The scope of meditech embraces all textile materials used inhealth and hygiene applications in both consumer and medical markets. Dependingon the nature of application, many medical products are disposable and made outof nonwoven fabrics.

Textile products are used in medical and healthcare sectorin various forms. The complexity of applications has increased with researchand developments in the area of medical textiles. The surgical gown, operatingroom garments and drapes require special antibacterial properties combined withthe wearers comfort. Other major uses of medical textiles are incontinencediapers, sanitary napkins and baby diapers. Wound dressing, bandages and swabsare also widely used conventional medical textiles.

Textiles are also being used as sutures, orthopaedicimplants, vascular grafts, artificial ligaments, artificial tendons, heartvalves and even as artificial skins. Recent advances in medical textiles to beused as extracorporeal devices are also significant; these include artificialkidney, artificial liver, mechanical lungs etc. New materials are finding specializedapplications like antimicrobial and antifungal fibres and additives used inbarrier fabrics, abdominal post-operative binders, applications inneurodermatitis treatment and various other wound management and surgicaltreatments.

Although the type of fibre used and the fabric structurevaries with the specific end use, all medical fibres must be non-toxic,non-carcinogenic, non-allergic and capable of being sterilized withoutsuffering chemical or physical damage. In addition, for many applicationsabsorbency is essential, favoring the use of cotton or viscose. In mostapplications, cotton has been replaced by synthetics such as polyester (becauseof its durability and low linting characteristics), by polypropylene (the mostpopular fibre, largely due to its capillary & inert characteristics), andby viscose rayon (due to its absorbency and biodegradability)

TTC-Technical textile Component

Sanitary napkins:

Sanitary napkins are absorbent disposable single use products designed to receive, absorb and retain body fluids. In the sanitary napkins, non-woven is generally used which is normally made up of polypropylene. However, a combination of viscose and polypropylene is also gaining acceptance. Some of the premium brands of sanitary napkins have also started using plastic films instead of non-woven.

Sanitary napkins have highly promising market potential provided there is extensive promotional activity, advertising and publicity through the print and electronic media. The assessed requirement of non-woven for sanitary napkins is around 920 tones per annum and the bulk of the requirement is met through imports and a few local suppliers also provide the non-woven fabrics.

An all out effort also needs to be made to make this product available at affordable price to Indian consumers. This may require setting up of economic size non-woven fabric (spun bond with Minimum economic size: 690 kg/hour and thermal bond with Minimum economic size: 200 kg /hour) manufacturing units to meet specific requirement of the MNCs.

Survey has revealed that Indian market for sanitary napkins shows immense future potential. The market size of sanitary napkins is estimated to increase from 1228 mn. numbers with a value of Rs.420 crore in 2003-04 to 1997.44 mn. numbers with a value of Rs.699 crore in 2007-08.

The sanitary napkins are reportedly reserved for production by the SSI sector. The cost of core machinery required for production of napkins exceeds the SSI ceiling for investment. Therefore, there is reported to be large scale under invoicing of machinery to bring the same under SSI limit. SSI reservation prevents setting up of large scale MES units. Therefore, there is strong need to dereserve the sanitary napkins.

Incontinence diapers:

Incontinence diapers are absorbent, disposable single use product designed to receive, absorb and retain body fluids. The use of incontinence diapers is hygienic as the diapers prevent fungal infection of the skin since the aggressive substance present in the urine does not come in contact with the skin.

The diapers are made up of cellulose and super absorbent materials and cotton having polyester sheet covering. The key performance parameters for incontinence diapers are similar to the other categories of absorbent hygiene products, viz., high absorption capacity and skin dryness; reduced odour; protection from leakage; maximizing user comfort, particularly when saturated with liquid and; simple to use.

The end user segment for diapers is senior citizens and hospitals, mostly the people above 75 years of age suffering from incontinence. The present level of awareness about the product is low even in the metro cities and high-income groups. Further, the price (Rs.45 Rs.80 per diaper) is also on higher side. On account of high price structure and lack of awareness, this product has not penetrated significantly in the target customer segment even in the metro cities / hospitals.

