Advanced Textiles for Wound Care

Advanced Textiles for Wound Care......Page 1
 Copyright......Page 2
 List of Contributors......Page 3
 Preface......Page 6
 Recently Published and Upcoming Titles in The Textile Institute Book Series......Page 8
   1.2.1 Describing the aetiology of a wound......Page 9
   1.3.2 Healing by secondary intention......Page 10
   1.4.1 Haemostasis......Page 11
    1.4.2.1 Role of neutrophils......Page 12
    1.4.2.4 Role of inflammatory mediators......Page 13
    1.4.3.1 Granulation tissue formation......Page 14
    1.4.3.4 Contraction......Page 15
    1.5.1.1 Bioburden......Page 16
    1.5.1.4 Neoplasia......Page 17
    1.5.2.3 Diabetes and impaired glucose tolerance......Page 18
  1.6 Wound healing: treatment options......Page 19
   1.6.1 Wound dressings......Page 20
    1.6.1.7 Low-adherent dressings......Page 22
    1.6.1.11 Odour adsorbent dressings......Page 23
    1.6.3.1 Negative pressure wound therapy......Page 24
    1.6.4.1 Topical......Page 25
   1.7.1 Gene therapy......Page 26
  References......Page 27
  2.1 Introduction......Page 31
   2.2.2 Prototyping and testing......Page 32
  2.3 The development of wound dressings......Page 33
  2.4 Importance of performance-based specifications......Page 34
   2.5.1 Fluid handling tests – absorbency of wound dressing......Page 36
    2.5.1.1 Free swell absorbency/absorptive capacity......Page 38
    2.5.1.2 Fluid handling capacity (Payne cup method)......Page 40
   2.5.3 Moisture vapour transmission rate......Page 41
   2.5.4 Development of the Wrap rig......Page 42
   2.5.5 Conformability of wound dressing......Page 44
   2.5.8 Rate of absorption......Page 46
   2.5.11 Evaluation of swelling characteristics......Page 47
   2.5.13 Waterproofness testing of occlusive dressings......Page 48
   2.5.14 Measurement of the peel from stainless steel testing at 180° angle......Page 49
   2.5.15 Odour adsorption test......Page 50
  2.6 Microbiological tests......Page 52
   2.6.1 Tests for antimicrobial agents released from dressings......Page 55
   2.7.1 pH measurement test method......Page 56
   2.7.2 Lateral area wicking......Page 58
   2.8.1 Part 5: tests for in vitro cytotoxicity......Page 59
  References......Page 60
  3.1 Introduction......Page 63
  3.2 The role of dressings......Page 64
  3.4 Minor wounds......Page 65
  3.5 Healing mechanisms......Page 67
   3.7.1 Historical......Page 69
   3.7.2 Case for moist environment......Page 70
   3.7.4 General classification......Page 71
   3.7.5 Wound occlusion, environment and healing......Page 74
   3.8.1 Gauze dressings......Page 75
    3.8.1.3 Impregnated gauze......Page 76
   3.8.4 Composite dressings......Page 77
   3.8.5 Biological dressings......Page 78
   3.8.7 Alginate dressings......Page 79
   3.8.8 Chitosan dressings......Page 80
   3.8.9 Chitosan/alginate bicomponent fibre dressings......Page 81
    3.8.11.1 Amorphous gels......Page 82
   3.8.13 Antimicrobial dressings......Page 83
    3.8.15.3 Dressings that donate moisture......Page 84
   3.9.1 Protease-modulating dressings......Page 85
  3.10 Bandages......Page 86
   3.11.1 Cotton......Page 87
   3.11.3 Polyester......Page 89
   3.11.5 Polyolefins......Page 90
   3.11.7 Elastomeric fibres......Page 91
   3.11.8 Chitosan......Page 92
   3.11.9 Alginate......Page 93
   3.12.3 Woven fabrics......Page 94
   3.12.4 Knitted fabrics......Page 95
   3.12.6 Nonwoven fabrics......Page 96
    3.12.6.1 Unidirectional dry-form process......Page 97
    3.12.6.3 Chemical and thermal bonding of webs......Page 98
    3.12.6.4 Spun-bond process......Page 99
