Tribological investigation of a functional medical textile with lubricating drug-delivery finishing.

Textile-based drug delivery systems have a high potential for innovative medical and gerontechnological applications. In this study, the tribological behaviour and lubrication properties of a novel textile with drug delivery function/finishing was investigated by means of friction experiments that simulated cyclic dynamic contacts with skin under dry and wet conditions. The textile drug delivery system is based on a loadable biopolymer dressing on a polyester (PES) woven fabric. The fabrics were finished with low (LC) and highly cross-linked (HC) polysaccharide dressings and investigated in the unloaded condition as well as loaded with phytotherapeutic substances. The mechanical resistance and possible abrasion of the functional coatings on the textile substrate were assessed by friction measurements and scanning electron microscopical analyses. Under dry contact conditions, all investigated fabrics (PES substrate alone and textiles with loaded and unloaded dressings) showed generally low friction coefficients (0.20-0.26). Under wet conditions, the measured friction coefficients were typically higher (0.34-0.51) by a factor of 1.5-2. In the wet condition, both loaded drug delivery textiles exhibited 7-29% lower friction (0.34-0.41) than the PES fabric with unloaded dressings (0.42-0.51), indicating pronounced lubrication effects. The lubrication effects as well as the abrasion resistance of the studied textiles with drug delivery function depended on the degree of dilution of the phytotherapeutic substances. Lubricating formulations of textile-based drug delivery systems which reduce friction against the skin might be promising candidates for advanced medical textile finishes in connection with skin care and wound (decubitus ulcer) prevention.

Neocellularization and neovascularization of nanosized bioactive glass-coated decellularized trabecular bone scaffolds.

In this study, the in vivo recellularization and neovascularization of nanosized bioactive glass (n-BG)-coated decellularized trabecular bone scaffolds were studied in a rat model and quantified using stereological analyses. Based on the highest amount of vascular endothelial growth factor (VEGF) secreted by human fibroblasts grown on n-BG coatings (0-1.245 mg/cm(2)), decellularized trabecular bone samples (porosity: 43-81%) were coated with n-BG particles. Grown on n-BG particles at a coating density of 0.263 mg/cm(2), human fibroblasts produced 4.3 times more VEGF than on uncoated controls. After 8 weeks of implantation in Sprague-Dawley rats, both uncoated and n-BG-coated samples were well infiltrated with newly formed tissue (47-48%) and blood vessels (3-4%). No significant differences were found in cellularization and vascularization between uncoated bone scaffolds and n-BG-coated scaffolds. This finding indicates that the decellularized bone itself may exhibit growth-promoting properties induced by the highly interconnected pore microarchitecture and/or proteins left behind on decellularized scaffolds. Even if we did not find proangiogenic effects in n-BG-coated bone scaffolds, a bioactive coating is considered to be beneficial to impart osteoinductive and osteoconductive properties to decellularized bone. n-BG-coated bone grafts have thus high clinical potential for the regeneration of complex tissue defects given their ability for recellularization and neovascularization.

A novel method for visualising and quantifying through-plane skin layer deformations.

Skin is a multilayer composite and exhibits highly non-linear, viscoelastic, anisotropic material properties. In many consumer product and medical applications (e.g. during shaving, needle insertion, patient re-positioning), large tissue displacements and deformations are involved; consequently large local strains in the skin tissue can occur. Here, we present a novel imaging-based method to study skin deformations and the mechanics of interacting skin layers of full-thickness skin. Shear experiments and real-time video recording were combined with digital image correlation and strain field analysis to visualise and quantify skin layer deformations during dynamic mechanical testing. A global shear strain of 10% was applied to airbrush-patterned porcine skin (thickness: 1.2-1.6mm) using a rotational rheometer. The recordings were analysed with ARAMIS image correlation software, and local skin displacement, strain and stiffness profiles through the skin layers determined. The results of this pilot study revealed inhomogeneous skin deformation, characterised by a gradual transition from a low (2.0-5.0%; epidermis) to high (10-22%; dermis) shear strain regime. Shear moduli ranged from 20 to 130kPa. The herein presented method will be used for more extended studies on viable human skin, and is considered a valuable foundation for further development of constitutive models which can be used in advanced finite element analyses of skin.

