This textbook aims to ensure that advances in medical textiles are addressed and that recent developments are able to be appreciated and understood not only by medical practitioners and healthcare personnel but also by textile scientists and technologists. The idea is to stimulate collaborative research and development in the field of medical textiles and to equip researchers with an understanding of the steps they need to take to ensure that their efforts, be they to develop new devices for implantation or items for external application, are carried out in such a way as to improve their effectiveness and enhance the prospects for their implementation. Attention is drawn to the need to improve outcomes in the practical setting and to guidance on the detailed planning required prior to engaging in experimental work. Standard tests can help researchers to monitor performance, but for some important applications such as those required to demonstrate antimicrobial and fluid-repellent performance in most items of protective wear, standard tests consistently fall seriously short in terms of predicting how well they might work in the practical setting. Guidance is therefore given for their further development.
Chapters within the textbook cover:
- The history of innovation within medical textiles with particular attention given to key concepts of the latter part of the 19th Century and subsequent associated developments.
- Textile and polymer science underpinning fibres, fabrics, nano-fibre technology and the functional finishes that can be applied to enhance the performance of medical textile products.
- Woven, knitted, nonwoven and braided fabrics and the key performance characteristics of each fabric type which make them particularly suited to specific medical textile roles such as mesh, grafts, filtration and scaffolds for tissue engineering.
- Implantable medical textiles, non-implantable medical textiles, health and hygiene products and extracorporeal devices that use textile products.
- Legislative requirements for medical devices.
- The design of experiments and suitability for purpose of textile test methods.
- Case studies to illustrate how medical textiles are applied in practice.
The book provides essential reading for textile professionals, biomedical engineers, and others involved in the research, design and engineering of medical and healthcare appliances, and for those employed in the medical profession wishing to gain new insights into the wealth of materials at their disposal.
Author(s): Holly Morris, Richard Murray
Series: Textile Institute Professional Publications
Publisher: CRC Press
Year: 2021
Language: English
Pages: 398
City: Boca Raton
Cover
Half Title
Series Page
Title Page
Copyright Page
Dedication
Table of Contents
Preface
Acknowledgements
Authors
Chapter 1 Introduction
References
Chapter 2 The Development of Textiles in Medicine and the Healthcare Environment over Time
2.1 Introduction
2.2 Protecting the Patients and the Healthcare Staff
2.2.1 Patient and Practitioner Safety
2.2.2 The Antiseptic Approach
2.2.3 The Aseptic Approach
2.2.4 Surgical Gloves
2.2.5 Surgical Masks
2.2.6 Radiation Protection
2.2.7 Uniform Wear
2.3 Repairing the Patient
2.3.1 Sutures
2.3.2 Artificial Tendons/Ligaments
2.3.3 Scaffolds and Tissue Engineering
2.3.4 Hernia trusses
2.3.5 Mesh
2.3.6 Stents
2.4 Maintaining Patient Comfort by Design, Protection and Support, and Personal Hygiene
2.4.1 Patient Comfort – Hospital Ward Design
2.4.2 Patient Comfort – Physical Support and Protection
2.4.2.1 Support
2.4.2.2 Protection
2.4.3 Patient Comfort – Hygiene
2.5 External Artificial Organ Support
2.6 Summary
References
Chapter 3 Textile Materials for Healthcare and Medical Applications
3.1 Introduction
3.2 Range of Applications
3.3 Properties Sought from Textiles for Medical and Healthcare Applications
3.4 Fibres, Yarns, and Fabrics
3.4.1 Fibres and Filaments
3.4.2 Microfibres and Microporous Fibres
3.4.3 Nanofibres
3.5 Yarns
3.6 Fabrics
3.6.1 Woven Fabrics
3.6.2 Knitted Fabrics
3.6.2.1 Weft-Knitted Fabrics
3.6.2.2 Warp-Knitted Fabrics
3.6.3 Non-woven Fabrics
3.6.4 Braids
3.6.4.1 Types of Braid
3.6.4.2 Tubular Braids
3.7 Summary
References
Chapter 4 Fibre Types and the Polymers Used in Medical Textiles
4.1 Introduction
4.2 Natural Fibres and Filaments
4.2.1 Animal-Based: Protein Fibres
4.2.1.1 Wool
4.2.1.2 Silk
4.2.2 Plant-Based: Cellulose Fibres
4.2.2.1 Cotton
4.2.2.2 Other Cellulose Fibres: Kapok, Hemp, Flax, Sisal, Manila
4.2.3 Natural-Polymer Man-Made Fibres
4.2.3.1 Protein Fibres: Casein, Collagen
4.2.3.2 Cellulose Fibres: Viscose Rayon, Lyocell
4.2.3.3 Calcium Alginate
4.2.3.4 Chitosan
4.2.3.5 Hyaluronan/Hyaluronic Acid
4.2.4 Natural Polymer Elastomer: Rubber
4.3 Synthetic Polymer Fibres and Filaments: Commodity Types
4.3.1 Nylon
4.3.2 Polyester
4.3.3 Polypropylene
4.3.4 Acrylic
4.4 Synthetic Polymer Elastomers
4.5 Synthetic Polymer High-Performance Fibres and Filament Materials and Other Specialist Polymer Structures
4.5.1 Aramids
4.5.2 Ultra-High Molecular Weight Polyethylene (UHMWPE)
4.5.3 Cross-Linked Polyethylene
4.5.4 Dendritic Polymers
4.6 Synthetic Absorbable Polymers (SA Polymers)
4.6.1 Aliphatic Polyesters
4.6.2 Polyurethanes
4.7 Super-Absorbent Polymers
4.8 Electroactive Polymer Fibres
4.8.1 Conductive Polymers
4.8.2 Piezoelectric Polymers
4.8.3 Photovoltaic Materials
4.8.4 Electrets
4.9 Other Materials
4.9.1 Carbon Fibres
4.9.2 Glass
4.10 Summary
References
Chapter 5 Medical Textiles: Finishing
5.1 Introduction
5.2 Antimicrobial Finishes
5.2.1 Inorganic Antimicrobial Finishes
5.2.2 Organic Antimicrobial Finishes
5.2.3 Other Finishes
5.2.3.1 Fluid-Repellent Finishing
5.2.3.2 Plasma Treatment
5.2.3.3 Chitosan
5.2.3.4 Cyclodextrins
5.2.4 Molecular Imprinting
5.3 Multifunctional Finishing of Medical Textiles
5.4 Antimicrobial Testing of Finishes
5.4.1 Qualitative Antibacterial Tests
5.4.2 Quantitative Antibacterial Tests
5.4.2.1 ISO 20743: Quantitative Test Methods to Determine the Antibacterial Activity of All Antibacterial Textile Products
