Author: Maggie D’Aversa
In celebration of the fourth annual New York Textile Month, members of the Textile Society of America will author Object of the Day for the month of September. A non-profit professional organization of scholars, educators, and artists in the field of textiles, TSA provides an international forum for the exchange and dissemination of information about textiles worldwide.
Textile structures have a unique place in the history of surgical prostheses whether in linear form as in yarns or braids or planar form as in a one- or two-dimensional fabric. Both forms can be further characterized by yarn and fabric geometry, material type and surface treatment all of which are dependent on the short and long term needs of the wound or injury. Each decision on the choice of the components within the textile is highly dependent on the specific anatomical space, the type of injury or wound, the vascularity of the space and the load bearing nature of the space and the frequency of anatomical movement. Essentially, the uniqueness of the textile structure lies in two areas; flexibility in design and multiple component choices for adjustment purposes.
This particular structure, a three-pronged, stitched and embroidered composite of polyester (non-absorbable) and absorbable fibers is intentionally designed to be an anchor for each of the three tendons attached to a rotator cuff to provide structural integrity during the healing period when there is a tear in any or all of them. The requirements of this textile appear to be the need for longitudinal integrity along each of the three prongs in order to stabilize the weakened or torn tendon(s), appropriate interstice size for anchoring the prosthesis to the tendon, radial integrity provided by a circumferential yarn placement as well as attachment capability to the humeral head as shown by the hole in the center prong. This type of injury (rotator cuff repair) requires a great deal of tension control in the first few weeks of rehabilitation and tenacity, absorption profile of the substrate and conformability are important. While a picture cannot indicate absorption profile of the substrate, the mention of polyester as a portion of the textile indicates an awareness of the need for high tenacity for this injury and the stitched fabric with surface embroidery signals conformability to a linear structure.
This piece demonstrates the unique intersection of resident expertise between surgeons, textile engineers and material scientists necessary to repair a system such as the rotator cuff within a larger complex – the musculoskeletal system. Embroidery, layered stitching, composite of absorbable and non-absorbable fibers and differing shapes are combined in this piece to address the needs of multiple and moving systems.
Maggie D’Aversa, a textile engineer, weaver and now social scientist spent close to 30 years researching and designing industrial and medical textiles for Johnson & Johnson, Inc.