The incontinence diapers market is dominated by a few MNCs which are primarily engaged in bulk import and repacking. The Indian market of incontinence diapers is estimated to be about Rs.54 crore and total consumption of nonwoven fabrics by this segment would be around 85 tonnes. However, since all the major players are presently engaged in bulk imports and repacking, the non-woven fabrics are not sourced locally.

The diapers are currently imported and in view of the high customs duty of 20 percent, the cost for the customer is rather high. In view of the product being consumed by the senior citizens, and hospitals the produce should be made duty free. This would certainly increase the product demand and the market size. With growing awareness the demand is estimated to increase from 9 mn pieces with a value of Rs.54 crore in 2003-04 to 22.51 mn. pieces with a value of Rs.135 crore in 2007-08.

The incontinence diapers are reportedly reserved for production by the SSI sector. The cost of core machinery required for production of incontinence diapers exceeds the SSI ceiling for investment. Thus, SSI reservation prevents setting up of large scale MES units. Therefore, there is strong need to dereserve the incontinence diapers.

Baby diapers:

Baby diapers also come under the disposable category and the properties required in diapers are liquid strike through, liquid acquisition, liquid distribution, liquid storage, liquid barrier, surface dryness etc.

World over, disposable diaper market penetration is very high, particularly in advanced countries. However, the use of this product has been limited in India compared to the washable terry towel diapers. But, the situation has been changing very rapidly in the recent years. The growing Indian economy means lot many people with higher disposable incomes. These people understanding the importance of hygiene and advantages of disposable nappies have taken to the product in a significant way.

The number of working women in the total work force is increasing. The number of double income families is increasing correspondingly. The numbers of double income families with higher disposable income have a positive impact on the market. The market is expected to increase from Rs.80.14 crore in 2003-04 to Rs.105.05 crore in 2007-08.

The baby diapers are reportedly reserved for production by the SSI sector. The cost of core machinery required for production of baby diapers exceeds the SSI ceiling for investment. Thus, SSI reservation prevents setting up of large scale MES units. Therefore, there is strong need to dereserve the baby diapers.

Surgical dressings:

Surgical dressings include wound care products and bandages. Wound care products include wound contact layer / absorbent pad / base material / nonadherent dressings / perforated films, while bandages include inelastic bandages /elastic bandages / light support bandages / orthopedic cushion bandages / plasters /waddings / guazes / lint.

v      Wound healing is a dynamic process and the requirements of dressing change as the wound healing progresses and no single dressing is universally available for all types of wounds.

v      Wound dressings were some of the earliest forms of medical textiles and lately have witnessed rapid developments. Wound healing depends not only on medication but also on the use of a proper dressing technique and suitable dressing material.

v      The prerequisite of wound dressings are ease of application, good padding characteristics, non-sticking nature to the wound and painlessness on removal, creation of an optimal environment for wound healing, softness, pliability, high absorbency, etc.

v      Modern wound dressings are composed of absorbent layers held between the wound contact layer and a base material. The wound contact layer (primary dressing) is generally placed directly over the wound and covered with an absorbent pad and the whole dressing retained with a base material. The wound contact layer has low adherency and can be easily removed without disturbing new tissue growth. The wound contact layer made of silk, polyamide, viscose; polyethylene is of woven or non-woven material. The absorbent layer (pad) is of non-woven type, made of cotton, viscose, acrylic etc. Viscose helps to absorb the fluid while acrylic helps to maintain the thickness of pad even after absorbing the fluids. The base material is non-woven or woven type made of viscose or is a plastic film.

v      Absorbent pads are also available as individual single use items. They are cotton pads covered with a guaze cloth.

v      Non-adherent dressings are applied to avoid adhesion when dealing with large area wounds such as burns and skin grafts. They are paraffin guaze dressings having a soft paraffin base. These dressings are also medicated with an antibiotic or any topical antiseptic.

