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Exploring use of warp-knitted spacer fabric as a substitute for the absorbent

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DOI: 10.1177/0040517514561922

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Exploring use of warp-knitted spacer fabric as a substitute for the absorbent layer for advanced wound
dressing
Shuk-fan Tong, Joanne Yip, Kit-lun Yick and Chun-wah Marcus Yuen
Textile Research Journal published online 5 December 2014
DOI: 10.1177/0040517514561922

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Textile Research Journal
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Exploring use of warp-knitted spacer ! The Author(s) 2014

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fabric as a substitute for the absorbent DOI: 10.1177/0040517514561922
trj.sagepub.com
layer for advanced wound dressing

Shuk-fan Tong, Joanne Yip, Kit-lun Yick and

Chun-wah Marcus Yuen

Abstract
Wound management has become more sophisticated as modern wound dressings now focus more on providing an
optimal microclimate for wound healing. As a novel three-dimensional textile material, warp-knitted spacer fabrics are
versatile enough to meet special requirements when their parameters are changed. This paper reports on an experi-
mental study on the required physical properties of warp-knitted spacer fabrics that can be developed as an absorbent
layer for advanced wound dressing. Three types of wound dressings available on the market have been chosen that are
especially used for burns and ulcers, as they are designed to provide good absorbing of extrudes and a cushioning effect.
The physical properties of spacer fabrics, including air permeability, thermal conductivity, water vapor permeability,
absorbency and compression, are evaluated and compared with those of existing wound dressings. The results show
that the air and water vapor permeabilities and the thermal conductivity of warp-knitted spacer fabrics are competitive
enough to prove that spacer fabrics can also provide a good ventilated environment for wound healing. Their good
compressional resistance and compressional resilience indicate that warp-knitted spacer fabrics can provide good pro-
tection as wound dressings. Although their absorbency is only somewhat better than some of the wound dressings, they
are also good for wounds with no heavy extrudes.

Keywords
wound management, wound healing, absorbent layer, physical properties, cushioning effect

For centuries, wound dressings have been used to cover There are various types of wound dressings on the
wounds and absorb bleeding. However, wound man- existing market designed for different wounds, such as
agement has become more sophisticated as modern foam, alginate, hydrofiber and silver dressings.2,7
wound dressings now focus more on providing an opti- However, there is no one dressing that can be applied
mal microclimate for wound healing.1–3 In general, to manage all types of wounds; the type of dressing
wound dressings are used to restrict the evaporation used depends on the type and the condition of the
of water from the surface of wounds, cushion pain wound.8 For example, transparent film dressing is per-
and trauma, manage exudates and protect wounds meable to gases and moisture while not permeable to
against bacteria invasion. According to various
researchers, an ideal wound dressing should be perme-
able to oxygen, but also able to absorb blood and exud-
ates. Also, it should prevent dehydration and the Institute of Textiles and Clothing, The Hong Kong Polytechnic University,
formation of scabs. Good protection against secondary Hong Kong, China
infections and mechanical damage, and sterilizability,
Corresponding author:
non-adherence, non-toxicity, non-allergenic and non- Joanne Yip, Institute of Textiles and Clothing, The Hong Kong Polytechnic
sensitizing are also the basic criteria of a good wound University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong.
dressing.4–6 Email: [email protected]

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2 Textile Research Journal 0(00)