    3.12.6.6 Wet-laid process......Page 100
    3.12.6.7 Spunlace process......Page 101
    3.12.6.8 Melt-blown process......Page 102
    3.12.6.9 Polymer web process......Page 103
    3.12.6.10 Advanced composites from combination of technologies......Page 104
  References......Page 105
  4.1 Introduction......Page 113
  4.2 Normal wound healing......Page 114
  4.3 Wound characteristics......Page 115
  4.4 Interactive wound dressings......Page 117
    4.4.1.1 Semi-permeable film dressings......Page 123
    4.4.1.3 Alginate dressings......Page 124
    4.4.1.5 Hydrogel dressings......Page 125
    4.4.2.2 Hyaluronic acid......Page 126
    4.4.3.1 Silver dressings......Page 127
    4.4.3.3 Polyhexamethylene biguanide hydrochloride dressings......Page 128
    4.4.4.1 Maggot dressings......Page 129
    4.4.4.2 Polyacrylate dressings......Page 130
    4.4.4.4 Cold atmospheric pressure argon plasma dressings......Page 131
   4.5.1 Colour......Page 132
   4.5.2 Depth......Page 133
  4.6 Future trends......Page 134
  4.8 Sources of further information and advice......Page 135
  References......Page 136
   5.2.1 Inflammatory phase......Page 143
   5.2.4 Collagen......Page 144
  5.3 Principles and roles of bioactive dressings......Page 145
   5.4.1 Alginates......Page 147
   5.4.2 Hydrocolloids......Page 149
   5.4.3 Hydrogel......Page 150
   5.4.4 Collagen......Page 151
   5.4.5 Honey dressings......Page 152
   5.4.6 Chitin, chitosan and derivatives......Page 153
   5.4.8 Medicated dressings......Page 157
   5.4.9 Naturally derived polymeric scaffolds......Page 158
   5.4.10 Composite dressing......Page 159
   5.5.1 General description of DBC......Page 160
   5.5.3 Rationale for the possible provision of butyrate......Page 161
   5.5.5 Haemocompatibility......Page 162
   5.5.6 Radical scavenging activity of DBC......Page 163
   5.5.8 In vivo animal experiments......Page 164
   5.5.10 Biodegradation of DBC in wound dressings......Page 166
  5.6 Future trends......Page 167
  References......Page 169
  Further reading......Page 174
  6.1 Introduction......Page 176
  6.2 Elastic compression bandages......Page 177
    6.3.2.1 Doppler ultrasonography......Page 178
    6.3.2.3 Photoplethysmography and air plethysmography......Page 179
    6.4.1.1 Classification......Page 180
    6.4.1.2 Compression hosiery......Page 181
    6.4.1.3 Compression system......Page 182
   6.4.3 Ideal compression bandages......Page 183
  6.5 Applications of bandages......Page 184
  6.6 Present problems and novel bandages......Page 185
  6.7 Three-dimensional spacer compression bandages......Page 191
   6.7.1 Effect of pressure transference of spacer bandages......Page 192
  6.8 Conclusions......Page 195
  References......Page 196
  7.1 Introduction......Page 200
   7.2.1 Chlorhexidine......Page 201
   7.2.4 Iodine......Page 202
   7.2.6 Silver......Page 203
   7.3.1 Textile fabric soaked with antimicrobial agents......Page 204
   7.3.4 Textile composite containing antimicrobial fibres......Page 205
   7.3.5 Other novel methods......Page 206
   7.4.1 The antimicrobial properties of silver......Page 207
   7.4.2 Types of silver compounds used in wound dressings......Page 208
  7.5 Applications of modern silver-containing antimicrobial wound dressings......Page 210
   7.6.1 Metal ions with antimicrobial properties......Page 213
  Sources of other information and advice......Page 214
  References......Page 215
  8.1 Introduction......Page 218
   8.1.1 Burn wounds......Page 219
   8.1.2 Management of burn wounds......Page 220
  8.2 Chronic wounds......Page 225
