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Medical and Healthcare Textiles
Автор: Elsevier Science
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- Издатель:
- Elsevier Science
- Издано:
- Jul 15, 2010
- ISBN:
- 9780857090348
- Формат:
- Книге
Описание
Medical textiles remain one of the most dynamic areas of research in textiles. Medical and healthcare textiles is the fourth in a series of conferences held at the University of Bolton. Like its predecessors, it has attracted papers from some of the leading international centres of expertise in the field. Contributors cover a range of topics including emerging textile-based biomaterials, hygienic textiles, the use of textiles in infection control and as barrier materials, bandaging and pressure garments for managing chronic infections such as ulcers, the role of textiles in the management of burns and wounds, textile-based implantable devices such as tissue scaffolds and sutures, and intelligent textiles.
Provides a comprehensive overview of medical textiles from the risk of infection control and barrier materials through to directives, regulations and standards shaping the medical device industry
Explores developments in healthcare and hygiene products, including odor and pH control as well as protective and disposable fabrics
Reviews development in the area of implantable materials featuring vascular grafts, knee implants and scaffolds
Активность, связанная с книгой
Начать чтениеСведения о книге
Medical and Healthcare Textiles
Автор: Elsevier Science
Длина: 1,159 стр.
Описание
Medical textiles remain one of the most dynamic areas of research in textiles. Medical and healthcare textiles is the fourth in a series of conferences held at the University of Bolton. Like its predecessors, it has attracted papers from some of the leading international centres of expertise in the field. Contributors cover a range of topics including emerging textile-based biomaterials, hygienic textiles, the use of textiles in infection control and as barrier materials, bandaging and pressure garments for managing chronic infections such as ulcers, the role of textiles in the management of burns and wounds, textile-based implantable devices such as tissue scaffolds and sutures, and intelligent textiles.
Provides a comprehensive overview of medical textiles from the risk of infection control and barrier materials through to directives, regulations and standards shaping the medical device industry
Explores developments in healthcare and hygiene products, including odor and pH control as well as protective and disposable fabrics
Reviews development in the area of implantable materials featuring vascular grafts, knee implants and scaffolds
- Издатель:
- Elsevier Science
- Издано:
- Jul 15, 2010
- ISBN:
- 9780857090348
- Формат:
- Книге
Связано с Medical and Healthcare Textiles
Отрывок книги
Medical and Healthcare Textiles
UK
Part I
Infection Control and Barrier Materials
Infection Control and Barrier Materials – an Overview
S. Rajendran, Institute for Materials Research and Innovation University of Bolton, Bolton BL3 5AB, UK
INTRODUCTION
With the arrival of high risk microorganisms such as (Methicillin-resistant staphylococcus aureus) MRSA and Swine flue (H1N1 virus), infection control is a serious problem, especially in hospital environments. Hospital-acquired infections cost the National Health Service (NHS) in the UK £1 billion and contribute to the death of an estimated 5000 patients a year. The Department of Health in the UK estimates that such infections can cost an extra £4000-£10000 per patient. Controlling wound infection in hospitals is a day-to-day problem for healthcare personnel despite the precautionary measures taken to avoid them. Both acute and chronic wounds are vulnerable to bacterial infection. Highly-exudating wounds, macerated and slough wounds are often at risk of infection. About 8% of hospital in-patients in England develop infections and in intensive care units the figure raises to 23%.
In order to address the problem with particular reference to MRSA and Clostridium difficile, a new £4.2 million consortium has been jointly created by the Biotechnology and Biological Sciences Research Council (BBSRC), the Medical Research Council (MRC), the National Institute for Health Research (NIHR) and the Welcome Trust in the UK. The projects the consortium plans to fund will range from organising a rapid response, springing into action if a particularly virulent strain of MRSA emerges and analysing its particular signature so it can be quickly detected and controlled, to finding the best ways to change the habits of hospital staff, patients and visitors to prevent infections from occurring and spreading. The consortium will look at issues such as quick detection and control of the spread of virulent strains of MRSA, the mode of spreading to hospital equipments such as latex gloves, and identify the best strategies for preventing the spread of infection.
