Medical Textiles: Application Of Implantable Medical Textiles

Medical Textiles: Application of Implantable Medical Textiles Polydioxanone (PDS): This synthetic monofilamentsuture can use for many types of soft tissue woundrepair (such as abdominal closures) as well as forpediatric cardiac procedures. Poliglecaprone (MONOCRYL): This syntheticmonofilament suture uses for general use in softtissue repair. This material shouldn’t be used forcardiovascular or neurological procedures. Polyglactin (Vicryl): This synthetic braided suture isto repair hand or facial lacerations. It shouldn’t beused for cardiovascular or neurological procedures.c) Types of nonabsorbable suturesSome examples of nonabsorbable sutures canbe found below. These type uses generally for softtissue repair, including for both cardiovascular andneurological procedures. Nylon: A natural monofilament suture. Polypropylene (Prolene): A synthetic monofilamentsuture. Silk: A natural braided suture. Polyester (Ethibond): A braided synthetic suture.d) Suture Selection and TechniquesThere are many different suture techniques.Some of them are:Figure 1: Surgical suturea) Types of SuturesThere are different types of sutures.First, Suture materials are either absorbable ornonabsorbable.Absorbable sutures don’t require to removefrom body. This is because enzymes found in thetissues of the body naturally digest them.Nonabsorbable sutures will need to be removedby your doctor at a later date or in some cases left inpermanently.Second, we can classify suture according to theactual structure of the suture material. Such asmonofilament suture and braided suture. Monofilamentsutures consist of a single thread. This allows the sutureto pass through tissues easily. Braided sutures consistof several small threads braided together. This can leadto better security, but at the cost of the increasedpotential for infection.Third, we can also classify sutures as eitherbeing made from natural or synthetic material.b) Types of absorbable sutures Gut: This natural monofilament suture uses forrepairing internal soft tissue wounds or lacerations. Itshouldn’t use for cardiovascular or neurologicalprocedures. The body has the strongest reaction toi.Continuous suturesThis technique involves a series of stitches thatuse a single strand of suture material. This type canplace rapidly and is also strong since tension isdistributed evenly throughout the continuous suturestrand.ii.Interrupted suturesThis suture technique uses several strands ofsuture material to close the wound. This technique leadsto a securely closed wound. If one of the stitchesbreaks, the remainder of the stitches will still hold thewound together.iii.Deep suturesThis type places under the layers of tissuebelow (deep) to the skin. They may either be continuousor interrupted. This stitch is often used to close fasciallayers.iv.Buried suturesThis type is applied so that the suture can findinside this type of suture is typically not removed and isuseful when large sutures use deeper in the body.v. Purse-string suturesThis types places around an area and tightenedmuch like the drawstring on a bag. For example, thistype use in our intestines to secure an intestinal staplingdevice. 2019 Global JournalsYearSurgical suture is a medical device used to holdbody tissues together after injury or surgery. Theapplication generally involves using a needle with adefined length of thread. Biocompatibility is of primeimportance if the textile materials are to be accepted bythe body and following four key factors will determinehow the body reacts to the implants.These are as follows:1) The most essential factor is porosity whichdetermines the rate at which human tissue will growand encapsulate the implant.2) Small circular fibers attach with human tissue betterthan larger fibers with irregular cross sections.3) Toxic substances must not realease, and the fibershould be free from surface contamination likelubricants and sizing agents.4) The property will influence the success of theimplantation in terms of its biodegradability.2019this suture and will often scar over. It does notcommonly use outside of gynecological surgery.Surgical Suture19Global Journal of Medical Research ( KD ) Volume XIX Issue IV Version IIII.