v      Perforated films are porous polyester films used for rapid dressing of surgical incisions.

v      Bandages can be used for many purposes like support, dressing retention and compression.

v      Elastic bandages are cotton crape bandages consisting of high twist yarn imparting the necessary elasticity and used in treating vericose veins. Inelastic bandages are medicated cloth bandages. These two bandages are grouped together as adhesive bandages and they have a layer of adhesive impregnated on the cloth layer.

v      Orthopedic cushions are made of cotton and synthetics. These bandages retain their cushioning effect in the moist atmosphere between skin and plaster. The plaster of Paris bandages are made of cotton gauze material of leno weave cloth. The interlocking thread is impregnated in the plaster of Paris solution and dried to get the bandages.

v      Traditionally cotton guazes were used for dressing because of their good absorption property and softness. Even today hospitals use the gauzes for dressing purposes mostly in layers to form swabs for better and higher absorption.

v      Lint is used as wipes or swabs for primary cleaning of wounds before applying the dressings.

v      Waddings are single use cotton pieces in great demand abroad. In India, for clinical practices as well as domestic purpose cotton rolls are preferred, pieces of cotton are removed as and when required. In the foreign countries, sterile single use cotton waddings are highly popular.

v      There are government established standards for various surgical dressings such as handloom cotton bandage cloth: IS: 863, cotton gauze absorbent, non-sterilized: IS: 758.

v      The wound care and wound management industry is distributed between the organized sector represented by few MNCs and the decentralized sector of SSIs / cottage industry using obsolete technology, no testing facilities and absence of research and development facilities.

v      There are no standard testing facilities available at the all India level while these products need to be checked for bio-burden, bio-compatibility and cytotoxicity.

v      The market size of wound care surgicals in 2001-02 was estimated at around Rs.450 crore with the units concentrated in Delhi, Ichalkaranji, Jalgaon, Meerut, Modinagar, Mumbai, Palghar, Tamilnadu etc.

v      The institutions / hospitals account for about 60 percent sales of the surgical dressings, while individual and general practitioners account for the remaining 40 %. Further, bandages account for about 65 percent of the market share and wound care for the remaining 35 percent.

v      The growth of surgical dressings is estimated to be in the range of 5-10 percent (avg. 7.5 percent), accordingly, market size is expected to increase from Rs.520 crore in 2003-04 to Rs.694.48 crore in 2007-08.

Healthcare textiles:

Healthcare textiles comprise surgical clothing (gowns, caps, masks, uniforms etc.), surgical covers (drapes, covers etc.) and beddings (sheets, blankets, pillow cases etc.). Healthcare textiles can be disposable or non-disposable. In India health care textiles continue to be predominantly non-disposable though in the global markets disposables are fast replacing non-disposable health care textiles.

All over the world, disposable healthcare textiles are replacing non-disposables due to ease of use and hygiene, infection free nature and also being cost effective by eliminating laundering. However, in India the use of non-disposable healthcare textiles is still quite significant, though there is a distinct shift towards use of disposable items. For the disposable healthcare items, polypropylene spun bond is most popular in India due to its low cost. However, in Western countries, spunbond- meltblown- spunbond (SMS) and spun lace are more popular because of their inherent advantages in terms of absorption, breath ability etc.

Healthcare textiles which have found acceptance in the Western countries are yet to make inroads in the Indian market in a significant manner due to various factors such as low hygiene awareness, pricing policies of the non-woven, disposal problems, and availability of cheap washing facilities favoring reusable cotton garments.

Though the general perception is reusable healthcare textiles are more expensive, a preliminary calculation done by committee reveals that in some cases disposable healthcare textiles are more cost effective.