WOUND INFECTION
Wound management that includes chronic wounds such as pressure sores, venous leg ulcers is one of the crucial areas which needed to be addressed for elderly and immobile communities because ageing and immobility weaken the intact of the skin that provide a physical barrier to the ingress of microorganisms. The skin is an important defence layer of the body as it protects from microorganisms, UV radiations and injury. It maintains the temperature of the body besides helping the body to gain vitamin D from sunlight. Wounds are formed when the skin is broken, and the healing process depends on the extent of damage to the epidermis, dermis and subcutaneous layers of the skin. Superficial wounds only damage the epidermis but the partial thickness and full-thickness wounds respectively damage the dermis and subcutaneous fatty tissues and/or bone. Wound healing by primary intention refers to the skin edges that have been brought together by sutures, and surgical adhesives. On the other hand, the secondary intention describes wound healing when the skin edges are not brought together and have to heal by contracting and filling up with granulating tissues. Wounds such as leg ulcers and pressure ulcers fall in this category, and they are chronic because it takes a longer time to heal.
The skin in children and healthy adults is strong and inhospitable to pathogenic microorganisms but weak for elderly population and those confined to wheelchair. Once the line of defence is broken there is a risk of infection. Ageing decreases the efficiency of wound healing mechanisms. Once wound is formed replacement of epidermal cells, inflammatory response, sensory perception and barrier function decrease through the ageing process. Arterial and venous disease can delay wound healing, and are a common problem to the elderly population. The ultimate aim of wound management is to promote healing without microbial infection. Infection in the wound results in an increased production of exudate and delayed wound healing. Wounds in elderly people do, however, heal with good effect with careful management by selecting appropriate dressings. Wound dressings vary with the type of wound and management technique and no single dressing is universally applicable for healing all types of wounds. An ideal dressing is normally expected to provide barrier against dirt and other foreign bodies, provide humid environment at the wound surface that enhances wound healing, control exudate and be removed without trauma. The dressing should provide a barrier against pathogenic bacteria including the challenging MRSA (methicillin-resistant staphylococcus aureus) and MRSSA (Methicillin susceptible Staphylococcus aureus) bugs because cross-infection by bacteria through wound dressings and hospital textiles is increasingly common in hospitals and has been a major problem over several years. In the UK alone only a small number of patients (104) were infected by MRSA in 1992 but this figure rose to 4,904 in 2001. According to Office for National Statistics, the number of death in England and Wales involving Staphylococcus aureus increased from 1,212 in 2001 to 2,083 in 2005. The death rate increased by 69% due to Clostridium difficile. Elderly people are vulnerable to risk as evidenced that the death rate in 2007 involving 85 and over age groups represents 767. It must be pointed out that certain bacteria, for example MRSA super bug shows resistance even to antibiotics. The bug is contagious and transmitted through skin contact as well as hospital textiles in hospital environment. It should be noted that the currently available wound dressings are effective against only a few types of bacteria and no such dressings provide a complete shield against a wide spectrum of pathogenic bacteria that include MRSA and MRSSA. In a broad sense, an ideal wound dressing should fulfil many major requirements which include high barrier properties against a broad spectrum of pathogenic microorganisms.
HOSPITAL PROTECTIVE MATERIALS
Infection and cross-infection are nowadays more common in hospitals where the prevalence of microorganisms is high. Microorganisms are broadly classified as bacteria, fungi and viruses. Gram-positive bacteria include Staphylococcus aureus, Staphylococcus epidermidis, MASA and MRSSA and Gram-negative bacteria comprises of Proteus vulgaris, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Fungi (Candida albicons, Aspergillus niger), bird flue and swine flue are typical examples of viruses. Gram invented a staining method in 1884 to distinguish the bacteria based on colour changes. Gram-positive bacteria are purple and Gram-negative bacteria are red after Gram staining. The bacteria cause infections such as superficial infections, acute gastro-enteritis, infections of wound, burn, respiratory and urinary tract. Infections associated with fungi are: ear, nose and lung infections; tinea nigra of palms; white pildra of beard; diaper rash; athlete’s foot; ring worm; and tinea, pulmonary, mucosa and hair infections.