Medical Textiles: Application of Implantable Medical TextilesSubcutaneous suturesThis type places in our dermis, the layer oftissue that lies below the upper layer of our skin. Shortstitches place in a line that is parallel to our wound.vi.Year2019e) Raw MaterialsNatural sutures are made of catgut orreconstituted collagen, or from cotton, silk, or linen.Polyglycolic acid, a glycolide-lactide copolymer; orpolydioxanone, a copolymer of glycolide andGlobal Journal of Medical Research ( K ) Volume XIX Issue IV Version I20trimethylene carbonate may make synthetic leneterephthalate, polybutylene terephthalate, polyamide,nylons or Goretex are the raw materials of syntheticnonabsorbable sutures. S stainless steel is the rawmaterials of some special types of suture.f)The Manufacturing ProcessThe manufacturing of sutures for surgical use isnot very different from the production.Preparation of raw polymer- Raw polymers are combined (polymerized), forced through a die anddischarged as tinny pellets.Forming individual filaments by extruder machine -The machine melts the polymer, and the liquidflows through the tiny spinneret (looking something like a shower head) forming many individualfilaments.Drawing of filaments- After extrusion, these are stretching between two rollers. It increases five timestheir original length.Manufacturing of sutures- Some sutures are producing as monofilaments. Others are braided ortwisted. The monofilament is winding onto bobbins, and the bobbins keep onto an automatic braidingmachine.Secondary Processing-After braiding, the suture undergoes several stages of secondary processing.Non-braided type will also go through these steps after extrusion and initial stretching. This stepmight take only a few minutes. The suture passes over a hot plate, and any lumps, snags, orimperfections are ironed out.Annealing- The annealing oven subjects the suture to high heat and tension, which orders thecrystalline structure of the polymer fiber into proper shape.Coating- Absorbable coatings include Poloxamer 188 and calcium stearate with a glycolide-lactidecopolymer. Nonabsorbable coating include wax, silicone, fluorocarbon.Surgical needle preparation- The surgical needles are made at another plant, and also shipped to thefinishing plant. The needles are made of fine steel wire and drilled lengthwiseQuality control-This step the suture conforms to the proper diameter, length, and strength, look forphysical defects and check the dissolvability of an absorbable suture in animal and test-tube tests.Sterilization- Next, the suture and attached needle are inserted into a foil packet and sterilized.Sterilization differs according to the suture material.g) Suture removalWhen sutures remove will depend on wherethey are on your body. According to American FamilyPhysician, some general guidelines are as follows: Scalp: 7 to 10 days Face: 3 to 5 days Chest or trunk: 10 to 14 days Arms: 7 to 10 days Legs: 10 to 14 days Hands or feet: 10 to 14 days Palms of hands or soles of feet: 14 to 21 days 2019 Global JournalsTo remove sutures, the doctor will first sterilizethe area. They’ll pick up one end of your suture and cutit, trying to stay as close to the skin as possible. Then,they’ll gently pull out the suture strand.IV.Artificial SkinWhen the skin has been damaged throughdisease or burns the body cannot act fast enough tomanufacture the necessary replacement cells. Woundslike skin ulcers, suffered by diabetes, may not heal, andlimbs must be amputated. Burn victims may die frominfection and the loss of plasma.

Medical Textiles: Application of Implantable Medical TextilesFigure 2: Artificial skina) Raw MaterialsThe raw materials needed for the production ofartificial skin falls into two categories, those arebiological components and necessary laboratoryequipment. Most of the donated tissues come fromneonatal foreskins removed during circumcision. Oneforeskin can yield enough cells to make four acres ofgrafting material. Manufacturer separates fibroblastsfrom the dermal layer of the donated tissue. Then hetestes fibroblasts for viruses and other hazardouspathogens such as HIV, hepatitis B and C, andmycoplasma. The mother’s medical history is recorded.The fibroblasts require to store in glass vials and frozenin liquid nitrogen at -94 F (-70 C). It should keep frozenuntil the fibroblasts needs to grow cultures. In thecollagen method, keratinocytes are also extracted fromthe foreskin, tested and frozen. To grow fibroblasts onmess scaffolding need polymer in combination ofmolecules of lactic acid; the same elements used tomake dissolving sutures. The compound undergoes achemical reaction resulting in a larger molecule thatconsists of repeating structural units.In the collagen method, a small amount ofbovine collagen needs to extract from the extensor and temperature are controlled, and temperaturemust control by the culture system. As the new cellscreate a layer of dermal skin, the polymerdisintegrates.Growth cycle completed. When cell growth on themesh completed, the tissue rinsed with morenutrient-rich media. Add cryoprotectant to themedia. Finally cassettes store individually with labeland frozen.ii. Collagen method Cells are transferred to a culture system. A smallamount of the cold collagen and nutrient mediaapproximately 12% of the combined solution isadded to fibroblasts. The mixture turns into moldsand allotted to come to room temperature. As thecollagen warms, its gels, trapping the fibroblastsand generating the growth of new skin cells. Keratinocytes added. Two weeks after the collagenadded to the fibroblasts the extracted keratinocytesare thawed and seeded onto the new dermal skin.They are allowed to grow for several days and thenexposed to air, including the keratinocytes to formepidermal layers. Growth cycle completed. The new skin is stored insterile containers until needed. 