5.5 Antiviral Testing of Finishes
5.5.1 Test Methods Using a Surrogate
5.5.2 Test Methods Requiring Tests with Each Individual Virus
5.5.3 Suitability of Test Method to Intended Application
5.6 Durability Testing of Finishes
5.7 Suitability of Antimicrobial Treatment to Intended Application
5.7.1 Mechanisms of Interaction between Antimicrobial Textiles and Pathogens
5.7.2 Tests for the Effectiveness of Antimicrobial Treatments in Different Applications
5.7.2.1 Implants
5.7.2.2 External Applications
5.7.2.3 Furnishings, Fixtures, and Fittings
5.7.3 Predictability of Mismatch between Expectation and Practice
5.8 Sterilisation
5.8.1 Physical Sterilisation Methods
5.8.1.1 Moist Heat Sterilisation
5.8.1.2 Low-Temperature Sterilisation
5.9 Summary
References
Chapter 6 Ensuring Regulatory Compliance
6.1 Introduction
6.2 Changes to Legislation
6.3 The Medical Devices Bodies
6.4 Essential Definitions and Changes to These
6.5 Classification of Medical Devices
6.5.1 Classification Rules
6.5.2 Custom-Made Devices
6.5.3 Exemption?
6.5.4 European Union Classification
6.5.5 FDA Classification
6.6 Risk Management and Risk Analysis
6.6.1 Risk Management Process (ISO 14971)
6.6.2 Risk Analysis
6.6.3 Identifying Hazards
6.6.4 Assessing Level of Risk
6.6.5 Other Risk Assessment Methods
6.6.6 Risk Management Procedure Document
6.6.7 Risk Management Folder in the Technical File
6.6.8 Risk Management and Internal Procedures
6.6.9 Software
6.7 Standards, Courses, and Certification
6.7.1 Courses and Certification
6.8 Biocompatibility
6.9 Technical Files
References
Chapter 7 Implantable Medical Textiles
7.1 Introduction
7.2 Desirable Properties in Implantable Medical Textiles
7.3 Sutures
7.3.1 Healing of Wounds
7.3.2 Advances in Suture Materials
7.4 Vascular Grafts, Stents, and Valves
7.4.1 Current Problems with Grafts, Stents, and Valves
7.4.2 Advances with Grafts, Stents, and Valves
7.5 Implantable Mesh Products
7.5.1 Tendons and Ligaments
7.5.2 Hernial Repair
7.5.2.1 Types of Mesh and Surgical Considerations
7.5.3 Urogynaecology
7.5.4 Problems with Mesh
7.5.5 Future Developments with Mesh
7.6 Ophthalmic Uses
7.6.1 Biomaterials
7.6.2 Contact Lens
7.6.3 Keratoprosthesis
7.6.4 Intraocular Implants
7.6.5 Scleral Buckle in Retinal Detachment Surgery
7.6.6 Orbital Implants
7.6.7 Viscoelastic Substances (VES)
7.7 Resorbable Scaffolds for Cell Growth
7.8 Testing of Implantable Medical Textiles
References
Chapter 8 Non-implantable Medical Textiles
8.1 Introduction
8.2 Wound Dressings
8.2.1 Desirable Properties in Wound Dressings
8.2.2 Passive Wound Dressings
8.2.3 Interactive Wound Dressings
8.2.4 Bioactive Wound Dressings
8.3 Products Used for Haemostasis
8.4 Pressure Garments
