Medical and Healthcare Textiles

Subhash C. Anand, J F Kennedy, M Miraftab, S. Rajendran

• Publisher: Woodhead Publishing
• Year: 2010
• Print ISBN:
  9781845692247
• eBook ISBN:
  9780857090348
• Topic: Technology & Engineering
• Subtopic: Materials Science
• Index: Technology & Engineering

Medical textiles remain one of the most dynamic areas of research in textiles. Medical and healthcare textiles is the fourth in a series of conferences held at the University of Bolton. Like its predecessors, it has attracted papers from some of the leading international centres of expertise in the field. Contributors cover a range of topics including emerging textile-based biomaterials, hygienic textiles, the use of textiles in infection control and as barrier materials, bandaging and pressure garments for managing chronic infections such as ulcers, the role of textiles in the management of burns and wounds, textile-based implantable devices such as tissue scaffolds and sutures, and intelligent textiles. - Provides a comprehensive overview of medical textiles from the risk of infection control and barrier materials through to directives, regulations and standards shaping the medical device industry - Explores developments in healthcare and hygiene products, including odor and pH control as well as protective and disposable fabrics - Reviews development in the area of implantable materials featuring vascular grafts, knee implants and scaffolds

Part I

Infection Control and Barrier Materials

Infection Control and Barrier Materials – an Overview

S. Rajendran, Institute for Materials Research and Innovation University of Bolton, Bolton BL3 5AB, UK

INTRODUCTION

With the arrival of high risk microorganisms such as (Methicillin-resistant staphylococcus aureus) MRSA and Swine flue (H1N1 virus), infection control is a serious problem, especially in hospital environments. Hospital-acquired infections cost the National Health Service (NHS) in the UK £1 billion and contribute to the death of an estimated 5000 patients a year. The Department of Health in the UK estimates that such infections can cost an extra £4000-£10000 per patient. Controlling wound infection in hospitals is a day-to-day problem for healthcare personnel despite the precautionary measures taken to avoid them. Both acute and chronic wounds are vulnerable to bacterial infection. Highly-exudating wounds, macerated and slough wounds are often at risk of infection. About 8% of hospital in-patients in England develop infections and in intensive care units the figure raises to 23%.

In order to address the problem with particular reference to MRSA and Clostridium difficile, a new £4.2 million consortium has been jointly created by the Biotechnology and Biological Sciences Research Council (BBSRC), the Medical Research Council (MRC), the National Institute for Health Research (NIHR) and the Welcome Trust in the UK. The projects the consortium plans to fund will range from organising a rapid response, springing into action if a particularly virulent strain of MRSA emerges and analysing its particular signature so it can be quickly detected and controlled, to finding the best ways to change the habits of hospital staff, patients and visitors to prevent infections from occurring and spreading. The consortium will look at issues such as quick detection and control of the spread of virulent strains of MRSA, the mode of spreading to hospital equipments such as latex gloves, and identify the best strategies for preventing the spread of infection.

WOUND INFECTION

Wound management that includes chronic wounds such as pressure sores, venous leg ulcers is one of the crucial areas which needed to be addressed for elderly and immobile communities because ageing and immobility weaken the intact of the skin that provide a physical barrier to the ingress of microorganisms. The skin is an important defence layer of the body as it protects from microorganisms, UV radiations and injury. It maintains the temperature of the body besides helping the body to gain vitamin D from sunlight. Wounds are formed when the skin is broken, and the healing process depends on the extent of damage to the epidermis, dermis and subcutaneous layers of the skin. Superficial wounds only damage the epidermis but the partial thickness and full-thickness wounds respectively damage the dermis and subcutaneous fatty tissues and/or bone. Wound healing by primary intention refers to the skin edges that have been brought together by sutures, and surgical adhesives. On the other hand, the secondary intention describes wound healing when the skin edges are not brought together and have to heal by contracting and filling up with granulating tissues. Wounds such as leg ulcers and pressure ulcers fall in this category, and they are chronic because it takes a longer time to heal.

The skin in children and healthy adults is strong and inhospitable to pathogenic microorganisms but weak for elderly population and those confined to wheelchair. Once the line of defence is broken there is a risk of infection. Ageing decreases the efficiency of wound healing mechanisms. Once wound is formed replacement of epidermal cells, inflammatory response, sensory perception and barrier function decrease through the ageing process. Arterial and venous disease can delay wound healing, and are a common problem to the elderly population. The ultimate aim of wound management is to promote healing without microbial infection. Infection in the wound results in an increased production of exudate and delayed wound healing. Wounds in elderly people do, however, heal with good effect with careful management by selecting appropriate dressings. Wound dressings vary with the type of wound and management technique and no single dressing is universally applicable for healing all types of wounds. An ideal dressing is normally expected to provide barrier against dirt and other foreign bodies, provide humid environment at the wound surface that enhances wound healing, control exudate and be removed without trauma. The dressing should provide a barrier against pathogenic bacteria including the challenging MRSA (methicillin-resistant staphylococcus aureus) and MRSSA (Methicillin susceptible Staphylococcus aureus) bugs because cross-infection by bacteria through wound dressings and hospital textiles is increasingly common in hospitals and has been a major problem over several years. In the UK alone only a small number of patients (104) were infected by MRSA in 1992 but this figure rose to 4,904 in 2001. According to Office for National Statistics, the number of death in England and Wales involving Staphylococcus aureus increased from 1,212 in 2001 to 2,083 in 2005. The death rate increased by 69% due to Clostridium difficile. Elderly people are vulnerable to risk as evidenced that the death rate in 2007 involving 85 and over age groups represents 767. It must be pointed out that certain bacteria, for example MRSA super bug shows resistance even to antibiotics. The bug is contagious and transmitted through skin contact as well as hospital textiles in hospital environment. It should be noted that the currently available wound dressings are effective against only a few types of bacteria and no such dressings provide a complete shield against a wide spectrum of pathogenic bacteria that include MRSA and MRSSA. In a broad sense, an ideal wound dressing should fulfil many major requirements which include high barrier properties against a broad spectrum of pathogenic microorganisms.

HOSPITAL PROTECTIVE MATERIALS

Infection and cross-infection are nowadays more common in hospitals where the prevalence of microorganisms is high. Microorganisms are broadly classified as bacteria, fungi and viruses. Gram-positive bacteria include Staphylococcus aureus, Staphylococcus epidermidis, MASA and MRSSA and Gram-negative bacteria comprises of Proteus vulgaris, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Fungi (Candida albicons, Aspergillus niger), bird flue and swine flue are typical examples of viruses. Gram invented a staining method in 1884 to distinguish the bacteria based on colour changes. Gram-positive bacteria are purple and Gram-negative bacteria are red after Gram staining. The bacteria cause infections such as superficial infections, acute gastro-enteritis, infections of wound, burn, respiratory and urinary tract. Infections associated with fungi are: ear, nose and lung infections; tinea nigra of palms; white pildra of beard; diaper rash; athlete’s foot; ring worm; and tinea, pulmonary, mucosa and hair infections.

It is known that textiles carry and transmit infections from one pe...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Woodhead Publishing Series in Textiles
• Preface
• Part I: Infection Control and Barrier Materials
• Part II: Healthcare and Hygiene Products
• Part III: Wound Care Materials
• Part IV: Bandaging and Pressure Garments
• Part V: Implantable Materials
• Part VI: Medical Devices
• Part VII: Smart Materials and Technologies
• Part VIII: Industry Standards and Regulations