ENGINEERED MEDICAL TEXTILES for Better Health Care facilities Suggestions from Ministry of Textiles New Delhi 01 -09-2009

ENGINEEREDENGINEERED MEDICAL TEXTILES for Better MEDICAL TEXTILES for Better Health Care facilitiesHealth Care facilities

Suggestions from Ministry of Textiles Suggestions from Ministry of Textiles

New DelhiNew Delhi

01 -09-2009 01 -09-2009

World Health Organisation in their Country Co-operation Strategy for India states :

“Communicable diseases account for about 38% of the disease burden with large variation across states. New or re-emerging diseases have highlighted the importance of public health system including surveillance, rapid response capacity, infection control and timely

health information”

Do we want to do something substantial to promote medical tourism ?

Engineered medical textile offers tremendous opportunities of reaching higher standards of medical care through :

Non woven disposable

•Gowns•Drapes•Masks•Caps•Shoe covers

Specialty wound care products.•Nonwoven gauge, sponges, dressings.•Elasticated flat bandages•Foam padded arm sling•Tubular finger bandages •Orthopedic casting bandage•Pressure gloves•Pressure garments

Implantable medical Textiles•Bifurcated arterial prosthetic graft•Artificial Joints•Artificial Kidney / Dialysers•Artificial Tendon (Mesh)•Artificial Vascular Grafts•Artificial heart valve etc

Nonwoven disposablesNonwoven disposables

Nonwoven disposablesNonwoven disposables

Mask & Cap

Mask , Caps, Gowns and Drapes

Why Nonwoven disposables? Why Nonwoven disposables? Need for Infection Control !! Need for Infection Control !!

• Use of disposable nonwoven medical fabrics play an important role in reducing hospital infections.

• International studies have indicated that single-use nonwoven products reduced infection by 2.5 times compared to traditional textiles.

• International studies have shown that 56% of reusable textiles had significant defects that could seriously compromise their performance

.

High barrier/Protection

• Traditional textiles are typically

absorbent and body liquid like blood,

Plasma etc can comes in contact with

skin of wearer .Unlike this Nonwoven

fabrics are engineered to have high

barrier to blood or body fluids.

Why Nonwoven disposables? Need for Infection Control !!

• Re-usable textiles can develop tears and holes during the washing process.

Low Linting

.

• Lint is a source of infection since bacteria often use it as a carrier

• Re-usable fabrics generate lot of lint during washing process.

• Nonwoven fabrics typically have low lint

Why Nonwoven disposables ? Why Nonwoven disposables ?

Proven Sterilization Performance

Nonwovens are compatible with

multiple sterilization methods such as

steam, ETO,gamma ( depending on

composition)


Comfort/Conformability

• Comfort critical for gowns

• Nonwovens have good breathability

• Conformability important for drapes

• Nonwovens are flexible/soft


Single Use and Economical

• Various studies indicate that when total costs are calculated single-use fabrics are generally lower cost than re-usables.

• Use of nonwoven will reduce the overall health care cost to the nation by reducing cross infection


Advantages of disposable products Advantages of disposable products in Government Hospitals/Health in Government Hospitals/Health CentresCentres Prevention of hospital acquired infection. Cross-infection reduced . Doctors’/Health workers’ protection from exposure to pathogen. Savings in overall healthcare costs due to reduced cross-infections. Total budgeted expenditure of Ministry of health of Rs 18380 crore

inclusive of National Rural Health Mission of Rs 12529 crore can be reduced significantly by adopting/increasing use of nonwoven disposable

WHO has recommended use of disposable personal protective equipments i.e apron,mask,gown,cap,gloves etc in its practical guidelines for infection control in health care facilities

Advantages of disposable Advantages of disposable productsproducts

Ultra disposable surgical gowns protects the medical professionals against the transmission of AIDS, hepatitis and other blood-borne infections.

Surgical masks protect medical and dental professionals from acquiring or transmitting infections.

Non-woven shoe covers protect surgeons from infections and the discharge and adverse effects of static electricity.

Disposable drapes prevent cross infections.

Disadvantages of reusable Disadvantages of reusable productsproducts

The reusable gown, drapes, face mask, cap need to be washed and sterilised after each surgery. For washing 1 kg of cloth more than 7 litres of water is required and host of polluting salt and detergents are released through untreated water.

SITRA studies have shown that after 15 washes the Bacterial Filtration Efficiency goes down drastically endangering medical professionals health.

Reusable Surgical GownReusable Surgical Gown

No. of washesNo. of washesBacterial Filtration Bacterial Filtration

Efficiency(%)Efficiency(%)Air Permeability Air Permeability (cm(cm33/cm/cm22/sec.)/sec.)

00 92.7992.79 5.835.83

22 92.7992.79 5.85 5.85

33 92.1992.19 5.875.87

55 90.2490.24 5.975.97

1010 89.0189.01 6.136.13

1515 88.3888.38 6.396.39

2020 72.8872.88 6.426.42

2525 71.6971.69 6.496.49

3030 69.2169.21 6.546.54

Very significant reduction in bacterial filtration efficiency with successive washes has been noticed in research studies.

Disposable non-woven surgical Disposable non-woven surgical gownsgowns

Bacterial filtration efficiency – 95 –98%

Air permeability – 25-30 cm3/cm2/sec

This shows not only these are safer, these are much more comfortable.

Comparative cost of disposable and Comparative cost of disposable and reusable productsreusable products

Cost of re-usable Cost of disposable

Caps (Rs.)