The details are given below:

Cost of caps & masks

The growth of healthcare textiles is expected to grow at very high rate over the years with increase in awareness about advantages of its usage coupled with cost effectiveness vis--vis reusable healthcare textiles. The growth of the healthcare textiles is linked to the growth of healthcare sector which is growing at around 13 percent - 16 percent. However, non-woven disposal is expected to register higher growth as it would be penetrating into the share of reusable medical textiles. It is estimated that disposable healthcare textiles would increase from Rs.11 crore in 2003-04 to Rs.120 crore in 2007-08.

Sutures:

Sutures are the simplest example of a textile bio-medical device. Sutures are used for wound closure to close cuts and incisions and thus prevent infection and are an integral part of all operations. In fact no surgery can be performed without the sutures. Absorbable sutures are ideal for wounds inside the body as they dissolve and get absorbed into the body after the operation.

Absorbable sutures are of two types:

synthetic absorbable sutures made up of poly glycolic acid (PGA) which are absorbed into the body within 20 days 90 days and \ natural absorbable sutures made up of mucosa of sheep intestine.

Non-absorbable sutures which are made up of nylon, polypropylene, silk, polyester, and polytetrafluoroethylene (PTFE) are not absorbed into the body and need to be removed by the surgeon. Non-absorbable sutures are generally used in external applications where they are easily accessible, removal is easy and prolonged high strength is required. Non-absorbable sutures are used for serious and complex wounds, where the need is that stitches should not dissolve fast to give the wound a chance to heal while preventing wound re-opening and scar tissue formation.

The Indian market for sutures is assessed at around Rs.280 crore with absorbable sutures having 60 percent of the share amounting to Rs.168 crore while 40 percent of the share is accounted for by non-absorbable sutures. Further, the market share of non-absorbable sutures produced using silk accounts for 50 percent, nylon 10 percent and the remaining 40 percent by other raw materials.

Indian exports of sutures are mostly to countries like Tunisia, Bangladesh, Indonesia, Netherlands, and Philippines etc. The exports have been in the range of Rs.11.15 crore to Rs.17.34 crore during the period 1999-2002. The imports of sutures have been from Denmark, Germany, Korea, USA etc. and were in the range of Rs. 3.39 crore to Rs.6.46 crore during the last three years.

The annual expenditure of hospitals on sutures has been increasing in the range of 10-20 percent per annum on account of increased number of operations being performed and the rise in accident cases. Accordingly, the demand for sutures is expected to grow from Rs.280 crore in 2003-04 to Rs.441 crore in 2007-08.

Medical implants and devices:

Medical implants and devices cover items like cardiovascular implants (vascular grafts, heart valves etc.), soft tissue implants (artificial tendon, artificial skin, artificial ligament, artificial cornea etc.), orthopedic implants (artificial joints) and extra corporeal devices (artificial kidney, artificial liver, mechanical lung, artificial heart etc.).

Vascular grafts:

Vascular grafts are used to treat hindrances to blood flow caused by vascular and other diseases. A vascular graft replaces the damaged artery or creates a new artery in order to increase blood flow.

The vascular grafts are sterile and single patient use only. They are of following types: Polyester grafts - used to repair thoracic and abdominal occluded arteries, Dacron grafts - for aortic surgeries and polytetrafluoroethylene (PTFE) grafts - to repair occluded arteries and veins in the hands and feet and for dialysis treatment of chronic renal failure patients.

The vascular grafts marketed in the country are imported by the players like W.L. Gore & Associates, who dominate the market with a share of about 60 percent followed by Edwards Life Sciences, Boston Scientific, Sri Chitra. The price of these grafts is in the range of about Rs.10, 000-Rs.20, 000 per piece.

The prerequisites of good vascular grafts are:

v      Bio-compatibility,

v      Non-fraying properties,

v      Flexibility,

v      Durability,

v      Resistance to sterilization,

v      Bacteria resistance and

v      Non-thrombogenicity.

The survey has revealed that the market for vascular grafts would grow at an annul growth rate of about 2 percent - 3 percent. Accordingly, the demand for vascular grafts is estimated to increase from Rs.3.19 crore in 2003-04 to Rs.3.59 crore by 2007-08.