   8.2.1 Management of chronic leg ulcers and diabetic foot wounds......Page 228
  8.4 Topical pharmaceutical agents......Page 229
    8.5.1.1 Natural polymers – chitin/chitosan derivatives......Page 231
    8.5.1.2 Cross-linked alginate dressings/fibroin and alginate sponge......Page 234
    8.5.1.3 Hyaluronic acid and its derivatives, collagen and gelatin......Page 237
    8.5.1.4 Cellulose and dextran-based dressings......Page 238
    8.5.2.1 Polyurethane......Page 240
    8.5.2.2 Chitosan/PU films containing minocycline......Page 242
    8.5.2.3 PVA- and PVP-based dressings......Page 243
    8.5.2.5 Other polymer-based dressings......Page 244
   8.6.1 Nanofibrous non-woven matrices......Page 245
   8.6.2 Novel wound dressings for managing deep skin wounds or ulcers......Page 246
    8.6.2.1 Advanced therapies......Page 247
    8.6.2.2 Cell therapy......Page 248
  8.7 Sources of further information and advice......Page 251
  References......Page 252
  Further reading......Page 267
  9.1 Introduction......Page 268
  9.2 Wound: definition and types......Page 269
  9.3 Wounds which require drug delivery......Page 270
   9.3.1 Wound infections......Page 271
    9.3.2.2 Bite wound infections......Page 272
    9.3.3.1 Diabetic ulcers......Page 273
    9.3.3.3 Venous leg ulcers......Page 274
  9.4 Delivering drugs to wounds......Page 275
  9.5 Types of dressings for drug delivery......Page 276
   9.6.2 Healing improvement......Page 283
   9.6.3 Controlling transport of biological fluid......Page 284
   9.7.1 Tissue engineering......Page 285
   9.7.3 Micro- and nanotechnology in drug delivery dressings......Page 286
   9.7.5 Environment-sensitive drug delivery dressings......Page 288
  References......Page 289
  10.2 Basic principles and types of smart textiles......Page 296
  10.3 Biomarkers and smart wound dressing......Page 297
   10.4.2 Sensors and dressings......Page 298
   10.4.4 Temperature-sensitive dressings......Page 299
   10.4.6 Non-contact normothermic wound therapy......Page 301
   10.4.7 Control of exudates from wounds......Page 303
   10.4.9 Selecting a dressing......Page 304
    10.4.9.2 Fluid-retention dressings......Page 305
   10.5.1 Hydrogel dressings......Page 306
   10.5.2 Fluid-retention dressings......Page 307
   10.5.6 Hydrocolloid dressings......Page 308
   10.5.10 Tissue-engineered ‘skin equivalents’......Page 309
    10.6.2.1 Smart bandages for pathogenic bacteria......Page 310
   10.7.1 Dressings and pathogens......Page 311
   10.7.2 pH-sensitive textiles......Page 312
  10.8 Sources of further information and advice......Page 314
  References......Page 315
  Further reading......Page 318
  11.1 Introduction......Page 319
  11.3 Structure of composite dressing......Page 320
   11.4.1 Non-adherent or semi-adherent layer......Page 323
   11.4.2 Absorptive layer......Page 324
   11.4.3 Bacterial barrier layer......Page 326
   11.5.1 Island composite dressing......Page 327
   11.5.2 Layered composite dressing......Page 328
   11.6.1 Embroidery technology for wound dressing......Page 329
    11.6.1.1 Multilayer dressings using nanofibres......Page 330
    11.6.1.2 Multilayer dressing using negative-pressure wound therapy......Page 331
  References......Page 332
  12.1 Introduction: principles of tissue engineering......Page 334
  12.2 Properties required for fibrous scaffolds......Page 335
   12.2.2 Specific requirements for fibrous scaffolds......Page 336
   12.2.3 Materials used for scaffolds......Page 337
   12.3.1 Scaffold topography......Page 338
   12.3.2 Fibre diameter......Page 339
   12.3.4 Surface property......Page 340