It is known that textiles carry and transmit infections from one person to another through clothing, bedding and related textile products used in hospitals and other potentially risk environments, and laundering process do not remove the risk of infection. Therefore it is vital that textile materials with antimicrobial properties are developed by using the following principal techniques:
• Imbuing antibacterial agents into the fibres or depositing onto the fibres.
• Chemical modification of fibres by formation of covalent bonds.
• Coating on the surface of fabrics.
• Microencapsulation of antibacterial agents.
• Plasma treatments.
It is also crucial that the developed materials should possess antimicrobial activity against a wide range of microorganisms that include super bugs such as MRSA. Antimicrobial textiles can be either active or passive materials. It will be noted that the passive materials do not contain active substances but their surface structure (Lotus effect) produces a negative effect on the living conditions of microorganisms (anti-adverse effect). Textile materials that contain active antimicrobial substances act upon either in or on the bacterilal cell.
There are several antimicrobial agents such as quaternary ammonium compounds, antibiotics, iodophors, phenols, ureas, organosilicons and silver containing agents and they are mostly act upon either the bacterial cell during the metabolism or within the genome. For example, Triclosan (polychloro phenoxy phenol) inhibits the growth of microorganisms by using an electro-chemical mode of action to penetrate and disrupt their cell walls. When the cell walls are penetrated, leakage of metabolites occurs and other cell functions are disabled thereby preventing the organism from functioning or reproducing. Silver has been known to possess antimicrobial characteristics since ancient times. Silver and nanosilver containing antimicrobial agents, for instance sodium silver sulphadiazine – SSD, are widely used both in hospital textiles and wound dressings because silver is generally recognised as a safe and broad-spectrum antimicrobial agent. Silver acts as a heavy metal by imparting the bacterial electron transport system and some DNA function.
In addition to the above synthetic antimicrobial agents, the natural product antimicrobial agents such as chitosan, aloe vera, tea tree oil, eucalyptus oil, tulsi extracts, neem and a number of medicinal plants have been systematically examined for potential use as effective antimicrobial agents in hospital textiles and wound dressings. The major advantages of using natural antimicrobial agents over synthetic antimicrobials include lower incidence of adverse reactions and eco-fnendliness. It should be mentioned that neem (Azadirachta indica) and tulsi (Ocimum basilicum) possess a rich source of antimicrobial compounds and are abundantly found in the Indian subcontinent. Recent studies have demonstrated the use of neem seed and bark extracts on cellulosic substrates to impart antibacterial activity against both Gram-positive and Gram-negative bacteria. It is a well established fact that honey possesses broad spectrum of antimicrobial activity and has a long history of medical use. The high sugar content and the ability to produce hydrogen peroxide make the honey antimicrobial. There is increasing interest nowadays in using honey in wound management. Medical grade honey particularly Manuka honey has been successfully used in a wide range of wound dressings for managing superficial wounds, sinus wounds, cavity wounds, burn wounds and the treatment of diabetic foot ulcers.
Bibliography
1. Bertal, K., Shepherd, J., Douglas, C.W.I., Madsen, J., Morse, A., Edmondson, S., Arms, S.P., Lewis, A., MacNeil, S. Antimicrobial activity of novel biocompatible wound dressings based on triblock copolymer hydrogels. J Material Science. 2009; 44(23):6233–6246.
