Raj Rajendran

The chapter discusses the need for understanding the application of textile materials and textile-based medical devices to enhance the healthcare and wellbeing of people. The aim of this chapter is to highlight the specific medical and surgical applications for which the textile materials are currently being used. A variety of products and their properties that make them suitable for these applications are discussed. Specialty polymers and fibres and their use in designing and developing medical devices for wound management, infection control management and life-saving risk management are highlighted. The physiology of wound, classification of wounds and appropriate dressing selection for a successful wound management are outlined. High-tech wound dressings and the current state of the art of novel dressings such as odour adsorbent and antimicrobial dressings are critically reviewed. The role of compression therapy in the treatment and prevention of venous leg ulceration is discussed. The merits and limitations of the current compression therapy regime and the research into the development of novel compression bandages are highlighted.

Infection, cross-infection, and infectious diseases are critical for health care personnel and patients in hospitals mainly owing to multi-drug-resistance pathogens. Textile materials and garments used in hospitals promote cross-infection as they are used as a vehicle by the pathogenic disease-causing bacteria to spread the infection. However, smart textile materials play a vital role in protecting against the transmission of diseases not only in hospitals but also in other environments where people gather in large numbers. This chapter discusses the application of such materials for infection control management including wound infection management in hospitals. The role of hospital protective garments is summarised. Test methods and standards that cover surgical gowns, drapes, and clean air suits are highlighted

This chapter discusses the physiology of wounds and their management. The classification of wounds and appropriate dressing selection for successful wound management are outlined. High-tech wound dressings and the current state-of-the-art novel dressings, such as odour adsorbent and antimicrobial dressings, are critically reviewed. The role of compression therapy in the treatment and prevention of venous leg ulceration is discussed. The merits and limitations of the current compression therapy regime, and research into the development of novel orthopaedic padding and compression bandages, are highlighted.

The application of woven textiles in healthcare and hygiene is discussed. It is demonstrated in this chapter that the conventional woven structures are still playing a crucial role in designing and engineering hi-tech medical devices. A brief discussion on classification of wounds and their management, infection control, antimicrobial, implantable products, wound dressings and bandages makes this chapter interdisciplinary. Specification and manufacturing aspects of a few product developments are outlined. Commercial names of a few medical devices and their specific applications are highlighted.

The chapter discusses the physiology of wounds and their management. The classification of wounds and appropriate dressing selection for a successful wound management are outlined. High-tech wound dressings and the current state of the art novel dressings such as odour adsorbent and antimicrobial dressings are critically reviewed. The role of compression therapy in the treatment and prevention of venous leg ulceration is discussed. The merits and limitations of the current compression therapy regime and the research into the development of novel orthopaedic padding and compression bandages are highlighted.

The paper gives a comprehensive review of antimicrobial finishing of textiles using natural products such as chitosan, natural dyes and other herbal products. The research work on antibacterial finishing of cotton textiles using the active ingredients of neem seed extract, a natural herbal product, is also presented. Neem tree, abundantly found in Indian subcontinent, is a rich source of medicinal compounds. Neem seed extract has been successfully integrated to the cellulosic substrate imparting a semi-durable antibacterial property against both Gram-positive and Gram-negative bacteria.

Venous leg ulceration is a common problem throughout the western world. The chronic nature of venous ulcers creates considerable demands upon all healthcare authorities in terms of treatment costs and nursing resources. Compression bandaging is considered as the “gold standard” for managing venous leg ulcers and treating the underlying venous insufficiency. The main function of a compression bandage is to exert external pressure onto the limb. The ability to generate and to maintain this sub-bandage pressure is determined by the bandage structure, the elastomeric properties of the yarns, as well as the finishing treatments applied to the fabric. Non-woven materials are currently used in combination with compression bandages in an attempt to evenly distribute pressure and provide protection over bony prominences of the leg (tibia). However, these multilayered bandage systems are uncomfortable to wear due to their bulkiness and undesirable thermo-physiological characteristics. They are also difficult to apply and are associated with relatively high costs due to the requirement for specific bandage types for each layer. The requirement for a single-layer compression bandage that incorporates the performance characteristics of multi-layered compression bandage systems is of paramount importance.
Three-dimensional knitted spacer fabrics are becoming increasingly important for developing novel medical textile products. In comparison to traditional woven or knitted fabrics, the range of physical and thermo-physiological properties which can be achieved is considerably wider. These novel structures consist of two independent faces with interconnecting threads joining them. They can be exceptionally soft, incorporate large volumes of air, and provide good resilience to compression, temperature control, and moisture management. The layer of air that lies between the two independent textile faces creates a comforting, climate-controlling effect which prevents sweating and overheating of the skin. Spacer fabrics also provide an excellent cushioning effect which means that there is no need to use multiple layers of padding and compression bandages. When elasticated yarns are incorporated into the spacer fabric structure it is also possible to produce similar pressure-generating characteristics to those of traditional compression bandages.
The focus of this paper is to discuss the design criteria and important functional properties of three-dimensional single-layer compression systems. A range of both weft and warp knitted spacer-fabrics were tested in order to determine their basic functional properties. Mechanical testing was also undertaken in order to assess the elastic and elongation properties of these spacer-fabrics. Load elongation hysteresis is important since it not only relates to the materials ability to generate external pressure, but also how this pressure maybe affected from any changes in tension, extension, and elastic properties. The tension, and hence external pressure, generated within traditional compression bandages normally decays slowly over an extended period of time after application onto the limb. The tension decay test simulates bandage application and highlights a materials ability to sustain tension throughout a pre-determined time period (15hours).
Thermo-physiological and climate-controlling properties of the spacer-fabrics will also be discussed in this paper. These tests directly relate to the functional comfort characteristics of the spacer-fabric structures which include thermal resistance, thermal absorpitivity, water vapour permeability, and evaporative heat loss. In all of the tests undertaken, comparisons are made to results obtained for traditional compression bandages and padding bandage materials.

The application of compression textiles in managing venous leg ulcers is discussed. The classification of compression bandages, merits and limitations of the current compression therapy regimen, and the research into the development of novel orthopaedic padding and compression bandages are highlighted. The role of compression therapy in the treatment of oedema, varicose veins and deep vein thrombosis (DVT) is outlined. Research and development of a novel single-layer 3D spacer bandage, which replaces the existing multilayer bandage regime, is discussed.