8.4.1 Desirable Properties in Pressure Garments
8.4.2 Engineering the Pressure Garment
8.4.3 Thromboembolic Devices
8.4.4 Pressure Garments in the Management of Fractures and Soft Tissue Injuries
8.4.5 Pressure Garments in the Management of Burns
8.5 Orthotics
8.5.1 Desirable Properties in Orthotics
8.5.2 Hernia Trusses
8.5.3 Hip Protectors
8.5.4 Braces and Splints
8.5.5 Scoliosis Braces
8.5.5.1 Management of Scoliosis
8.5.5.2 Types of Brace
8.5.5.3 Adjuncts to Brace Therapy
8.5.6 Exoskeletons
8.6 Testing of Non-implantable Medical Textiles
References
Chapter 9 Healthcare, Hygiene, and Personal Protective Equipment (PPE)
9.1 Introduction
9.2 Healthcare Equipment
9.2.1 Desirable Properties in Healthcare Equipment
9.2.2 Furniture, Furnishings, and Coverings
9.2.3 Hospital Sheets, Pads, and Pillowcases
9.2.4 Air Treatment
9.2.4.1 Room Sterilisers
9.2.4.2 Air Filters
9.2.4.3 Airflow modelling
9.3 Hygiene Products
9.3.1 Desirable Properties in Hygiene Products
9.3.2 Incontinence Products
9.3.3 Feminine Hygiene Products
9.3.4 Cloths and Wipes
9.3.5 Dental Floss
9.3.6 Reusability and Disposability of Hygiene Products
9.4 Personal and Protective Equipment
9.4.1 Desirable Properties in Personal and Protective Equipment
9.4.2 Surgical Gowns, Aprons and Hats
9.4.3 Surgical Gloves
9.4.4 Surgical Masks and Respirators
9.4.5 Healthcare Workers’ Clothing and Uniforms
9.4.6 Patient Clothing
9.5 Testing of Health and Hygiene Products
9.6 Summary
References
Chapter 10 Extracorporeal Devices
10.1 Introduction
10.2 Extracorporeal Membrane Oxygenation
10.2.1 Tubing
10.2.2 Pump
10.2.3 Oxygenator
10.3 The Kidney
10.3.1 The Artificial Kidney and Associated Role of Textiles
10.4 The Pancreas
10.4.1 The Artificial Pancreas and Associated Role of Textiles
10.5 Other Devices for the Support of Homeostasis
10.6 Testing of Extracorporeal Devices
References
Chapter 11 Intelligent (SMART) Medical and Healthcare Textiles
11.1 Introduction
11.2 Smart Textiles
References
Chapter 12 Case Studies
12.1 Case Study One: PPE and Planning for Emergencies
12.1.1 2020 Vision: Epidemics and Shortages of PPE
12.1.1.1 Early Warnings
12.1.1.2 Single Use vs Reusable
12.1.1.3 Quantity Issues
12.1.1.4 Quality Issues
12.1.1.5 Supply Issues
12.1.1.6 Supply-Chain Management Issues
12.1.1.7 Decontamination and Reuse Issues
12.1.2 2020 Hindsight: Prepare for the Next Healthcare Crisis
12.1.3 Beyond 2020: Planning
References
12.2 Case Study Two: Aortoduodenal Fistula after Endovascular Aneurysm Repair
12.2.1 Discussion
References
12.3 Case Study Three: Nasal Haemostasis
12.4 Case Study Four: Cataract
12.5 Case Study Five: Risk Analysis Table
Chapter 13 Medical Textiles: The State of the Art
References
Index