2. Lim, S.H., Hudson, S.M. Review of chitosan and its derivative as antimicrobial agent and their uses as textile chemicals. J Macromolecular Science, Polymer Reviews. 2003; C43:223–269.
3. Atiyen, B.S., Costagliola, M., Hayek, S.N., Dibo, S.A. Effect of silver on bum wound infection control and healing: Review of the literature. Korean J Dermatology. 2008; 46(12):1595–1602.
4. Joshi, M., Ali, W., Purwar, R., Rajendran, S. Ecofriendly antimicrobial finishing of textiles using bioactive agents based on natural products. Indian J Fibre & Text Res. 2009; 34:295–304.
5. Joshi, M., Ali, S.W., Rajendran, S. Antibacterial finishing of polyester/cotton blend fabrics using neem (azadirachta indica): A natural bioactive agent. J Applied Polymer Science. 2007; 106:793–800.
6. NHSSB Wound Management Manual, Northern health and Social Services Board, 2005:41–42.
7. National Prescribing Centre. Modem wound dressing management. Pres Nurse Built. 1999; 1(2):8.
8. Basualdo, C., Sgroy, V., Finola, M.S., Marioli, J.M. Comparison of the antimicrobial activity of honey from different provenance against bacteria usually isolated from skin wounds. Vet Microbial. 2007; 124:375–381.
9. Mohan, P.C. The role of honey in wound management. J Wound Care. 1999; 8(8):415–418.
10. Betts, J., Guidelines for the clinical use of honey in wound care. R. Cooper, P. Molan, R. White. Honey in Modem Wound Management, Aberdeen, 2009. [HealthComm UK Ltd].
Antimicrobial Properties of Silver-Containing Chitosan Fibers
Yimin Qin and Changjun Zhu, The Biochemical Materials Research and Development Center, Jiaxing College, 56 Yuexiu Road South, Jiaxing 314001, Zhejiang Province, China.. E-mail address: yiminqin1965@126.com
ABSTRACT
In order to prepare antimicrobial silver containing chitosan fibers, silver sodium hydrogen zirconium phosphate with particle diameter < 1um were mixed with the chitosan solution and made into fibers by the wet-spinning process. When in contact with solutions containing protein and metal ions, silver ions can be released from these fibers through chelation and ion exchange. This paper discussed the antimicrobial effect of chitosan fibers and silver containing chitosan fibers against three common types of bacteria, i.e., Candida albicans, Staphylococcus aureus and Pseudomonas pyocyanea. Results showed that the silver containing chitosan fibers have much stronger antimicrobial effect than the chitosan fibers.
Key words
chitosan fiber
silver containing chitosan fiber
antimicrobial property
INTRODUCTION
Silver has a long history as an antimicrobial agent[1-⁵], especially in the treatment of bums. While metallic silver is relatively inactive, silver ions are effective against a wide range of bacteria. When low concentrations of silver ions accumulate inside cells, they can bind to negatively charged components in proteins and nucleic acids, thereby effecting structural changes in bacterial cell walls, membranes and nucleic acids that affect viability[6-⁸]. In addition, although silver is a highly effective antimicrobial agent, it has a limited toxicity to mammalian cells[9]. It was found that the use of silver containing wound dressings can increase the rate of epithelialisation by 28%, indicating a beneficial effect of silver ions to skin regeneration, in addition to its antimicrobial activity.
In recent years, silver has been gaining importance as an effective antimicrobial agent that does not result in bacteria resistance. Silver containing antimicrobial products have been developed so that a low concentration of silver ions can be released over time. A number of laboratory studies have shown the excellent antimicrobial performances of the silver containing antimicrobial products[2, ⁴].
This paper presents the results of a study on the antimicrobial properties of silver containing chitosan fibers.