Heart valves:

The heart valves assist cardio-thoracic surgeons in treating valvular diseases. The heart valves are of two types, namely, mechanical valves and tissue valves.

Mechanical valves are used for younger patients and require periodical check-ups and after a particular period, the patients need to be operated a second time. Mechanical valves are made of titanium, around which is a knitted fabric to be stitched to the original tissue called as sewing ring. The sewing ring of the caged-disc type of prostheses uses a silicon-rubber insert under a knitted composite PTFE and polypropylene fibre cloth. The price of mechanical valve is in the range of Rs.30, 000 to Rs.50, 000 each.

v      Tissue valves are used for slightly aged patients and do not require any periodic checkups. The life of these valves is 15-20 years and the price is in the range of Rs.45, 000 to Rs.65, 000 each.

v      Mechanical and tissue valves are available in sizes ranging from 17 mm to 35 mm. Mechanical valves constitute about 90 percent of the total market while tissue valves account for about 10 percent of the total market.

v      Indian exports of artificial heart valves have been in the range of Rs. 0.15 crore to Rs.0.72 crore during the last three years. The imports of artificial heart valves have been from Canada, USA, Switzerland, Singapore etc. and were in the range of Rs. 11.54 crore to Rs.23.86 crore during the last three years.

v      The market size for artificial heart valves is estimated to grow at an average annual growth rate of 7 percent. Accordingly, the future market size of the heart valves would increase from Rs.56 crore in 2003-04 to Rs.73 crore by 2007-08.

Artificial tendon (Mesh):

The composite meshes made up of polyester, polypropylene and polyester / carbon fibre are used for repairing hernia. The utilization of mesh grafts in humans for hernia operations is based on the fact that during the absorption period a neomembrane is formed at the site where the mesh has been implanted. The mesh graft prevents recurrence of hernia and hence has an advantage over the tissue repair technique practiced for a long time in India.

The imported meshes are purchased in sterilized packaged form and sold in the Indian market. The existing market size for artificial tendon (mesh) was assessed at about Rs.20 crore in 2001-02.The market size for artificial tendon (mesh) is estimated to grow at an average annual growth rate of 11 percent. Accordingly, the market size of artificial tendon (mesh) would increase from Rs.25 crore in 2003-04 to Rs.37 crore by 2007-08.

Artificial joints:

The artificial joints are made of stainless steel, chromium cobalt, titanium or some other inert material. The textile material present in the joints is Ultra High Molecular Weight HDPE (UHMWHDPE). Artificial joints are covered under BIS No. IS : 5810. The imports of artificial joints have been from Germany, France, Switzerland, USA etc. and were in the range of Rs. 0.59 crore to Rs.4.07 crore during the last three years. Indian exports of artificial joints were in the range of Rs. 1.03 crore to Rs.1.90 crore during the last three years.

The market size for artificial joints is estimated to grow at an annual rate of 12 percent and accordingly, the market size of artificial joints is estimated to increase from Rs.9.00 crore in 2003-04 to Rs.14.21 crore by 2007-08.

Artificial kidney:

Artificial kidney consists of a semi-permeable membrane, on one side of which blood passes while a special dialysate solution is passed along the other. The artificial kidney is made of polyacetate and polysulphone in equal proportions.

The market size for artificial kidneys has been growing at an annual rate of 5 to 10 percent and accordingly, the market size of artificial kidneys is estimated to increase from Rs.13.00 crore in 2003-04 to Rs.17.00 crore by 2007-08.

According to Textile Commissioner and Chairmen expert of the committee estimates the textile industry the next few years and India will be able to emerge as one of the technical textile economy to be reckoned with in the international scenario. The market size of the technical textile component of the technical textile industry in the country is estimated at Rs.19,130 crore during 2003-04 and Rs.29,580 crore in 2007-08.

Reference:

Report of the Expert Committee on Technical Textiles -Volume I

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