liquid, so wounds will not be dehydrated by its use. evaluated and compared with those of wound dressings
However, transparent film dressing is non-absorbent, from the market. It is anticipated that a deeper under-
which is not suitable for wound with exudates. Foam standing of the particular physical properties of warp-
dressings are made of sponge-like polymer that can knitted spacer fabrics tailored for use as the absorbent
provide a cushioning effect and support to wounds layer of modern wound dressings will be obtained.
and is suitable for chronic and acute exudative
wounds, or full or partial thickness wounds, including
ulcers and malignant and surgical wounds; however, Experimental details
they are not recommended for non-exudative wounds.
Hydrocolloids are adhesive wafer dressings that are
Materials
carbohydrate based. They can promote autolytic Seven different types of spacer fabrics bought from
debridement as they are composed of a matrix of cel- local shops are used as samples in the present study.
lulose and gel-forming agents. However, hydrocolloids All of them are warp-knitted spacer fabrics and their
are impermeable to oxygen, water and water vapor. specifications are listed in Table 1. Their fabric charac-
They are therefore good for wounds with mild to mod- teristics, including fabric structure, angle of spacer
erate exudates, but not for those with heavy exudates or yarn, areal density and bulk density, were determined.
that are infected.9,10 Also, three different types of wound dressings, Allevyn
Based on the existing research, researchers generally (Dressing 1), Duo Derm CGF (Dressing 2) and
believe that warp-knitted fabric is commonplace in Cutinova Hydro (Dressing 3), which were purchased
technical and medical textile aspects.11–14 In accordance from local shops, have a cushioning effect, and are
with its versatile properties, spacer fabric is one of the especially used for the management of extruding
most widely used warp-knitted fabrics. Spacer fabrics wounds, such as burns, ulcers and surgical wounds,
are a novel kind of three-dimensional knitted fabric were selected for comparison. Allevyn is a non-adhesive
with two distinctive textile layers connected together dressing that combines an absorbent hydrocellular pad
or kept apart by spacer threads with particular spa- sandwiched between a perforated non-adherent wound
cing.15 Warp-knitted spacer fabrics show good linear contact layer and a waterproof outer film. Duo Derm
elastic compressibility and perform well at reducing CGF is an adhesive hydrocolloid wound contact dres-
peak pressure.16 In addition, their breathability and sing where CGF stands for control gel formula. The
thermal conductivity are also good. According to hydrocolloids are contained within the dressing mass
some of the research work, warp-knitted spacer fabrics and the adhesive layer contains polymers, which
have been recently used more and more as cushioning enhance the ability of the dressing to contain wound
material in personnel protective clothing and equip- exudates by forming a cohesive gel. Finally, Cutinova
ment against impacts due to their excellent compression Hydro is a hydro-selective self-adhesive wound dressing
behavior and moisture-wicking and temperature- for the management of extruding wounds surrounded
controlling characteristics. Furthermore, they are by intact skin. It contains a highly absorbent material
widely used in shoes or insoles, face fabrics for sports, embedded in a self-adherent polyurethane matrix and is
molded cups for intimate apparel17 and other types of covered with a waterproof polyurethane film. All of the
bandages. Also, researchers believe that warp-knitted tests were conducted in accordance with ASTM D1776,
spacer fabrics are becoming more popular in the cush- at a temperature of 20 C and relative humidity of 65%.
ioning market, which has been dominated by polyur-
ethane foam, and could be widely used in furniture in
the future.18,19
Air permeability
In our previous work, we reported that air perme- The Kawabata Evaluation System (KES) was adopted.
ability, thermal conductivity and mechanical properties The KES-F8 was used to measure the air permeability
of spacer fabrics greatly depend on the fabric charac- of the three-dimensional spacer fabrics and a KES-
teristics.11 The objective of this research is to study the F8-AP1 air permeability tester was used to evaluate
particular physical properties of warp-knitted spacer the resistance of the fabrics to the passage of air,
fabrics that may be used as a substitute for the absorb- which is strongly related to comfort. The speed of the
ent layers of wound dressings in the existing market to piston was 2 cm/s and the air flow rate was 8 p cm3/s. In
provide a more optimum environment for wound heal- considering that the structure of spacers and wound
ing. Therefore, the required physical properties of the dressings is different, different hole sizes were selected.
absorbent layer of wound dressings, including air per- As spacer fabrics have many pores on the surface, the
meability, thermal conductivity, water permeability, smallest hole of 0.2 p cm2 was selected in order for more
absorbency and compression, are examined in three- precise measurements, and the air flow rate per unit
dimensional warp-knitted spacer fabrics, and then area was 0.4 p m/s. On the other hand, as the structure

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Tong et al. 3

Table 1. Physical properties of spacer fabrics and wound dressings (including standard deviation)

Angle of spacer
yarn (y)
Thickness Spacer yarn Areal density Bulk density
Fabric type Composition (mm) type (g/m2) (kg/m3) Wale Course

Spacer 1 Warp-knitted 100% Polyester 1. 03  1.49 Monofilament 135.32  2.16 131.29  2.10 19.02 20.15
Spacer 2 Warp-knitted 100% Polyester 1.76  0.05 Monofilament 172.91  1.70 98.09  0.96 32.06 44.88
Spacer 3 Warp-knitted 100% Polyester 2.19  0.34 Monofilament 146.35  1.83 66.77  0.83 14.23 51.23
Spacer 4 Warp-knitted 100% Polyester 2.29  0.11 Monofilament 138.53  2.52 47.65  0.85 26.63 29.11
Spacer 5 Warp-knitted 100% Polyester 2.48  0.16 Monofilament 199.04  1.90 80.30  0.77 34.25 54.89
Spacer 6 Warp-knitted 100% Polyester 2.90  0.10 Monofilament 241.29  1.53 83.28  0.54 27.71 50.59
Spacer 7 Warp-knitted 100% Polyester 3.33  0.08 Monofilament 242.24  2.01 72.76  0.60 40.21 43.23
Dressing 1 – Hydrocellular 6.04  0.06 721.14  10.30 119.32  1.84 – –
Allevyn polyurethane foam
Dressing 2 – Hydrocolloid 2.34  0.19 1434.80  15.73 614.21  6.73 – –
Duo Derm
CGF
Dressing 3 – Hydro-active 1.56  0.03 1825.96  17.18 1173.49  11.04 –
Cutinova Hydro polyurethane matrix