EXPERIMENTAL
A spinning dope was prepared by dissolving 3 kg of chitosan powder in 97 kg of 1% aqueous acetic acid solution. 30 g AlphaSan RC5000 (a silver sodium hydrogen zirconium phosphate containing 3.8% by weight silver) was added into the solution and thoroughly mixed with the chitosan solution. After storage at room temperature for two days to remove the bubbles, fibers were produced by extruding the dope through a spinneret with 4,000 holes (hole diameter 80 um) at 12 m/min into an aqueous coagulation bath containing 4% NaOH. The as-spun fibers were taken up at 7.2 m/min and then stretched at 80 °C to the maximum extent. The fibers were then washed with water and acetone before being dried by hanging in air. Finally, the dry tow was cut to produce 50 mm length staple fibers.
When analyzing the silver ion contents in the chitosan fibers, 0.5 g fibers were treated with 7 ml concentrated sulphuric acid until the fibers were fully digested. The mixture was then diluted to 100 ml with distilled water and filtered. The silver ion concentration was determined by using atomic absorption spectrometer.
When testing the release of silver ions from the fibers, the fiber sample was placed in contact with 40 times its own weight of either distilled water, solution A or aqueous solutions containing different amount of protein. The British Pharmacopeia specified solution A as an aqueous solution containing 142 millimoles of sodium chloride and 2.5 millimoles of calcium chloride, representing the typical ion concentrations of body fluid. The protein used was water soluble soya bean protein. After conditioning at specified temperatures for different periods of time, 5 ml solution was taken out and tested for silver ion concentration by using atomic absorption spectrometer.
The antimicrobial activity of the fibers was tested against three common strains of bacteria, i.e., Candida albicans, Staphylococcus aureus and Pseudomonas pyocyanea. The bacteria were suspended in 0.5% peptone water with the bacteria concentration at about 1.5 × 10⁴ to 1.5 × 10⁵ cfu/ml. 35 ml 0.5% peptone water were measured into 100 ml conical flasks and to each of them were added 2.5 ml of the bacteria suspension, with the bacteria concentration in the conical flask controlled at between 1 × 10³ and 1 × 10⁴ cfu/ml. After that, 0.375 ± 0.002 g of sterilized silver containing chitosan fibers were added into the conical flasks respectively. The fibers were placed in contact with the bacteria suspension; the conical flasks were placed in a water bath at 36 °C and were shaken at a speed of 180 r/min for 8 hrs. 0.1 ml of the bacteria containing solution was then taken out to measure the colony forming units.
The reduction in the number of bacteria is calculated in the following equation :
Reduction in bacteria = [A—B]/A × 100%
Where :
A : The average bacteria concentration in the control sample after shaking, cfu/ml
B : The average bacteria concentration in the test sample after shaking, cfu/ml
RESULTS AND DISCUSSION
Figures 1 show the SEM photomicrographs of the silver containing chitosan fibers. It can be seen that although the silver containing chitosan fiber generally has a smooth surface structure, the AlphaSan RC5000 particles are visible and can be seen embedded into the chitosan structure. When the fiber is wet with 0.1% aqueous acetic acid solution, it can be seen under optical microscope that the silver containing AlphaSan RC5000 particles are fairly uniformly distributed inside the fiber structure, acting as the reservoir for releasing the antimicrobial silver ions.
Fig 1: SEM Photomicrograph of the silver containing chitosan fiber
Figure 2 shows the release of silver ions when the silver containing chitosan fibers were placed in contact with three different solutions at 37 °C. With distilled water, the silver concentration was low and remained at about 0.137 ug/ml over extended period of time. In both solution A and 2.9% aqueous protein solution, the silver concentrations in the contacting solutions were much higher than in distilled water. With solution A, the silver concentration slowly rose from 0.402 ug/ml at 30 min to about 0.654 ug/ml after 24 hrs. The silver concentration in the 2.9% protein solution was much higher than in solution A. At 4 hrs, the silver concentration in the protein solution was 1.31 ug/ml, about twice those measured in solution A after same period of contact with the silver containing fibers.