Masks (Rs.)

Caps (Rs.)

Masks (Rs.)

No. of usage 10 10

2.00 – 3.00

3.00

Cloth + Stitching (Fixed cost)

35.00 17.50

Laundry + Sterilisation (Recurring Cost at Rs.1.50 per cycle for 10 cycles)

15.00 15.00

Total Cost 50.00 32.50Cost per Usage 5.00 3.25

The above cost of re-usable products is excluding the environmental cost. It is noteworthy that many court pronouncements insist for zero discharge norm.

Source : Report of the Expert Committee on Technical Textiles (ECTT)

Specialty wound care productsSpecialty wound care products..


Tubular Finger Bandages

Elasticated Flat Bandage

Pressure Gloves Pressure Garments

Specialty wound care productsSpecialty wound care products

Foam Padded Arm Sling Elasticated Net Garment

Orthopaedic Casting Bandage

Presently in most of the wound cases gauze bandages are used. This causes discomfort for the patient and in many cases the curing takes long time.

One more commonly used bandage is Crepe bandages which also have similar disadvantages.

Why Specialty wound care products ?Why Specialty wound care products ?

In developed countries such as UK, USA bandages made of

different fibres are being used. These are generally specialty

bandages for particular wounds. Such use has also been observed

in reputed hospitals in private sector. For e.g., Appollo Hospital,

Meenakshi Hospital, Asian Heart Institute, Escorts etc.

Nonwoven sponges,dressing,bandage rolls provide improved

absorbent capacity and greater wicking

These wound care products enhances wound healing and patient

confort

Why Specialty wound care products ?Why Specialty wound care products ?

Existing Indian Standards are only for woven cotton bandages.

The Japanese pharmaceutical law enforcement regulation has identified nonwoven gauges through its Bulletin No. 133.

The European standards for nonwoven dressings are covered under European standard EN 1644-1.

Nonwoven disposables comply with the Association for the Advancement of Medical Instrumentation (AAMI) PB70 standards


IMPLANTABLE MEDICAL IMPLANTABLE MEDICAL TEXTILESTEXTILES

Implantable medical TextilesImplantable medical Textiles

Bifurcated Arterial Prosthetic Graft

Artificial Heart Valve Artificial Heart Valve (Includes knitted fabric) (Includes knitted fabric)

Most of implantable medical textiles are imported now.

Availability of Indian standards will encourage in producing these products in India, which in turn will reduce the price of those products.

IMPLANTABLE MEDICAL IMPLANTABLE MEDICAL TEXTILESTEXTILES

Center of ExcellenceCenter of ExcellenceTo provide infrastructure support at one place for the

technical textile manufacturer the government has

set up four Centers of Excellence(COE) in the thrust

areas of technical textiles. The details are given

below:

The four COEs have been sanctioned Rs.43.31 crore

by th MOT

Segment Agency

Meditech SITRA with AC college of technology,Chenai

Protech NITRA with IIT delhi

Geotech BTRA with ATIRA

Agrotech SASMIRA with MANTRA and Navsari agriculture University

Centre of Excellence Centre of Excellence MeditechMeditech

SITRA has been sanctioned Rs Rs. 10.36

crore for setting up of COE for Meditech.

So far an amount of Rs 3.875 crores has

been released to the COE : SITRA.

Centre of ExcellenceCentre of Excellence

:

The SITRA-COE Meditech is in the process of createing the following facilities:Facilities for testing and evaluation of products of segments of technical textiles.

Develop as a national and international accreditation center

Development of Resource Centre with I.T. infrastructure

Facilities for training of core personnel and regular training of personnel from the industry

RecommendationsRecommendations

RecommendationsRecommendations Majority of health care administration in the country is done

through civil hospital, public health centres, hospitals run by local bodies, i.e., Municipal hospitals. Further ESI, CGHS, railway hospital, defence hospitals and hospitals run by PSEs are also very significant health care provider. We would like to refer them loosely as government hospitals.

The government hospitals and health centres should be encouraged to use disposable products such as drape, bed linen and medical professionals’ gowns, face mask, cap, shoe cover etc. The largest supplier to the government hospital is through GMSD (Govt. Medical Stores Department). These items should be included in the vocabulary of the GMSD.

RecommendationsRecommendations contd.contd.

The Hospitals and Health Care centres should be encouraged to use specialty wound care products for faster healing and comfort to the patients.

Awareness programmes need to be conducted for Medical and Health professionals on regular basis.

RecommendationsRecommendations Standards may be prescribed for nonwoven disposable to encourage

production of international standards medical disposable. AAMIPB 70/CEN standards for drapes and gowns;EN868-1 and EN868-2 for sterilization wraps can be referred to.

Nonwoven as an option along with woven bandages and gauges should be included in Schedule F-2 of Drugs and Cosmetic Act and also in Indian Pharmacopoeia

In Indian Pharmacopoeia in addition to cotton and viscose other manmade fibers like polyesters should also be included

Awareness about the latest medical textile products should be created amongst Indian health personnel.

For more detail please contact

1. Dr. Arindam Basu, Director, SITRA

(Mob. No. 09790384532)

2. visit SITRA’s websites:

www.sitra.org.in

www.sitrameditech.org.in

3. Visit MOT website

www.texmin.nic.in

www.technotex.gov.in

Thank YouThank You

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ENGINEERED MEDICAL TEXTILES for Better Health Care facilities Suggestions from Ministry of Textiles New Delhi 01 -09-2009