Bioactive materials in medical textiles – technologies and market perspectives

by  Pertti Nousiainen

  • Developing countries: most urgent needs for basic functions and products (water, shelter, hygieneity, basic drugs)
  • Developing countries: high mortalities of children, infectious deseases
  • Ebola virus epidemic in western Africa
  • Industrialised countries face big deseases: cancer, cardiovascular deseases, living habits, environment related, aids, traffic accidents
  • Consequence of different living standards: pandemia threath
  • The ageing of people changes needs of tomorrow
  • Rising consumer expectations for health and fitness
  • Health care 10-25 % of state budgets (EU), 8-16% of GNP
  • Demands of efficiency, new methods, new materials, implantated products, hygiene
  • Good business opportunities for companies, private and public-private- partnership (PPP)
  • China and india healthcare have huge nr of health care institutions and hospitals (China alone 300,000 institutions and 60,000 hospitals)
  • Healthcare textiles – medical textiles – rapidly growing in the technical textile market due to burgeoning population, change in the standard of living and demographics
  • Medical textiles range from simple bandage materials or gauze to scaffolds for tissue repairing and a large variety of prostheses for body implants
  • Usage depends on their properties like flexibility, absorption, softness, filtering
  • Classification: non-implantable materials, implantable materials, healthcare and hygiene products and extracorporeal products
  • Medical textiles for: first aid, clinical purpose, rehabilitation, hygieniety, wound care, wound infection, bandaging & pressure garment, extra corporal and implantable materials
  • Europe is one of the leading markets in the medical textile industry. U.K, France, Italy and Germany hold the larger segment of the market
  • North America follows Europe, while Asia Pacific is one of the emergent markets. Countries support and providing various schemes in order to promote the production and consumption of medical textile

Medical textiles – market development

  • In USA in 1980–1990, the growth of medical textile products 11% p.a. and 10% during 1991–2000
  • In W Europe the usage of nonwoven medical products climbed from 3000 tonnes in 1980 to 19 700 tonnes in 1991 and in 58.500 tonnes in 2012
  • product sales form $11.3 bill/1980 to $32.1 bill/1990, this figure have staggered at $76 billion by the year 2000 and at 80 billion in 2010
  • The US market for disposable healthcare products alone rising from $1.5 bill/1990 to $2.6 bill/1993
  • medical textiles are 12% share of the technical textiles with 1,7 Mt of fibres in 2005, a growth rate of 3–4% p.a., a market of US $ 9,5 bill. in 2005 up to 12 bill. in 2010 with 2,8 Mt of processed fibers
  • new uses are still being found by utilizing new and existing fibres and fabric-forming techniques
  • fibre manufacturers producing a variety of fibres with properties covering the product and the ultimate application, whether the requirement is absorbency, tenacity, flexibility, softness, or biodegradability
  • Bacteria infect wounds and produce vast costs
    • After a surgical operation, 1,5-30% of all wounds get infected depending on the type of surgery (source: MedLinePlus)
    • Bacteria resistant to antibiotics are increasing and making infections vicious
    • In Finland, the annual costs related to Hospital Acquired Infections reach €400M
    • In the US, the annual costs amount to
    • Advanced wound care solutions, that are safe to use, are extremely expensive and cannot help the prevention of wound infections
    • Such solutions are practically not available in developing economies
    • Antimicrobial dressings are not used to prevent infections due to high prices & safety concerns
    • Wound care already consumes 2-5% of total health care costs: 355-888M€ for Finland alone and 84-210€ billion for OECD countries in total
    • Sources: Juutilainen & Hietanen, MedLinePlus=> As the numbers for resistant forms of bacteria and costly infections are growing, globally, so is the need for new antimicrobial solutionsThe number of wounds is growing rapidly

      The solutions to prevent wound infections are neither affordable nor safe

      This results in suffering and vast economic costs.

      Aging population and serious lifestyle disorders (obesity, diabetes) produce ever more wounds

      Of all people, almost 1% suffer from chronic ulcer (open leg wound), 2,5% will develop a diabetic ulcer and 0,75% will face amputation

      After surgeries, up-to 30% of all wounds get infected and, as more bacteria are resistant to antibiotics, infections are increasingly viciousTraditional wound dressings with absorbent textile materials (CO, CV) by knitting or by mechanical or mechano chemical non-woven methods

    • High moisture absorbing dressings with fibrous layer and gel-forming fibres incorporated into the fibrous matrix
    • Foamed polymers combined antimicrobial additives, such as silver ions (Ag+) or other antimicrobial substances
    • Gelled wound dressing with antimicrobial additives, such as metal salts, chitosan or organic antimcrobial compounds
    • Basic structure combined for the actual need (liquid wicking/absorption, liquid    evaporation, antimicrobial activity, mechanical strength)
    • A risk of sticking to the healing wound tissue during scar-forming.
    • Reinforcing fibres are used for improving the strength of the wound dressing
    • Large amount of fibres is needed capable of absorbing moisture for preventing  maceration of the wound.
    • Antimicrobial components added separately (deposit silver on the fabric or gel)
  • World consensus about silver in wound dressingThe experience of many clinical studies have confirmed positive effects of silver dressings when used appropriately

    Silver dressings are unlikely to cause true argyria because only low levels of silver are presented for systemic absorption

    Silver dressings should be reserved for use in wounds with or at risk of high bioburden or local infection

    An apparent lack of response to silver does not relate to resistance, rather to inappropriate treatment of the underlying infection and/or wound aetiology

    The major cause of antibiotic resistance remains misuse or overuse of antibiotics themselves

    Silver dressings should be used in the treatment of children not for more than two weeks without good clinical reasons

    The proportion of total silver production that is used in dressings is very small with regard to low/no environmental effects

    Silver dressings are generally no more expensive than other types of antimicrobial dressings