Fig 2: Silver ion concentrations after the silver containing chitosan fibers were in contact with three different solutions
Figure 3 shows the effect of temperature on the silver release when the silver containing chitosan fibers were in contact with solution A. After 24 hrs, the silver ion concentration in solution A were 0.370, 0.654 and 0.765 ug/ml at 21, 37 and 65 °C respectively, with the silver ion concentration at 65 °C roughly double that at 21 °C. This shows that the rate of silver ion release can be significantly elevated when temperature is increased. It is possible that at a higher temperature, the fibers can swell more as water penetrates inside the fiber. In addition, the ion exchange process can also be accelerated at an elevated temperature.
Fig 3: Effect of temperature on the silver release when the silver containing chitosan fibers were in contact with solution A
Figure 4 shows the silver ion concentrations when the silver containing chitosan fibers were in contact with aqueous solutions containing different amount of protein at 37 °C. It is clear that the silver ion concentration in the contacting solution is directly proportional to the protein concentration. The effect of a high protein concentration is fairly obvious, with the silver ion concentration in the 5% protein solution about 4 times that of the 1% protein solution after 30 min.
Fig 4: Silver ion concentrations when the silver containing chitosan fibers were in contact with aqueous solutions containing different amount of protein at 37 °C
The silver ions released from the silver containing chitosan fibers can act as an effective antimicrobial agent. Although chitosan is already well known for its antimicrobial properties, this is mostly due to the positive charge on the amine groups which controls bactetia growth by its ability to combine the negatively charged bacteria cells. Though this action can help limit the bacteria growth, its action is bacteriastatic rather than bactericidal.
Table 1 shows the antimicrobial effect of the silver containing chitosan fibers against three common strains of bacteria. It is clear that with all three types of bacteria, the silver containing chitosan fibers are effective in reducing the bacteria count by more than 98%. In Table 2, the antimicrobial effect of chitosan fibers and silver containing chitosan fibers are compared against Candida albicans. Under the same test conditions, the reduction in bacteria count for the chitosan fiber is 78.62%, whilst for the silver containing chitosan fiber, the reduction is 97.22%. This clearly demonstrates that the silver containing chitosan fiber is more effective in controlling bacteria growth than the chitosan fiber.
Table 1
The antimicrobial effect of silver containing chitosan fibers against three common bacteria
Table 2
The antimicrobial effect of chitosan fibers and silver containing chitosan fibers against Candida albicans
CONCLUSIONS
This study has shown that silver containing chitosan fibers can be made by blending silver containing AlphaSan RC5000 particles in the spinning dope. Experimental results showed that when the silver containing chitosan fibers are placed in contact with either solution A or aqueous protein solution, silver ions can be released from the fiber through ion exchange and chelation. More effective in releasing the silver ions from the fiber takes place with chelation with protein molecules. It has been found that the silver containing chitosan fiber is more effective in controlling bacteria growth than the original chitosan fiber.
Acknowledgement
This work was financially supported by the Natural Science Fund of Zhejiang Province, China (Grant No. Y405030).
REFERENCES
1. Coombs, C.J., Wan, A.T., Masterton, J.P. Do burns patients have a silver lining. Bums. 1992; 18(3):179–184.
2. Deitch, E.A., Marino, A.A., Malakanok, V. Silver nylon cloth: in vitro and in vivo evaluation of antimicrobial activity. J. Trauma. 1987; 27(3):301–304.
3. Furr, J.R., Russell, A.D., Turner, T.D. Antibacterial activity of Actisorb Plus, Actisorb and silver nitrate. J. Hospital Infection. 1994; 27(3):201–208.
4. Lansdown, A.B.G., Sampson, B., Laupattarakasem, P. Silver aids healing in the sterile wound: experimental studies in the laboratory rat. Brit. J. Dermatol.. 1997; 137:728–735.
5. Russell, A.D., Hugo, W.B.Ellis G.P., Luscombe D.K., eds. Antimicrobial activity and action of silver. London: Progress in Medicinal Chemistry, 1994. [Elsevier Science].
