Medical Textile And Healthcare Dr. N.K.Pandey SURGERY – PAST, PRESENT & FUTURE Dr N K Pandey FRCS (Edin, Glasgow ) FICS, FACS Dr B C Roy Award 2005 Chairman, Asian Institute of Medical Sciences President –Elect, Association of Surgeons of India Joint Editor Indian Journal of Surgery Secretary, American College of Surgeon (India Chapter) Past President, International College of Surgeons, India FICCI, New Delhi, 01-SEP-2009

The first recorded use of Fibres – ‘Surgical Papyrus’ 4000 years ago Materials used - Horse Hair, Leather Strip, Cotton, Animal Sinew and Fibrous tree bark - Source ‘Susanta Sambita ’

FICCI, New Delhi, 01-SEP-2009 Brief History of Medical Textile Medical Textile developed with development of our knowledge of wound closure Sutures(5000 – 3000 BC) Flax, Silk, Linen strips & Cotton were extensively used Lubricated with oils / Wine – Susruta ( 800 BC) Use of Sutures & Clips - Celsus (30 AD) Silk & Catgut – Galen ( 150 AD)

FICCI, New Delhi, 01-SEP-2009

Fast Facts Medical textiles are textile products and constructions for medical applications They are used for first aid, clinical or hygienic purposes Implants and rehabilitation Biomedical textiles are fibrous structures designed for use in specific biological environments, where their performance depends on biocompatibility with cells and biological tissue or fluids

FICCI, New Delhi, 01-SEP-2009 Textile Medical Products Fabrics Woven Yarns KnittedBraidedNonwoven Fibers Polymers

FICCI, New Delhi, 01-SEP-2009 Different Products Constitute This Sector SURGICAL DRESSINGS Surgical BandagesSurgical GauzesOther Surgical Dressings - Crepe Bandage - Rolled Bandage - POP Bandage - Triangular Bandage - Orthopedic Wool Bandage - Elastic Adhesive Crepe Bandage - Absorbent Gauze - Wound Care Gauze - Paraffin Gauze Dressing - Anklet - Eye Pad - Knee Cap

FICCI, New Delhi, 01-SEP-2009 HEALTHCARE TEXTILE Medical Applications Pressure Garments Use in Plastic /Burn Surgery Cosmetic Surgery Graduated Pressure Garments Prevention of DVT Treatment of Lymph Edema Non-Medical Applications Gowns Caps Masks Drapes Bedding Sheets Pillow Cases Different Products Constitute This Sector

FICCI, New Delhi, 01-SEP-2009 SUTURES and LIGATURES ETHICON PRODUCTS SUTURES MaterialConstructionAbsorption Profile Coated VICRYL* PlusPolyglactin 910Braided / Monofilament days (63 day avg.) MONOCRYL* Plus Antibacterial Poliglecaprone 25 Irgacare MP Monofilament days PDS* Plus Antibacterial Polydioxanone Polydioxanone and Irgacare MP Monofilament days VICRYL RAPIDE*Polyglactin 910Braided42 days Coated VICRYL*Polyglactin 910Braided / Monofilament days (63day avg.) MONOCRYL*Poliglecaprone 25Monofilament days PDS* II Polydioxanone Polydioxanone and Irgacare MP Monofilament days Surgical Gut Suture – Chromic Beef Serosa or Sheep Submucosa Monofilament (Virtual)90 days Surgical Gut Suture – Plain Beef Serosa or Sheep Submucosa Monofilament (Virtual) Sutures: Absorbable Different Products Constitute This Sector

FICCI, New Delhi, 01-SEP-2009 ETHICON PRODUCTS SUTURESMaterialConstruction PRONOVA* Poly Polymer blend of poly (vinylidene fluoride) and poly (vinylidene fluoride-co- hexafluoropolypropylene) Monofilament ETHIBOND EXCEL*Polyester / DacronBraided ETHILON* Nylon SutureNylon 6Monofilament MERSILENE* Polyester Fiber Suture Polyester / DacronBraided NUROLON* Nylon SutureNylon 6Braided PERMA-HAND* Silk SutureSilkBraided PROLENE* Polypropylene SuturePolypropyleneMonofilament Surgical Stainless Steel Suture316L Stainless SteelMonofilament SUTURES and LIGATURES Sutures: Non-Absorbable Different Products Constitute This Sector

FICCI, New Delhi, 01-SEP-2009 MEDICAL IMPLANTS AND DEVICES Different Products Constitute This Sector