  12.4 Textiles used for tissue scaffolds and scaffold fabrication......Page 341
    12.4.1.1 Microstructural aspects of textile structures......Page 342
    12.4.1.2 Mechanical properties of textile structures......Page 343
    12.4.2.1 Knitting......Page 344
     Braiding......Page 345
    12.4.2.2 Technologies for fabrication of textile nanofibres......Page 346
     Nonwoven......Page 347
   12.5.2 Vascular grafts......Page 350
   12.5.3 Tissue-engineered liver......Page 351
   12.5.5 Bone grafts......Page 352
  12.6 Future trends......Page 353
   12.7.2 Trade and professional bodies......Page 355
  References......Page 356
  Further reading......Page 367
   13.1.1 Clinical need of advanced wound dressings......Page 368
  13.2 Collagen as building block of advanced wound dressings......Page 370
   13.2.1 Protein composition and organisation in vivo......Page 371
   13.2.2 Extraction of collagen ex vivo......Page 373
   13.2.3 Collagen sources and antigenicity......Page 374
   13.3.1 Non-hydrolysed collagen formulations......Page 375
   13.3.2 Hydrolysed collagen-based formulations......Page 378
   13.4.1 Synthesis of network architectures to achieve dressing multifunctionality......Page 380
   13.4.2 Customisation into single fibrous component for wound dressing manufacture......Page 382
   13.4.3 One-step manufacture of multifunctional collagen-based meshes......Page 385
  13.5 Outlook......Page 387
  References......Page 388
  14.1 Introduction......Page 395
   14.1.1 Pathophysiology of wound healing......Page 396
    14.1.2.2 Wound assessment......Page 397
   14.2.1 Reason of non-healing wounds......Page 398
   14.2.4 Impact of hard-to-heal wounds on the patient......Page 399
   14.3.2 According to the nature of materials used [28,30]......Page 400
   14.3.3 According to the physical form [28]......Page 401
   14.3.4 Characteristics of an ideal wound dressing......Page 402
   14.4.1 Speciality dressings for controlled drug release......Page 403
   14.4.2 Speciality dressings for rapid control of bleeding......Page 405
   14.4.3 Speciality dressing for detecting/inhibiting bacterial infections in healing wound......Page 406
   14.4.4 Speciality dressings for stimulating healing by electric current......Page 409
   14.4.7 Dressings through tissue engineering......Page 411
   14.4.9 Regenerative bandage......Page 412
   14.5.2 Speciality dressing for easy removal to prevent trauma and epithelial tissue damage during healing......Page 415
   14.5.3 Speciality dressing for moisture management......Page 416
   14.5.4 Negative-pressure wound therapy......Page 417
  14.6 Future of wound care......Page 418
  References......Page 419
  15.1 Introduction......Page 426
  15.2 Medical devices......Page 427
  15.3 Phases in the life span of a medical device......Page 429
  15.4 European Medical Devices Directive Regulations......Page 431
   15.4.2 Application of the classification rules......Page 432
   15.4.3 Compliance requirements......Page 433
   15.4.5 Notifying bodies......Page 435
   15.4.7 Conformity assessment procedure......Page 436
   15.4.8 Wound dressings and regulatory norms......Page 437
    15.4.8.1 Class I wound dressing......Page 438
    15.4.8.2 Class IIa wound dressing......Page 439
   15.5.1 Premarket review process......Page 440
   15.5.3 Device classification......Page 442
   15.5.4 Premarket approval......Page 443
   15.5.5 PMA supplements......Page 444
   15.5.6510 (k) notification......Page 445
   15.5.8 Regulations pertaining to wound dressing in the United States......Page 447
