have excellent mechanical properties compatible to
hard tissue. Typical characteristics of polymers related to hard tissue replacements are good
processability, chemical stability and bio compatibility. )pplications include artificial bone,
bone cement and artificial +oints. Arthopedic implants are used to replace bones and +oints,
and fixation plates are used to stabili:e fractured bones. Textile structural composites are
replacing metal implants for this purpose. ) non.woven fibrous mat made of graphite and
Teflon is used around the implant to promote tissue growth.
Nerve ()idance channe
) developing area of research is the development of nerve guidance channels that are used
to bridge the damaged nerve endings and facilitate the passage of molecules secreted by the
nerve and bar fibrous tissue from infiltrating the area thus preventing repair. )n innovation is
the use of electrically conducting polymers such as polypyrole to promote nerve regeneration
by allowing a locally applied electrical stimulus. %t is a blossoming field of textile research,
since the nerve guidance channel may be a single continuous hollow tube, or it may be a
hollow tube comprised of fibres.
Bio#ateria" in o$htha#oo('
6atural and synthetic hydro gels physically resemble the eye tissue and hence have been
used in ophthalmology as soft corneal lenses. !oft contact lenses are made of transparent
hydro gel with high oxygen permeability. 0ard contact lenses are made of poly 7methyl
methacrylate8 and cellulose acetate butyrate. -lexible contact lenses are made from silicone
rubber.
Denta %io#ateria"
Ma+or re,uirements of dental polymers include translucence or transparency, stability, good
resilience and abrasion resistance, insolubility in oral fluids, non.toxicity, relatively high
softening point and easy fabrication and repair. The most widely used polymer for dental use
is poly 7methyl methacrylate8 7"MM)8 and its derivatives. Ather materials for denture base
polymers are polysulfone and polyether polysulfone.
Ti"")e en(ineerin(
Tissue engineering is one of the fastest growing research fields in modern medicine. Tissue
engineering unites cell and molecular biologists, clinicians and surgeons, bioreactors and
biomaterial specialists. The spectrum ranges from the multiplication of simple skin cells for
burnt victims to the regeneration of entire tissues and organs from the patients own cells.
Tissue engineering is the replacement of damaged tissues or organs with biologically based
systems. Tissue engineering seeks to create functional substitutes for damaged tissues by
combining engineering principles with those of life sciences.
) small number of healthy cells are taken from a patient and allowed to multiply in the
laboratory culture. These are then combined with an absorbable polymer that may be shaped
to mirror the target organ or tissue. This may be fabricated in a number of ways including a
three dimensional arrangement of fibres into a scaffold. The scaffold material provides
structural integrity and mechanical stability in the short term. The cells are added to the
scaffold and allowed to adhere and grow on the plastic material. The cellBscaffold is implanted
into the patient and as the cells develop and form tissue, the plastic breaks down and is
removed from the body. Thus the fundamental application of a scaffold is to grow new
tissuesBorgans by culturing isolated cells on templates. Textile structures form an important
class of porous scaffolds.
1mbroidery technology is being widely used for medical textiles and tissue engineering.
1mbroideries complement the field of technology and medical textiles in a uni,ue way since
they combine very high architectural variability with the freedom of ad+usting the mechanical
properties in a wide range and matching it with the mechanical properties of the host tissue.
S)##ar'
Textiles are developing into interdisciplinary high tech products with interesting chances on
the market. Awing to the greater co.ordination among textile technologists and medical
researchers, textile products for surgical procedures are being developed indigenously.
Textile structures in implantation are identified by structure, material composition, behavior of
fibre surface and degradation. 4evelopments of biologically friendly and predictable
absorbable fibres will be of great interest, both as suture materials and as the basis of tissue
engineering constructs. %mproved absorbable fibres will be of great interest, both as suture
materials and as the basis of tissue engineering constructs. %mproved absorbable fibres will
be necessary as new sterili:ation technologies are introduced to meet evolving environmental
specifications. )dvances in textile technology will clearly bring a new and improved group of
biomedical textiles.
Source :
Biomedical Textiles *esearch 3entre,
0eriot.9att 2niversity, 6etherdale,
=alashiels, T4; @0-.
Tel: $;>C< >C';<>/ -ax: o;>C< D(>C<(.
http://www.hw.ac.uk/sbc/BTRC/BTRC/_private/Whatare.htm