Review of multifarious applications of polymers in medical and health care textiles (2023)

Table of Contents
Abstract Introduction Section snippets Fibres used in medical and health care textiles Smart textiles in health care Sustainable protective clothing Disposable versus reusable medical textiles Industry insights and reasons for the growth of medical textile market Concluding remarks & future perspectives CRediT authorship contribution statement Declaration of Competing Interest References (48) The Relationship of Selected Fabric Characteristics and the Barrier Effectiveness of Surgical Gown Fabrics Am. J. Infect. Control Data Transfer for Smart Clothing Requirements and Potential Technologies Biomaterials Int. J. Pharm. Biomaterials Prog. Polym. Sci. Regul. Toxicol. Pharm. Developments in medical textiles Textile Progress, Tayler & Francis, vol. 1, Advanced textiles for wound care Study of properties of medical compression garment fabrics J. Fiber Bioeng. Inform. Compression garments and exercise Sports Med. Non implantable materials in medical textiles Int. J. Curr. Res. which dialyser membrane to choose? Nephrol. Dialysis Transplant Advances in non-hygienic applications of superabsorbent hydrogel materials J. Mater. Sci. Aaps Pharm. Cited by (7) Biomedical applications of bio-degradable green composites Gallic acid functionalized polylysine for endowing cotton fiber with antibacterial, antioxidant, and drug delivery properties Soft Fiber Electronics Based on Semiconducting Polymer Prominent processing techniques to manipulate semiconducting polymer microstructures Hydrophilic cloth by surface modification of polypropylene fabrics with mineral particles DEPOSITION OF BACTERICIDAL AGO+CUO COATINGS USING HIGH-POWER PULSED MAGNETRON SPUTTERING TECHNOLOGY (HPIMS) ON POLYPROPYLENE SUBSTRATE Recommended articles (6) Comparative investigations of raw and alkali metal free banana peel as adsorbent for the removal of Hg2+ ions Effect of reduction in column stiffness on the seismic resilience of a building Lift enhancement technique using roller belt arrangement for moving surface over a composite wing structure considering fluid-material interaction One-way fluid-material interaction study on a plunging UAV wing Remedial measures for the spring-in effect in L-angled FRP composites Alternative therapies for Covid-19

Materials Today: Proceedings

Volume 55, Part 2,

2022

, Pages 330-336

Author links open overlay panel

Abstract

The medical and related healthcare and hygiene sector is the most important and growing part of the textile industry. Due to recent development and advancement in polymer science, the research fraternity explored variety of polymers in medical applications ranging from a single thread suture to the complex composite structures for the replacement of bone and cartilage, and from simple cleaning wipes used in operation rooms to advanced barriers fabrics, all are majorly categorised as health care and hygiene products, extracorporeal, implantable and non –implantable devices.

The polymers with desirable properties such as bio-compatibility, non-toxic, non-allergic, non-carcinogenic and good mechanical properties like flexibility, durability and strength have found diverse specialized applications. Chitin, the nitrogen rich polysaccharide has many bio active properties such as anti-bacterial, anti-viral and anti-fungal, which are promising for use in pharmaceutical and scaffolds applications. Protein based natural polymers like collagen; albumin and gelatine are used as membranes for wound healing. Polymeric materials like hydrogels and bio-degradable polymers are inherently capable of taking care of the infection in sutures and wound dressings, also preventing pollution. Polymers with bio active coatings or bio functional surfaces like herbal agents, nano-silver and plasma offer desired anti-microbial features on material surface required in health care regime. Biological, natural or synthetic derived biopolymers find major application as haemostats due to their structural integrity, flexibility and ease of handling. Shape memory and conductive polymers add unimaginable scope in therapeutic care.

This paper presents an overview of polymers used in medical and health care textiles and their wide spread applications classified as in the patient, on the patient, for the patient and near the patient. The future holds bounteous scope for research in the fields of bio-polymers and medical sciences, which help in improving healthcare quality globally by introducing meaningful, new and invaluable products to market.