Assessment of biophysical skin properties at different body sites in hospitalized old patients: results of a pilot study.

BACKGROUND: Skin aging is a risk factor for a decubitus and biophysical skin properties could help to identify persons at risk. Whether such biophysical properties of aged human skin differ between areas is undetermined. OBJECTIVE: To investigate whether viscoelasticity, hydration or friction differ between important areas for decubitus risk. METHODS: Pilot study in 32 (18 female, 14 male) acute and subacute old patients aged 81.9 ± 5.9 years (±SD), without active skin disease after an average of 10 days of stay. Assessment of skin resilience/viscoelasticity (E) and hydration (H) at the volar forearm (VF), trochanter (TR) and the sacrum (SA), nutrition by a Mini Nutritional Assessment (MNA), total body water (TBW), lean body mass (LBM), % body fat (%F) by bioimpedance and routine laboratory parameters (hemoglobin, hematocrit, leukocytes, C-reactive protein, serum proteins and creatinine). RESULTS: Mean body mass index (27 ± 4.2), MNA (22.5 ± 2.9), Braden score (20 ± 2.5), E (68.5 ± 6.0%) and H (38.3 ± 6.7) at any site and laboratory parameters did not differ by sex. Men had more TBW (+12 ± 1.5 liters), LBM (+9 ± 2 kg), less %F (-8.8 ± 2.1%), increased H-TR (+7.11 ± 2.8) and H-SA (+5.68 ± 2.5). Overall E-VF correlated significantly with E-TR (r(2) = 0.40, p < 0.0001) and E-SA (r(2) = 0.40, p < 0.0001). In contrast, skin hydration was not correlated. CONCLUSION: Results of forearm elasticity experiments can be used as a model for other body sites at risk for the development of pressure ulcers.

Skin-textile friction and skin elasticity in young and aged persons.

BACKGROUND/PURPOSE: The mechanical properties of human skin are known to change with ageing, rendering skin less resistant to friction and shear forces, as well as more vulnerable to wounds. Until now, only few and contradictory results on the age-dependent friction properties of skin have been reported. This study has investigated in detail the influence of age on the friction of human skin against textiles. METHODS: In vivo skin-friction measurements on a force plate were combined with skin analyses concerning elasticity, hydration, pH value and sebum content. Thirty-two young and 28 aged persons rubbed their volar forearm in a reciprocating motion against various textiles on the force plate, using defined normal loads and sliding velocities, representing clinically relevant contact conditions. RESULTS: Mean friction coefficients ranged from 0.30 +/- 0.04 (polytetrafluoroethylene) to 0.43 +/- 0.04 (cotton/polyester). No significant differences in the friction properties of skin were found between the age groups despite skin elasticity being significantly lower in the aged persons. Skin hydration was significantly higher in the elderly, whereas no significant differences were observed in either skin pH value or sebum content. CONCLUSION: Adhesion is usually assumed to be the dominant factor in skin friction, but our observations imply that deformation is also an important factor in the friction of aged skin. In the elderly, lower skin elasticity and skin turgor are associated with more pronounced skin tissue displacements and greater shear forces during frictional contact, emphasizing the importance of friction reduction in wound-prevention programmes.

Influence of epidermal hydration on the friction of human skin against textiles.

Friction and shear forces, as well as moisture between the human skin and textiles are critical factors in the formation of skin injuries such as blisters, abrasions and decubitus. This study investigated how epidermal hydration affects the friction between skin and textiles.The friction between the inner forearm and a hospital fabric was measured in the natural skin condition and in different hydration states using a force plate. Eleven males and eleven females rubbed their forearm against the textile on the force plate using defined normal loads and friction movements. Skin hydration and viscoelasticity were assessed by corneometry and the suction chamber method, respectively.In each individual, a highly positive linear correlation was found between skin moisture and friction coefficient (COF). No correlation was observed between moisture and elasticity, as well as between elasticity and friction. Skin viscoelasticity was comparable for women and men. The friction of female skin showed significantly higher moisture sensitivity. COFs increased typically by 43% (women) and 26% (men) when skin hydration varied between very dry and normally moist skin. The COFs between skin and completely wet fabric were more than twofold higher than the values for natural skin rubbed on a dry textile surface.Increasing skin hydration seems to cause gender-specific changes in the mechanical properties and/or surface topography of human skin, leading to skin softening and increased real contact area and adhesion.