of dressings are denser, all three hole sizes, 0.2, 2 and 20 sample (cm2) and
T is the temperature difference
p, with the air flow per unit area of 0.4, 4 and 40 p m/s, between the BT-Box and water box:
respectively, were used. For each sample, 10 readings
KSI ¼ k  100
were taken, and the average value of the air resistance
(R) was measured as kPa s/m.
Water vapor permeability
Thermal conductivity Water vapor permeability (WVP) is defined as the abil-
The KES-F7 was adopted to measure the ability of the ity to transmit moisture or vapor from the skin. The
fabric to conduct heat (thermal properties), and a KES- WVP was measured by using the cup method in accord-
F Thermo Labo II was used. During the experiment, ance with BS 7209. In each case, 10 specimens were
the sample was placed into a T-box to detect heat and measured and the average value was recorded.
heat retention, and the temperatures of the BT-Box, By measuring the weight of the samples before and
which is the heat plate, and water box, were preset to after the experiment, the WVP was calculated by using
30 C and 20 C, respectively. Ten specimens were mea- the following equations:
sured for each case and the average value was recorded.
By measuring the amount of heat that passes through
24M
WVP gm2 day1 ¼ ð2Þ
the sample from the power consumption of the test At
plate heater, the thermal conductivity value (k) rec-
orded in a unit of W/cmK and the KSI (W/mK) can d2  106
A¼ ð3Þ
be calculated by using following equation: 4

where M is loss in mass (g), t is time between weighing

Thermal conductivity ðkÞ
(h), A is the internal area of the cup (m2) and d is the
Heat flow rate  distance internal diameter of the cup (mm).
¼ ð1Þ
area  temperature difference

Absorbency
W D
k¼  The BS 7959-1:2004 (Materials used for the control of
t A 
T
liquid spillages - Determination of sorbency) standard
where W is the quantity of heat (watt), t is time, D is was adopted to measure the absorbency of the test
thickness of the sample (cm), A is the surface area of the samples. Distilled water and 0.9% saline water were

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4 Textile Research Journal 0(00)

selected as the testing liquids and their temperature was type of fabric, nine specimens were tested and the aver-
controlled at 20  2 C in accordance with standard BS age values were reported.
7959-1:2004. In each case, five specimens were mea-
sured and the average value was recorded.
By weighing the samples before and after the experi- Results and discussion
ment, the absorbency of the test samples after 30 s of Material specification of spacer fabrics and wound
draining was calculated by using the following
equations:
dressings
The material specifications of the seven types of warp-
V30 knitted spacer fabrics and three types of wound dres-
S30 ðL=kgÞ ¼ ð4Þ
Wp sings are shown in Table 1. The thickness of the spacer
fabrics selected in this study is between 1 and 3.3 mm
where WP is the mass of the test sample (kg) and V30 is and that of the dressings ranges between 1.6 and 6 mm.
the volume of liquid (L) held by the test sample after The front, back and side microscopic views of the seven
30 s of draining. types of spacer fabrics and three types of wound dres-
sings are shown in Tables 2 and 3. Also, the chain
W30
V30 ¼ ð5Þ

Table 3. View of three wound dressings
where W30 is the mass of liquid held by the test sample
after 30 s of draining (kg). Dressing 1 Dressing 2 Dressing 3
Allevyn Duo Derm CGF Cutinova Hydro
W30 ¼ WA2  WA1  Wp ð6Þ
Front view
where WA1 is the mass of the receptacle + ‘‘S’’ hook
(kg), WA2 is the mass of the receptacle + ‘‘S’’
hook + test sample + liquid retained after 30 s of drain-
ing (kg) and  is the density of the test liquid (kg/L).
Back view

Compression
According to Kato Tech Co., Ltd, the compression
property of spacer fabrics can be tested by using a Side view
KES-FB3-A compression tester. The sample size used
in the compression test was 10 cm  10 cm and the
maximum pressure used was 200 gf/cm2. For each

Table 2. Microscopic view of seven spacer fabrics

Spacer 1 Spacer 2 Spacer 3 Spacer 4 Spacer 5 Spacer 6 Spacer 7

Front view

Back view

Side view (course-wise)