2019 Global JournalsYearb) The Manufacturing ProcessThe manufacturing process is deceptivelysimple. Its function is to trick the extracted fibroblastsinto believing that they are in the human body so thatthey can communicate with each other in the naturalway to create new skin.i. Mesh scaffolding method In this process the manufacturer thaw and expandfibroblast. The fibroblasts need to transfer from thevials into roller bottles, which resemble liter sodabottles. Then the bottles keep their sides for three tofour weeks for rotting. The rolling action allows thecirculation of oxygen, essential to the growthprocess. Cells should transfer to a culture system. The cellsare removed from the roller bottles, combined witha nutrient-rich media, flowed through tubes into thin,cassette-like bioreactors housing the biodegradablemess scaffolding, and sterilized with beamradiation. As the cells flow into cassettes, theyadhere to the mesh and begin to grow. The cellsflow back and forth for three to four weeks. Leftoversuspension should remove each day as well asfresh nutrient should add. Oxygen, pH, nutrient flow,2019tendon of young calves. The collagen is mixed with anacidic nutrient, and stored in a refrigerator at 39.2 F(4 C).Laboratory equipment includes glass vials,roller bottles, grafting cartridges, molds, and freezers.21Global Journal of Medical Research ( KD ) Volume XIX Issue IV Version IArtificial skin- is a collagen scaffold that inducesregeneration of the skin in mammals such as humans.The skin is the largest organ in the human body.It is made up of three layers the epidermis, dermis, andhypodermis (fat layer). The epidermis is the outer layer ofskin that keeps vital fluids in and harmful bacteria out ofthe body. The dermis is the inner layer of skin thatcontains blood vessels, nerves, hair, follicles, oil, andsweet glands. Severe damage to large areas of skinexposes the human organism to dehydration andinfections that can result in death.Traditional ways to dealing with losses of theskin grafts from the patient (autografts) an unrelateddonor cadaver. The former approach has thedisadvantage that there may not be enough skinavailable, while the latter suffers from the possibility ofrejection or injection until the late twentieth century skingrafts constructed from the patient skin. This methodcreated a problem when the skin had been damagedextensively, making it impossible to treat severely injuredpatients entirely with outgrafts.

Medical Textiles: Application of Implantable Medical TextilesYear2019V.Global Journal of Medical Research ( K ) Volume XIX Issue IV Version I22Artificial CartilageArtificial cartilage is a synthetic material made ofhydrogels or polymers that aims to mimic the functionalproperties of natural cartilage in the human body. Tissueengineering principles use to create non-degradableand bio-compatible material that can replace cartilagewhile creating a useful synthetic cartilage material;certain challenges need to overcome. First cartilage isan avascular structure in the body, and therefore doesnot repair itself. This creates issues in the regenerationof the tissue. Artificial cartilage also needs to be stablyattached to its underlying surface, bone lastly in thecase of creating synthetic cartilage to be used in jointspaces, high mechanical strength under compressionneeds to be an intrinsic property of the material.a) ComponentsWater (almost 80%), Chondrocytes, Collagen,Proteoglycans, Glycoproteins. Most of the syntheticcartilages are Kevlar based, or Poly Vinyl Alcohol (PVA)based.1) Water- Water makes up 80% of cartilage.2) Chondrocytes- Chondrocytes are the cells thatproduce and maintain the cartilaginous matrix. Theyare separately dispersed throughout cartilage andonly make up 2% of the total volume of cartilage.Chondrocytes vary in size, shape, andconcentration depending on their location inarticular cartilage.3) Collagen- Collagen is a structural protein present inthe extra cellular matrix (ECM) of cartilage. Collagenis composed of a triple helix structure of polypeptidechains and offers shear and tensile properties to thecartilage ECM.4) Proteoglycans- Proteoglycans are the second mostabundant macromolecule ECM of cartilage.Proteoglycans consist of a linker protein along with acore protein to which glycosaminoglycans (GAGs)attach. The most common GAGs are chondroitinsulfate and keratin sulfate. Proteoglycans attach to acontrol chain usually hyaluronic acid, via a linkerprotein to create larger proteoglycan aggregates.Proteoglycans are hydrophilic and therefore attractand restrain water molecules. This provides cartilagewith its intrinsic ability to resist compression.5) Glycoproteins- Many other glycoproteins are presentin cartilage ECM in small amounts that helpmaintain structure and organization. Speciallylubricin helps to create a lubricating surface on thecartilage for joint mobility. Fibronectin and integrinother glycoproteins present that help in adhesion ofchondrocytes to the ECM.b) StructureThere are structural tree zones in articularcartilage including superficial tangential zone, atransitional zone, a middle transitional zone, and a deep 2019 Global Journalszone. In the transitional zone, collagen fibers are alignedparallel to the surface and become gradually randomlyaligned while moving into a deep area. Collagen fibersin the suitable region are aligned parallel to the surfaceto restrict shear stresses. Similarly, collagen fibers arealigned perpendicular to the surface in the deep zone torestrict