6. Charley, R.C., Bull, A.T. Bioaccumulation of silver by a multispecies population of bacteria. Arch. Microbiol.. 1979; 123:239–244.
7. Modak, S.M., Fox, C.L. Binding of silver sulfadiazine to the cellular components of Pseudomonas aeruginosa. Biochemical Pharmacology. 1973; 22(19):2391–2404.
8. Wells, T.N., Scully, P., Paravicini, G. Mechanisms of irreversible inactivation of phosphomannose isomerases by silver ions and flamazine. Biochemistry. 1995; 34:7896–7903.
9. Hollinger, M.A. Toxicological aspects of silver pharmaceuticals. Crit. Rev. Toxicol.. 1996; 26:255–260.
Copper-Impregnated Antimicrobial Textiles; an Innovative Weapon to Fight Infection
Gadi Borkow, Anthony Felix and Jeffrey Gabbay, Cupron Inc, Greensboro, USA
ABSTRACT
A platform technology has been developed in which copper oxide is impregnated or plated into polymeric fibres or cotton fibres, respectively, endowing the fibres with potent broad-spectrum anti-bacterial, anti-viral, anti-fungal and anti-mite properties [1], This durable platform technology introduces copper oxide-treated fibres and enables the mass production of woven and non-woven fabrics with no requirement for alteration of industrial procedures or machinery. This technology facilitates the production of anti-viral gloves and filters (which deactivate HIV-1 and other viruses); anti-bacterial self-sterilizing fabrics (which kill antibiotic resistant bacteria, including MRSA and VRE); anti-fungal socks (which alleviate symptoms of athlete’s foot); anti-dust mite mattress-covers (which reduce mite-related allergies) and gauze (which is highly effective in promoting skin regeneration, closure of chronic wounds and the alleviation of bed sores). This paper will demonstrate the potential use of copper in new applications that address medical issues of the greatest importance such as viral transmissions; nosocomial infections; wound healing and the spread of antibiotic resistant bacteria.
COPPER AS A BIOCIDE
Copper ions have been used for centuries to disinfect fluids, solids and tissues [2,3]. The ancient Greeks (400 BC) prescribed copper for pulmonary diseases and for purifying drinking water. The Celts produced whisky in copper vessels in Scotland around 800 AD, a practice that has continued to the present day. Copper strips were nailed to ship’s hulls by the early Phoenicians to inhibit fouling, as cleaner vessels were faster and more manoeuvrable. Gangajal (holy water taken from the Ganges River) has been stored in copper utensils in Hindu households for centuries due to copper’s anti-fouling and bacteriostatic properties. By the 18th century, copper had come into wide clinical use in the western world for the treatment of mental disorders and afflictions of the lungs. Early American pioneers moving west across the continent put silver and copper coins in large wooden water casks to provide them with safe drinking water for their long voyage. In World War II, Japanese soldiers put pieces of copper in their water bottles to help prevent dysentery. Copper sulphate is highly prized by some inhabitants of Africa and Asia for healing sores and skin diseases. NASA first designed an ionization copper- silver sterilizing system for its Apollo flights.
Today copper is used as a water purifier, algaecide, fungicide, nematocide, molluscicide, and as an anti-bacterial and anti-fouling agent [4-8]. It is considered safe to humans, as demonstrated by the widespread and prolonged use of copper intrauterine devices (IUDs) by women [9-11]. In contrast to the low sensitivity of human tissue (skin or other) to copper [12], micro-organisms are extremely susceptible to copper. Copper toxicity to micro-organisms, including toxicity to viruses, may occur through the displacement of essential metals from their native binding sites, from interference with oxidative phosphorylation and osmotic balance and from alterations in the conformational structure of nucleic acids, membranes and proteins [13].