    15.5.8.3 Class III wound dressing......Page 448
  15.6 Medical device regulations in Canada......Page 449
   15.6.2 Quality systems......Page 451
   15.6.4 Post-market regulation......Page 452
   15.7.1 Medical device classifications......Page 453
   15.7.2 Conformity assessment......Page 455
   15.7.3 Essential principles......Page 456
    15.7.4.1 Class I wound dressing......Page 457
  15.8 Recent changes in EU medical devices regulations......Page 458
  15.9 Challenges in medical device regulations......Page 460
  References......Page 461
  16.1 Introduction......Page 465
  16.3 Role of natural biopolymers as wound dressings......Page 466
   16.3.1 Polysaccharide biopolymers......Page 467
    16.3.1.1 Neutral polysaccharides......Page 468
    16.3.1.2 Acidic polysaccharides......Page 469
    16.3.1.4 Sulphated polysaccharides......Page 470
   16.3.2 Proteoglycans......Page 471
    16.3.3.3 Pectins and gums......Page 472
   16.4.2 Polyethylene glycol......Page 473
   16.4.5 Polyvinylpyrrolidone......Page 474
   16.5.1 Silicone dressings......Page 475
   16.5.4 Smart silk dressings – for treating chronic wounds......Page 477
   16.5.6 Oxidised regenerated cellulose and collagen......Page 478
   16.5.8 Neem and aloe vera dressings......Page 479
  16.7 Bioprinting......Page 480
  16.9 Conclusion......Page 481
  References......Page 482
  Further reading......Page 490
  17.2 Nanostructure wound dressings......Page 491
   17.2.1 Mechanism of antimicrobial action of silver nanoparticles......Page 492
   17.2.2 Treatment of wound healing using silver nanoparticles......Page 494
   17.2.3 Silver-based ceramic and organic polymeric nanomaterials......Page 496
  17.3 Chitin/Chitosan–Ag NP-based wound dressings......Page 498
  References......Page 505
  18.1 Introduction......Page 511
  18.2 Classification of the wounds......Page 512
  18.3 Healing phases of the wounds......Page 513
   18.3.3 Proliferation......Page 515
   18.4.1 Weaving......Page 516
   18.4.2 Knitting......Page 519
   18.4.3 Spacer fabrics......Page 520
   18.4.4 Embroidery technique......Page 522
   18.4.5 Nonwoven......Page 523
    18.4.5.1 Parallel-laid web forming......Page 524
    18.4.5.3 Random-laid or air-laid process......Page 525
    18.4.5.5 Melt-blown web forming......Page 526
    18.4.5.6 Chemical and thermal bonding of webs......Page 528
    18.4.5.7 Spunbond process......Page 529
    18.4.5.8 Spunlace(hydroentanglement) process......Page 530
    18.4.5.9 Novel nonwoven based wound dressings......Page 531
   18.4.6 Electrospinning......Page 532
    18.4.6.1 Electrospun wound dressings......Page 534
  References......Page 538
  19.1 Introduction......Page 543
    19.2.1.2 Abrasion test......Page 544
   19.2.2 Evaluation of antiallergy of the finished fabric contact allergy test using in-house method......Page 545
  19.3 Natural extract–based bamboo and other wound dressings......Page 546
  19.4 Wound healing materials for skin tissue engineering......Page 548
   19.4.1 Management of wound......Page 549
    19.4.2.1 Biopolymers (natural polymers)......Page 550
  19.5 Wound healing materials from biopolymers......Page 554
    19.5.2.2 Hyaluronic acid and its derivatives......Page 555
    19.5.2.5 Alginate......Page 556
  19.7 Conclusion......Page 557
  References......Page 558
  A......Page 564
  B......Page 566
  C......Page 567
  D......Page 570
  E......Page 571
  F......Page 572
  H......Page 573
  I......Page 575
  M......Page 576
  N......Page 578
  P......Page 580
  S......Page 583
  T......Page 586
  V......Page 588
  W......Page 589
  Z......Page 591