Introduction

Medical and Healthcare textiles are a major growth area within the scope of technical textiles. Medical Textiles (UK) was defined by the Textile Institute as a general term which describes a textile structures and products that have been designed and produced for use in variety of medical applications, including implantable applications. Health care textiles are defined as “textile materials and products designed and manufactured primarily for their technical performance and functional properties rather than their aesthetic or decoration characteristics”. Resulting from the collaborative research of textile science and medicine, these innovative textiles help in preventing and curing of injuries and diseases. The research and development of medical/ healthcare textiles have attracted enormous attention and effort for having promotion of human health as its primary aim [1].

The purpose of this paper is to highlight the specific medical and surgical applications for which textile materials/polymers are used. A variety of products and their properties that make them suitable for these applications will be discussed. The textile materials used include monofilament and multi filament yarns, woven, knitted and nonwoven fabrics, and composite structures. The number of applications is huge and diverse ranging from simple to advanced, which can be classified into four separate and specialised areas of applications as follows[2].

  • A.

    Implantable medical textiles

Implantable medical textiles are biomaterials used in the Patient for wound closure (ex. suture), replacement surgery (ex. artificial ligaments and vascular grafts). Soft-tissue implants, another important category are flexible and strong materials commonly used for replacement of tendons, ligaments and cartilage in both corrective and reconstructive surgery. Suspensors and reinforcing surgical meshes are used in plastic surgery for repairing defects of the abdominal wall in cases like Hernia. They are also used as implants for heart valves, artificial skin, joints, veins and bones etc.

Implantable medical textiles are indispensable for the repair and reconstruction of the human body. Implantable medical textile products are also more critical than those disposable medical textile products used outside the human body. They require great technical sophistication because of the safety, biological complexity and challenges of the human body. Silk is the only natural fibre that has been adopted successfully in modern implantable medical textile field. Synthetic fibrous materials have received a great deal of attention from the medical industry, out of which particularly nanofiber sized electro spun fibrous membranes are significant for their use as scaffolds for tissue engineering and regeneration [3]. Monofilament, braided, woven, knitted and non-woven structures are used based on the application [4] as detailed in Fig. 1 given below, as the properties of polymers will influence the success of the implant [5].

  • B.

    Non-Implantable medical textiles

These are used on the Patient for external applications/used outside the human body for surface wound treatments of different parts of the human body. They provide protection against infection, to absorb blood and exudates and to promote healing. They include wound dressings, bandages, plasters, absorbent pads, gauzes, wadding, pressure garments and orthopaedic belts, heating pads etc.

Bandages come in a variety of sizes, classifications and provide a number of functions from simple retention to graduated compression systems. Bandages such as adhesive, tubular, crepe and compression bandages should be flexible, breathable, stretchable, non-slip, supportive and non-stick. The common types of medical textiles for wound healing are gauze dressing, impregnated dressing, transparent film dressing, composite dressing, biological dressing, and absorptive dressing which are made from different types of fibres such as cotton and silk, natural and synthetic polymers like polyester, polyamide, PP, polyurethane, polytetrafluoroethylene, alginates, proteins, poly-glycolic acid, regenerated cellulose, chitin, chitosan etc. [6]. Warp knitted spacer fabrics have high breathability, excellent compression elasticity and cushioning, good bending performance, good draping, adjustable vapour transport, high stiffness, and strength-to-weight ratios [7]. Compression products are knitted or woven fabrics containing elastomeric fibres which are used to stabilize, compress, support the underlying tissues and restrict the movements by applying substantial mechanical pressure on the surface of needed body zones [8], [9].

  • C.

    Extra-Corporal Devices

Extra corporal devices are used for the Patient indicate mechanical organs that are used for blood purification such as haemodialysis, hemofiltration, plasma-apheresis orextra corporeal membrane oxygenation. Making of these devices to function as artificial kidney, liver and mechanical lung requires precise designing and manufacturing. Medical filters made from porous hollow fibres provide long-term or temporary extracorporeal supports for such failed human organs as the kidney, liver, lungs, and pancreas [10]. Modified cellulosic materials including cellulose acetate, cellulose triacetate, and cuprammonium rayon (Cuprophan) are used for hemodialyzers [11]. In addition, synthetic polymers such as polysulfone, polyamide, and polyacrylonitrile are used for synthetic hollow fibre membranes. These synthetic hollow fibre membranes have larger pore sizes, higher water permeability, and higher flux than cellulose-based membranes. Biocompatibility is the most important criteria for materials in direct contact with living organisms.