INCORPORATION OF COPPER OXIDE INTO NATURAL AND SYNTHETIC FIBERS
Utilizing the properties of copper, two durable platform technologies were developed [1,13]: the first one plates cotton fibres with copper oxide (Fig 1, left panel) and the second one impregnates polyester, polypropylene, polyethylene, polyurethane, polyolefin or nylon fibres with copper oxide (Fig 1, right panel). The fibres can be cut into short staple or produced in filament form and texturized, if so desired. The product yielded is a fibre that can be introduced at the blending stage of yarn production or directly into a woven or knit product so that no manufacturing processes are changed. Woven and non-woven fabrics can be produced.
Figure 1 SEM images of cellulose fibres plated with copper oxide (left panel) and polyester fibres containing 3% (w/w) copper oxide particles (right panel).
BIOCIDAL PROPERTIES OF FABRICS CONTAINING COPPER OXIDE
Antibacterial
Exposure of gram positive or gram negative bacteria to fabrics containing copper oxide particles results in potent reduction in their viable titres (Table 1).
Table 1
Antimicrobial properties of copper-oxide impregnated fabrics
Antifungal
Exposure of fungi to fabrics containing copper oxide particles results in potent reduction in their viable titres (Table 2).
Table 2
Antifungal properties of copper-oxide impregnated fabrics
The American Association of Textile Chemists and Colorists (AATCC) Test Method 100-1993 was used to determine the biocidal properties of the fabrics against the bacteria and fungi tested. The initial bacterial or fungal inoculum used varied between 1×10⁵ to 4×l0⁶ colony forming units (cfu)/sample. These tests were carried out by independent laboratories: AminoLab Laboratory Services, Weizmann Industrial Park, Nes Ziona 79400, Israel, and Hy Laboratories Ltd., Park Tamar, Rehovot 76325, Israel.
Antiviral
Filters containing copper oxide-impregnated polypropylene fibres can reduce infectious titres of a panel of viruses spiked into culture media (Table 3). Enveloped; non-enveloped; RNA and DNA viruses were affected, suggesting the possibility of using copper oxide-containing devices to deactivate a wide spectrum of infectious viruses found in filterable suspensions. Prolongation of the exposure of these micro-organisms to the copper oxide-containing fibres further reduced their viable titers.
Table 3
Reduction of infectious viral titers by copper-oxide containing filters
The CMV testing was done at the Ben Gurion University, Beer Sheva, Israel by Dr. Shemer-Avni; HIV-1 and Adenovirus testing was done in Cupron Biosafety Viral Laboratory, Rehovot, Israel. All other viruses were tested at the Institute for Antiviral Research, Utah State University, Utah, USA.
Anti-mite efficacy
Figure 2 shows the result of an experiment in which the effect of two fabrics, one containing 0.4% and one containing 2% copper oxide (w/w), were tested for anti-mite activity. The house dust mite tested was Dermatophagoides farinae. While during the first 12 days of the experiment all mites exposed to control fabrics were alive, more than 60% and 100% of the mites exposed to the 2% copper fabric were dead after 1 and 5 days, respectively. Approximately 50% of the mites exposed to the 0.4% copper fabrics died within 12 days of exposure to the fabrics. After 47 days of culture, 86% and 67% of the mites in the absence of any fabric and in the control fabric containers were alive, while all mites exposed to the 0.4% copper fabric were dead.
Figure 2 Anti-mite activity of fabrics containing 0.4 and 2% copper oxide (w/w)
This and other experiments with mites were conducted under a subcontract agreement by Dr. Kosta Y. Mumcuoglu from the Department of Parasitology, Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel.
CLINICAL STUDIES
Athlete’s foot efficacy
Fifty six individuals suffering from athlete’s foot (tinea pedis) were given socks containing 1% copper-oxide in the soles of the socks. The individuals were asked to wear the copper-socks on a daily basis. During this period the individuals did not receive any local or systemic anti-fungal treatment and their feet were monitored by a
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