Woodhead Publishing in Textiles: Number 85 Advanced textiles for wound care Edited by S. Rajendran Oxford Cambridge New Delhi © 2009 Woodhead Publishing Limited The Textile Institute and Woodhead Publishing The Textile Institute is a unique organisation in textiles, clothing and footwear. Incorporated in England by a Royal Charter granted in 1925, the Institute has individual and corporate members in over 90 countries. The aim of the Institute is to facilitate learning, recognise achievement, reward excellence and disseminate information within the global textiles, clothing and footwear industries. Historically, The Textile Institute has published books of interest to its members and the textile industry. To maintain this policy, the Institute has entered into partnership with Woodhead Publishing Limited to ensure that Institute members and the textile industry continue to have access to high calibre titles on textile science and technology. 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A list of Woodhead books on textile science and technology, most of which have been published in collaboration with The Textile Institute, can be found at the end of the contents pages. © 2009 Woodhead Publishing Limited Published by Woodhead Publishing Limited in association with The Textile Institute Woodhead Publishing Limited, Abington Hall, Granta Park, Great Abington Cambridge CB21 6AH, UK www.woodheadpublishing.com Woodhead Publishing India Private Limited, G-2, Vardaan House, 7/28 Ansari Road, Daryaganj, New Delhi – 110002, India Published in North America by CRC Press LLC, 6000 Broken Sound Parkway, NW, Suite 3 0 0, Boca Raton, F L 334 8 7, USA First published 2009, Woodhead Publishing Limited and CRC Press LLC © Woodhead Publishing Limited, 2009 The authors have asserted their moral rights. This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. 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Typeset by SNP Best-set Typesetter Ltd., Hong Kong Printed by TJ International Limited, Padstow, Cornwall, UK © 2009 Woodhead Publishing Limited Contents Contributor contact details xi Woodhead Publishing in Textiles xv Preface xxi Part I The use of textiles in particular aspects of wound care 1 1 Wound management and dressings 3 S. Ather and K. G. Harding, Cardiff University, UK 1.1 Introduction 3 1.2 Types of wound 3 1.3 Mechanism of wound healing 4 1.4 Factors affecting wound healing: why wounds fail to heal 11 1.5 Wound healing: treatment options 13 1.6 Future trends 17 1.7 Conclusions 18 1.8 References 18 2 Testing dressings and wound management materials 20 S. T. Thomas, formerly of Surgical Materials Testing Laboratory, Medetec, UK 2.1 Introduction 20 2.2 The need for laboratory testing 21 2.3 Fluid-handling tests 23 2.4 Low-adherence tests 36 2.5 Conformability tests 37 2.6 Microbiological tests 38 2.7 Odour control tests 42 v © 2009 Woodhead Publishing Limited vi Contents 2.8 Biological tests 44 2.9 References 45 3 Textile materials and structures for wound care products 48 B. S. Gupta, North Carolina State University, USA, and J. V. Edwards, United States Department of Agriculture – Agricultural Research Service, USA 3.1 Introduction 48 3.2 The role of wound dressings 49 3.3 Categorization of wounds 50 3.4 Minor wounds 51 3.5 Healing mechanisms 53 3.6 Wound dressings 55 3.7 Types of dressings available 60 3.8 Bandages 70 3.9 Materials used in dressings and bandages 71 3.10 Textile processes involved in formation of dressings and bandages 79 3.11 Acknowledgement 92 3.12 References 92 4 Interactive dressings and their role in moist wound management 97 C. Weller, Monash University, Australia 4.1 Introduction 97 4.2 Normal wound healing 98 4.3 Wound characteristics 100 4.4 Dressings 102 4.5 Interactive wound dressings 105 4.6 Future trends 110 4.7 Conclusions 111 4.8 Sources of further information and advice 112 4.9 References 112 5 Bioactive dressings to promote wound healing 114 G. Schoukens, Ghent University, Belgium 5.1 Introduction 114 5.2 Physiology of wound healing 115 5.3 Principles and roles of bioactive dressings 117 5.4 Types and structures of bioactive dressings 118 © 2009 Woodhead Publishing Limited Contents vii 5.5 Example of bioactive dressing: di-O-butyrylchitin (DBC) 127 5.6 Future trends 144 5.7 Acknowledgements 146 5.8 References 146 6 Advanced textiles for wound compression 153 S. Rajendran and S. C. Anand, University of Bolton, UK 6.1 Introduction 153 6.2 Elastic compression bandages 154 6.3 Venous leg ulcers 155 6.4 Venous leg ulcer treatment 157 6.5 Applications of bandages 163 6.6 Present problems and novel bandages 165 6.7 Three-dimensional spacer compression bandages 169 6.8 Conclusions 175 6.9 References 175 7 Antimicrobial textile dressings in managing wound infection 179 Y. Qin, Jiaxing College, China 7.1 Introduction 179 7.2 Topical antimicrobial agents in wound care 181 7.3 Main types of antimicrobial wound dressings 183 7.4 Wound dressings containing silver 187 7.5 Applications of modern antimicrobial wound dressings containing silver 190 7.6 Future trends 193 7.7 Sources of further information and advice 195 7.8 References 195 8 Novel textiles in managing burns and other chronic wounds 198 H. Onishi and Y. Machida, Hoshi University, Japan 8.1 Introduction: current practice in the management of deep skin wounds or ulcers 198 8.2 Normal treatment options for deep skin wounds or ulcers 201 8.3 Novel wound dressings for managing deep skin wounds or ulcers 205 8.4 Future trends 212 © 2009 Woodhead Publishing Limited viii Contents 8.5 Sources of further information and advice 215 8.6 References 215 Part II Types of advanced textiles for wound care 221 9 Drug delivery dressings 223 P. K. Sehgal, R. Sripriya and M. Senthilkumar, Central Leather Research Institute, India 9.1 Introduction 223 9.2 Wounds: defi nition and types 224 9.3 Wounds which require drug delivery 226 9.4 Delivering drugs to wounds 231 9.5 Types of dressings for drug delivery 235 9.6 Applications of drug delivery dressings 240 9.7 Future trends 244 9.8 Conclusions 246 9.9 References 247 10 The use of ‘smart’ textiles for wound care 254 J. F. Kennedy and K. Bunko, Advanced Science and Technology Institute, UK 10.1 Introduction 254 10.2 Basic principles and types of smart textiles 255 10.3 Characteristics of smart textiles 256 10.4 Textiles in control of exudate from wounds 262 10.5 Examples of ‘smart’ textiles for wound care 265 10.6 Response of dressings to bacteria 267 10.7 Future trends 268 10.8 Sources of further information and advice 271 10.9 References 272 11 Composite dressings for wound care 275 M. Joshi and R. Purwar, Indian Institute of Technology Delhi, India 11.1 Introduction 275 11.2 Defi nition of composite dressings 276 11.3 Structure of composite dressings 277 11.4 Materials and textile structures used in composite dressings 279 © 2009 Woodhead Publishing Limited Contents ix 11.5 Types of composite dressings 284 11.6 Trends in composite dressings: embroidery technology 286 11.7 Conclusions 288 11.8 References 288 12 Textile-based scaffolds for tissue engineering 289 M.