  • D.

    Healthcare/Hygiene products

Health care and hygiene products are used near the Patient in applications related to daily use in hospitals and health care industries.The range of these products available is vast but typically they are used in the operating room theatre or on the hospital ward for the hygiene, care and safety of staff and patients. Hygienic and personal products have a huge market and generate the largest total revenues in medical sectors. These products include feminine care, sanitary napkins, panty shields, baby diapers, and adult incontinence items which promote a better lifestyle experience and convenience. Nevertheless, as hygienic and personal care segment volumes continue to grow; disposability, sustainability, and environmental problems are considered as one of the most serious concerns [12]. Superabsorbent polymers (SAPs) are the main component for the absorbent core of a personal care product such as baby diapers and feminine incontinence products. SAPs are a group of cross-linked hydrophilic polymers which are able to absorb a large amount of water and aqueous solutions like blood and urine (up to hundreds of times of their original weight) without any changes in their shape and structure in a short time and to retain them under a slight mechanical pressure [13]. They keep the skin dry and prevent irritation there by providing comfort to the user. The products and suitable options for application of fibres and fabrics are as given in the below Fig. 2.

In the vanguard of these developments are the fibres manufacturers who produce a variety of polymers whose properties govern the products and their ultimate applications, whether the requirement is absorbency, tenacity, flexibility, softness or biodegradability. This article provides an overview of the main types of biodegradable polymers highlighting their biomedical applications as well as health care and hygiene textile applications.

Section snippets

Fibres used in medical and health care textiles

All Textile fibres are made of macromolecules or polymers, which are formed when hundreds or thousands of small molecules known as monomers (units) are covalently bonded, usually into a linear chain. The fibres used in medical applications must possess properties such as non-toxic, non-allergenic, non-carcinogenic, bio compatible and be able get sterilised without any alterations to their physical and chemical characteristics. Fibres used in health care and hygiene may be classified primarily

Smart textiles in health care

A variety of intelligent textiles, termed as smart or active textiles have been used to promote health and quality of life. These refer to textile structures that are potentially able to sense, react and/or adapt to environmental stimuli, and therefore can be used in products for performing these functions. Ex: the photo-, thermo-, electro-, and halo chromic materials that exhibit colour change upon change of external stimuli. Phase changing polymers can communicate for health monitoring. The

Sustainable protective clothing

Medical textiles are used in the manufacturing of personal protective clothing for healthcare and hygiene applications, specifically to mitigate the risks from exposure to hazardous substances including body fluids and to minimize the risk of cross-infections [2]. There are several different types of medical clothing products, including coveralls, footwear covers, full body suits, gloves, independent sleeves, scrubs, surgical gowns, surgical masks, and scrub hats. Microfibers, in particular,

Disposable versus reusable medical textiles

Both disposable and reusable medical textiles are employed in hospitals now for healthcare and Hygiene. All healthcare workers must wear or use protective textiles such as gowns, gloves, drapes, and facemasks when in contact with patients to reduce or prevent disease transmission [43]. The selection of reusable and disposable textiles is determined by many factors, such as cost, protective and comfort properties of the textiles, government regulations, and possibly social and psychological

Industry insights and reasons for the growth of medical textile market

In terms of global revenue share based on regions, North America is anticipated to dominate the medical textiles sector followed by Europe the second-largest and Asia Pacific was the third largest region of overall market share in 2018 as shown in Fig. 3.

Fabric insights reveal that nonwoven segment dominated followed by woven as second largely consumed with knitted being the last with their specific applications mostly as implantable materials.

Based on application, implantable goods are

Concluding remarks & future perspectives

Medical health care and hygiene sector is one of the important and emerging parts of the textile industry. The development is taking place due to the simultaneous expansion and improvement of technology in both textile as well as medical sector. Textile polymers play a significant role in all aspects of medicine and surgery and the range and extent of applications of these materials is a reflection of their enormous versatility. The range of fibres and fabric forming techniques resulted in

CRediT authorship contribution statement

Srivani Thadepalli: Conceptualisation, Data curation, formal analysis, Wriring- Review and editing.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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