FICCI, New Delhi, 01-SEP-2009 Fibre TypeFabric StructureApplication Collagen, catgut, polyglycolide fibre, polylactide fibre Monofilament, braided Biodegradable sutures Polyester fibre, polyamide fibre, PTFE fibre, polypropylene fibre, polyethylene fibre Monofilament, braided Non-biodegradable sutures PTFE fibre, polyester fibre, silk, collagen, polyethylene fibre, polyamide fibre Woven, braided Artificial tendon Polyester fibre, carbon fibre, collagen BraidedArtificial ligament Low-density polyethylene fibreArtificial cartilage ChitinNonwovenArtificial skin Poly (methyl methacrylate) fibre, silicon fibre, collagen, Eye-contact lenses and artificial cornea Silicone, polyacetyl fibre, polyethylene fibre Artificial joints/bones PTFE fibre, polyester fibreWoven, knittedVascular grafts Polyester fibreWoven, knittedHeart valves Implantable Materials

FICCI, New Delhi, 01-SEP-2009 Cardiovascular Implants Vascular Grafts Heart Valves Different Products Constitute This Sector

FICCI, New Delhi, 01-SEP-2009 Artificial Tendon Artificial Skin Artificial Ligament Artificial Cornea Soft Tissues Impla nts Different Products Constitute This Sector Cosmetic Lens

FICCI, New Delhi, 01-SEP-2009 Orthopedic Implants Artificial Joints Different Products Constitute This Sector

FICCI, New Delhi, 01-SEP-2009 Extra Corporeal Devices Dialysis Machine Artificial Liver Tissue Mechanical Lung Artificial Heart Different Products Constitute This Sector

FICCI, New Delhi, 01-SEP-2009 Trend In world Trade of Medical Textile Population growth rates, particularly in newly developing global regions Changes in demographic, including the aging of the population and budging middle class in the Indian market Changes in living standards in India Attitude in health risks; increased awareness of the risks to health workers from health threats from blood- borne diseases, airborne pathogens, current pandemic of Influenza A(H1N1)

FICCI, New Delhi, 01-SEP-2009 Recent Development Compression and bandaging - The design of pressure garments for the treatment of hypertrophic scarring caused by burns - Evaluation of the pressure distribution performance of padding bandage materials - Elastic fabrics for use in pressure garments – comfort properties - Methods of calculation of local pressure of elastomer products - Twenty years of new development – what clinical benefit for the patient?

FICCI, New Delhi, 01-SEP-2009 Recent Development Modern materials and processes - New developments in the manufacture of circular knitting machines for the production of medical textiles - Non-wovens – the choice for the medical industry into the next millennium - Production of yarns and fabrics from alginate fibres for medical applications - Opportunities and challenges for fibrous products in healthcare and medical applications - Knitting seamless three-dimensional shell structures on modern electronic flat-bed knitting machines - Medical textiles with specific characteristics produced on flat knitting machines

FICCI, New Delhi, 01-SEP-2009 Recent Development Healthcare and hygiene - Development of a versatile antimicrobial finish for textile materials for - Development of a versatile antimicrobial finish for textile materials for healthcare and hygiene applications healthcare and hygiene applications - Air permeability and porosity evaluation of antiallergical bed linen - Air permeability and porosity evaluation of antiallergical bed linen - Influence of sterilisation on the properties and performance of O R - Influence of sterilisation on the properties and performance of O R disposable garments disposable garments - Formation of creases in bedsheets – a cause of decubitus - Formation of creases in bedsheets – a cause of decubitus - The design of needlefelts to control the flow of liquids in incontinence - The design of needlefelts to control the flow of liquids in incontinence products products

FICCI, New Delhi, 01-SEP-2009 Recent Development Wound Care - Anisotropic fluid transmission in nonwoven wound dressings - Fibrous scaffolds for tissue culturing - Functional requirements of bedding materials for elderly patients

FICCI, New Delhi, 01-SEP-2009 Recent Development Implantable Devices - Time dependent behaviour of some suture materials - Surface treatment of the textile graft which reduces thrombogenicity and improves healing - Embroidery technology for medical textiles - Tissue engineered synthetic scaffolds for tissue repair – a textile approach to implant design

FICCI, New Delhi, 01-SEP-2009 Recent Development Test methods - Pitfalls of statistics in clinical trials design - The drug tariff and its relevance to medical textiles

FICCI, New Delhi, 01-SEP-2009 (In Crores) Years Forecast world Consumption -Medical Textile Sources : MPB Article,December 2001

FICCI, New Delhi, 01-SEP-2009 Future of Medical Textile Fabric enhanced with nanopores- Aspen aerogel Fabric enhanced with silver nanoparticles – reduces odor(burn,wound) – Nanohorizons Fabric enhanced with nanoparticles – bacteria, water,stain resistant – Nanogroup Fabric with nanowhiskers enhanceWater & stain resistant – Nanotex

FICCI, New Delhi, 01-SEP-2009