compressive forces. Between bone and deepzone lies calcified cartilage. Cell arrangement alsovaries between the zones in deeper zones chondrocytesare stacked into columns while in the superficial zonesthey are arranged randomly. In the superficial regions,the cells are also more entangled, while in deeper zonesthey are more spherical.Figure 3: Artificial cartilageMany people with joint injuries would benefitfrom a replacement for cartilage.Articular cartilage has a characteristic shockabsorbing effect attribute to its viscoelastic properties.c) Synthetic cartilagei.PVAWe use Poly (vinyl alcohol) (PVA) hydrogels inthis study. It was difficult to meet the mechanicalproperties of articular cartilage using this hydrogel.There were no inflammatory or degenerative changes inarticular cartilage or synovial membrane surround thisartificial PVA cartilage. PVP hydrogels were also studied.They exhibit high hydrophilicity, biocompatibility, andcomplexing ability. When used as a blend of PVA/PVPhydrogel, they produced similar internal 3D structureand water content as natural articular cartilage. Thebest mechanical properties and friction system wereblended hydrogel with one wt % PVP. Due to the interchain hydrogen bonding, adding PVP to the purePVA proved a better option. They acted witha characteristic viscoelastic behavior of articularcartilage. [9]ii. Kevlar basedThe new Kevlar-based hydrogel recreates themagic of cartilage by combining a network of toughnanofibers from Kevlar—the “aramid” fibers best knownfor making bulletproof vests—with a material commonlyused in hydrogel cartilage replacements, called polyvinylalcohol, or PVA.In natural cartilage, the network of proteins andother biomolecules gets its strength by resisting the flow

Medical Textiles: Application of Implantable Medical TextilesLigament is a short band of tough, flexiblefibrous connective tissue which connects two bones orcartilages or holds together a joint. It is also known asarticular ligament. Ligaments are generally subject to alot of wear and tear and also carry the risk of septicarthritis. The usage of the ligament varies based on thetype of operation. Ligaments are nowadays replacedartificial means through surgery. Artificial ligaments areformed by polyester, silk, Poly Tetra Fluoroethylene(PTFE). Polyethylene terephthalate- (PET-) basedartificial ligaments (PET- ALs) are commonly available inanterior cruciate ligament (ACL) reconstruction surgery.An artificial ligament is a medical device madeup of textile fibers and used for joining ends of bonesthe requirement of a prosthetic ligament are: Extensive tough but have just the right stiffness tomatch the compliance of a ACL. It must have the durability to withstand high tensileloads for millions of cycles without wear. And it must be perfectly tolerable to the hos.d) LEEDS-KEIO artificial ligament (Supplementary)With the design to design a graft that combinedthe properties of a permanent prosthesis and a tissuepromoting scaffold, Fujikawa and seldom developed theLeeds-Keio artificial ligament a polyester mesh-likestructure anchored to the femur and a tibia with a boneplugs. This mesh was intended as a scaffold for softtissue growth through the articular and extra-articularsections of the ligaments, eventually uniting the boneplugs. The implant was considered sufficiently flexible tobe suitable with a maximal tensile strength ofapproximate 2100 N (Newton), which significantlyexceeds that of the average young adults’ natural ACL(about 1730 N)VII.ConclusionA brief overview of the application ofimplantable medical textile products in various areas ofmedical sectors for the healthier life and betterment ofhuman being. The development of new item will help thepatients to overcome their suffering in previous days.This study provided an overview of the innovative,intelligent and smart textile products related to medicaltextiles, particularly implantable medical textile productssuch as surgical sutures, artificial skin, Artificial cartilage,and artificial ligaments.References Références ReferenciasFigure 4: Artificial LigamentThere are various types of artificial ligaments inthe market. The most prominent are:a) Carbon fiber prostheticThis type of ligament is available with carbonfiber coated with collagen, and an absorbable polymersuch as polylactic acid (PLA) and polycaprolactone is abiodegradable polyester with a low melting point ofaround 60 C. The PLA is meant to resorb and thecarbon fibers degraded as a new tissue developedencouraging tissue generation without permanentlyreplacing it.b) Gore-tex permanent prosthesisThe Goretex ligament prosthesis is composedof a long fiber of expanded polytetrafluoroehylene(PTFE). The ultimate strength is about three times that ofhuman ACL and the result from cyclical creep tests andthe bending fatigue testing seem to identify Gore-tex pod.comCookson P G. Deakin University. Centre formaterials and fibre innovation, Medical Applicationof Fibres & Textile. nkTextile Terms and Defination, J. E. Mclistyre, P. N.Daniels, 10th Edition Published by the TextileInstitute. pp 206.Anand SC and Horrocks AR. Handbook ofTechnical Textile, 2000, Pp. //www.healthline.com/health/suturesS.Akter, AYMA Azim, MAA Faruque Medical textiles:significance and Future prospect in Bangladesh,European Scientific Journal April 2014 editi

much like the drawstring on a bag. For example, this type use in our intestines to secure an intestinal stapling device. Medical Textiles: Application of Implantable Medical Textiles 19 Year 201 Global Journal of Medical Research Volume XIX Issue IV Version I DD (D) K 2019 Global Journals a) Types of Sutures There are different types of sutures.