Study of skin-fabric interactions of relevance to decubitus: friction and contact-pressure measurements.

BACKGROUND/PURPOSE: Prolonged pressure as well as friction and shear forces at the skin-textile interface are decisive physical parameters in the development of decubitus. The present article describes the contact phenomena at the skin-textile interface and the development of a purpose-built textile friction analyser (TFA) for the tribological assessment of skin-fabric interactions, in connection with decubitus prevention. METHODS: Interface pressure distributions were recorded in the pelvic and femoral regions between supine persons and a foam mattress. Fabrics made of various natural and synthetic yarns were investigated using the TFA. A vertical load of 7.7 kPa was applied to the swatches, simulating high interface pressures at the skin-fabric interface and clinical conditions of bedridden persons. Fabrics were rubbed in reciprocating motions against a validated skin-simulating material to determine static as well as dynamic friction coefficients (COFs). RESULTS: Maximum contact pressures ranged from 5.2 to 7.7 kPa (39-58 mmHg) and exceeded the capillary closure pressure (32 mmHg) in all investigated bedding positions. For both COFs, a factor of 2.5 was found between the samples with the lowest and highest values. Our results were in a similar range to COFs found in measurements on human skin in vivo. The results showed that our test method can detect differences of 0.01 in friction coefficients. CONCLUSION: TFA measurements allow the objective and reliable study of the tribology of the skin-textile biointerface and will be used to develop medical textiles with improved performance and greater efficacy for decubitus prevention.

Titanium dioxide (TiO(2)) nanoparticles filled poly(D,L lactid acid) (PDLLA) matrix composites for bone tissue engineering.

Titanium dioxide (TiO(2)) nanoparticles were investigated for bone tissue engineering applications with regard to bioactivity and particle cytotoxicity. Composite films on the basis of poly(D,L lactid acid) (PDLLA) filled with 0, 5 and 30 wt% TiO(2) nanoparticles were processed by solvent casting. Bioactivity, characterised by formation of hydroxyapatite (HA) on the materials surface, was investigated for both the free TiO(2) nanoparticles and PDLLA/TiO(2) composite films upon immersion in supersaturated simulated body fluid (1.5 SBF) for up to 3 weeks. Non-stoichiometric HA nanocrystals (ns-HA) with an average diameter of 40 nm were formed on the high content (30 wt% TiO(2)) composite films after 2 weeks of immersion in 1.5 SBF. For the pure PDLLA film and the low content composite films (5 wt% TiO(2)) trace amounts of ns-HA nanocrystals were apparent after 3 weeks. The TiO(2) nanopowder alone showed no bioactivity. The effect of TiO(2) nanoparticles (0.5-10,000 microg/mL) on MG-63 osteoblast-like cell metabolic activity was assessed by the MTT assay. TiO(2) particle concentrations of up to 100 microg/mL had no significant effect on MG-63 cell viability.

Biostability of polyether-urethane scaffolds: a comparison of two novel processing methods and the effect of higher gamma-irradiation dose.

This article deals with enzyme-induced biodegradation behavior of thermoplastic polyether-urethane (TPU). Porous scaffolds were processed by a new foaming method applied in hot pressing and injection molding. The scaffolds were subsequently gamma sterilized. The samples were incubated with cholesterol esterase (CE) for 28 days to simulate an enzymatic degradation order to assess polymer biostability. The main focus of degradation products was the most toxic one: methylene dianiline (MDA). LC/MS was used to separate the breakdown products and to identify possible MDA amounts. The results showed that (a) the hot-pressed sample released an MDA amount almost twice as large (0.26 ng +/- 0.008) as that of the injection-molded samples (0.15 ng +/- 0.003) after incubation with enzyme activity in the physiological range, and (b) a tenfold increase in CE activity revealed considerably higher MDA amounts (7540.0 ng +/- 0.004). This enzyme concentration is physiologically unlikely, however, but may occur for extreme high inflammation behavior. Even for extremely high levels of CE enzyme, the scaffold will not discharge MDA above toxic levels. The injection-molded samples sterilized at 25 kGy seem to represent the most promising processing method. Therefore, the new injection-molding foaming process of polyether-urethane can be considered appropriate for use as a biomaterial.