Gp Capt RK Pathni O/o DGAFMS, DG-2Gp

MIN OF DEFENCE DGAFMS DGMS(AIR)DGMS(NAVY)DGMS(ARMY) CHIEFS OF STAFF COMMITTEE

MEDICAL TEXTILES Gp Capt RK Pathni O/o DGAFMS, DG-2Gp

Why What Wishes How Conclusion Protocol - Scenario - Types - Users’ perspective - Issues - Innovations - Combat perspective

FUTURE INDIAN SOLDIERS TOI, 21 Feb 2011

COMBAT & MEDICAL TEXTILES Gp Capt RK Pathni O/o DGAFMS, DG-2Gp

2 nd fastest growing economy & 4 th largest

We are using more Population – More People Demography – More People who need Income – More People who can afford Travel -Awareness Medical tourism – Attitudes Growth of healthcare industry – demand Products – Increasing Range of products

SCENARIO Application of textiles has started going beyond the usual wound care, incontinence pads, plasters etc., In India, traditionally the segment is dominated by Woven Textiles. Lately, Nonwoven products have provided innovative product options Current Domestic Consumption Rs 2365 cr By Rs 3737 cr Heavily Import Dependent Unorganized Segment

Why Are Textiles A Good Choice?  Easy handling, manipulating and fashioning  Flexibility and suppleness  Pores  Mechanical strength  Good flex fatigue resistance  Proven clinical history. Textile-based materials for medical use are helping to improve people’s lives—and in some cases transform them.

Personal Hygiene Dressings & bandages Linen, Protective clothing Implantables Extracorporeal devices Applications

Personal Hygiene Dressings & bandages Linen, Protective clothing Implantables Extracorporeal devices Applications

Non-ImplantablesHygieneImplantables Extra Corporeal Absorbents with and without x-ray detactable  Abdominal pad  Absorbent gauze/absorbent  Wadding Gauze Bandages  W/W bandage (open bandages or gauze bandages)  Triangular Bandages Rigid bandages  POP bandages  Synthetic cast  Scaffold Extensible Bandages  Crepe bandages  Compression bandages  Elastic adhesive bandages Tubular bandages  Knitted fabric in tubular form  Surgical hosiery Wound dressing and medicated bandages  Chlorhexidine gauze dressing  Medicated Adhesive dressing  Framycetin gauze dressing  Paraffin gauze dressing  Surgical gowns  Surgical caps  Surgical mask  Surgical covers, drapes  Cloths/Wipes  Hospital bed sheets, pillows, pillow covers, blankets, mattresses  Patient clothing, Protective clothing  Burns clothing  Operation theatre clothing  Diapers, cover stock  Sanitary napkins Sutures Soft tissue implants Artificial tendon Artificial ligament Artificial skin Eye lenses Artificial lumen Orthopaedic implants Artificial joint bones Cardio-vascular implants Vascular grafts, heart valves  Artificial kidney  Artificial liver  Artificial heart  Mechanical lung

Various types of textiles in medical care I. NaturalMan Made II. WovenNon-Woven III. Sterile Unsterile IV. Disposable Re-useable V. PatientNon-Patient

In the Patient – Sutures, Implants like Meshes, Extracorporeal Membranes On the Patients – Surgical Swabs, Dressings Near the Patient – Gowns, Masks, Caps etc For the Patient – Wraps for Sterilisation Classification

MEDICAL Gp Capt RK Pathni O/o DGAFMS, DG-2Gp

Flexibility, Sterility, Tensile Strength, Non- fraying, Knotting Security, Bio-compatible, Durability, Stability, Sterilizability, Stiffness, Ease Of Handling, Low Adherence, No Loose Fibers, Absorbent, Adsorbent, Form-fitting, Causing no mechanical injury, Light -weight, Porosity, Firmness, Bio-degradable, Durable, Non-toxic, Absorbable, Comfortable, Ease of maintenance, Hydrophobic, Breathability, Hydrophilic, Environment-friendly, Disposable, Economy, Bio-compatible, Comfortable, Safe, Smart….

SMART MEDTEX

Patient comfort Hygeinic & non toxic Ease of usage Safety Affordable Quality Ease of disposal Aim

Requirements In the Patient – Biocompatible, Non toxic, Non Allergenic, Sterility Standards of Highest Level On the Patient – Non toxic, Non Allergenic, Sterile, Biocompatibility ?!! Near the Patient – Sterile, Lint free For the Patient – Clean General Properties – Strength, Elasticity, Durability, Fire Resistance, Antistatic, Biodegradability

Sutures & Ligatures  Easy to handle  Good knot security  Minimal tissue reaction  Unfriendly to bacteria  Strong yet small  Won’t tear through tissues  Affordable  Absorbable / Non-abs  Natural / Synthetic  Mono / Multi-filament  Double – barbs  Anti-bacterials  Staplers  Glue

Dressings  Cover  Stop bleeding  Aid healing  Prevent infection  Non-linting  Soft on granulation tissue  Drug delivery  Easy to remove  Affordable

Vascular Grafts, Mesh, Soft tissue implants  Bio-compatibility  Anti-coagulant  Flexibility, resilience  Porosity  Texture  Mech strength

DISPOSABLES  Resistant to liquid penetration - Blood / Water  Non-linting  Barrier against bacteria- Dry / Wet  Tropicalization – western products are not automatically suitable

Disposables vs Re-usables Cost Quality Environmental Issues waste load resource utilization In-house QC Safety of users / handlers

Quality Standards No mandatory standards – D&CA Raw material suppliers Innovation Niche production

Biomedical Waste Disposal Landfill – Fibreglass Orthopaedic casts Incineration – Polyurethane Orthopaedic Casting Bandages Recycling ??? A word about Hygiene products

Innovations Metallized textiles Nanotechnology Anti-microbial fabrics Fire retardant fabrics Risks Microbial Resistance Spray on Surgical Drapes Nano-silver treated hospital linen for burn patients Controlled drug release

 Bones -Textiles are replacing metal implants  Nerve guidance channels  Tissue Engineering  Scaffolds  Embroidery technology Innovations

SPIDER SILK - Exceptional mechanical properties  Tensile strength  1/5 th of the density of steel  Very high toughness (work to fracture)  Can hold their strength below −40°C to 220 °C  Humidity  supercontraction  Five times stronger than steel yet soft enough to be woven into a bulletproof vest.  Toughness : would be able to catch an F-16 aircraft if the silk were as thick as a washing line. that-could-catch-an-f html

COMBAT MEDICAL

MILITARY OPERATIONS “The object of war is not to die for your country but to make the other bastard die for his”. George Patton

Uniforms Back packs First field dressings (FFD) Shell dressings Tourniquet SCOPE Life saving army uniforms: Engineers and scientists will work to develop ideas such as a uniform that is nearly invisible and soft clothing that can become a rigid cast when a soldier breaks his or her leg. - DuPont

Innovations  Healing textiles  Smart / intelligent  Switches, Sensors, Secretions  Chitosan-alginate dressings  Spider silk  Rechargeable biocidals

Innovations  Bones – Textiles are replacing metal implants  Nerve guidance channels  Tissue Engineering  Scaffolds  Embroidery technology

INHS Asvini, Mumbai

OT on wheels

Casevac

“A microscopic machine roaming through the bloodstream, injecting or taking samples for identification and determining the concentrations of different compounds"

Tourniquet

Conclusion Medical textiles are a product of collaboration between medical researchers and textile scientists with immense scope and applications. Time is ripe to make the most of this expertise to raise the standards of health care delivery and make it comforting, convenient, affordable & safe. Interesting changes in the market will follow.

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