Side view (wale-wise)

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Tong et al. 5

notation of the yarn guide bars for the spacer fabrics is more difficult for air to pass through the fabric; there-
shown in Table 4 for Spacers 1–4 and Table 5 for fore, poor air permeability is the result. The air perme-
Spacers 5–7. ability of fabric is highly correlated with fabric areal
density and thickness, which are related to fabric tight-
ness.11 According to the air resistance results, no data
Air permeability
were recorded for Dressings 1, 2 and 3 even when the
In this study, the air resistance (R) of all the spacer largest hole and the maximum range were used, which
fabrics and wound dressings was recorded and is means that their air resistance exceeded 500 kPa s/m,
shown in Figure 1. A higher value of R indicates a thus indicating that they have very poor air permeabil-
higher air resistance of the fabric and means that it is ity. In considering that Dressing 1 is the thickest among
all of the test samples, and the bulk density of Dressing
3 is the largest, it will be difficult for air to pass through
the fabric and poor air permeability will result. It is also
Table 4. Chain notation of yarn guide bars for Spacers 1–4 true that Dressing 2 has greater thickness and bulk
density values. All of the spacer fabrics have a similar
Guide
air permeability due to their fabric structure. Air can
bar Chain notations Threading
easily pass through the spacer fabrics through their
1 (1–0, 0–0/1–2, 2–2)  3 full 1 empty pores. The air resistance of Spacers 5–7 is greater as
2/(3–4, 4–4/3–2, 2–2)  2// their fabric backs are denser than Spacers 1–4. More
2 (3–4, 4–4/3–2, 2–2)  3 full 1 empty air will be trapped between the fabrics, and as a result,
2/(1–0, 0–0/1–2, 2–2)  2// poor air permeability will be obtained. Apart from the
3 (1–0, 2–1/2–3, 1–2)  4// Full fabric structure, the results prove that thickness will
4 (0–0, 1–2/2–2, 1–0)  4// Full also greatly affect air permeability as air resistance
increases with increasing fabric bulk density, which is
shown in Spacers 1–4. The bulk density increases with
increasing air resistance and poorer air permeability
Table 5. The chain notation of yarn guide bars for Spacers 5–7 will result. The air permeability of Spacers 3 and 4 is
the best among the spacer fabrics as their bulk density
Guide
is the lowest. In addition, air permeability will be
bar Chain notations Threading
affected by fabric thickness, which is the case for
1 (1–0, 0–0/1–2, 2–2)  2/ 3 full 1 empty Spacers 5–7 in which their fabric bulk densities are
(3–4, 4–4/3–2, 2–2)  2// similar. The air permeability of Spacers 3 and 4 is the
2 (3–4, 4–4/3–2, 2–2)  2/ 3 full 1 empty best among the spacer fabrics as their bulk density is
(1–0, 0–0/1–2, 2–2)  2// the lowest.
3 (1–0, 1–0/1–2, 1–2)  4// Full As mentioned above, air permeability is one of the
4 (0–0, 1–2/2–2, 1–0)  4// Full important basic criteria of a good absorbent layer of a
5 (2–2, 1–0/0–0, 1–2)  4// Full wound dressing in order to provide a ventilated envir-
onment for wounds. In this study, the air permeability
of the spacer fabrics used is competitive with that of
existing wound dressings and even exceeds some of
them. However, this also implies that bacteria from
0.01440 the environment can enter the wound dressing and
s/m)

0.01220 infect the wound. So, it is suggested to apply antimicro-

0.01000 bial treatments on the outer layer of the spacer fabric in
Air resistance (kPa

order to block bacteria in the environment from enter-

0.00880
ing wounds and causing infections.20,21 At the same
0.00660
time, the antimicrobial treated fabric will still maintain
0.00440 air permeability.
0.00220
N/A N/A N/A
0.00000 Thermal conductivity
The thermal conductivity indicates the quantity of heat
Sam
mple transferred from the skin to the fabric surface.
Therefore, a higher thermal conductivity value means
Figure 1. Air resistance of different test samples. that the fabric sample has a better performance in

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6 Textile Research Journal 0(00)

conducting heat away from the skin and gives a cooler more water vapor is allowed to penetrate through the
effect.11,19,22 Figure 2 shows the results of the thermal fabric. The results of the WVP of all the test samples
conductivity testing of all the test samples. According are shown Figure 3. The bulk density and structure of
to some of the researchers, thermal conductivity of fabrics are highly correlated with their WVP.19 In gen-
spacer fabric is directly proportional to the thermal eral, it can be found that more water vapor can pene-
conductivity of individual fibers, fabric density and trate through the spacer fabrics than the wound
thickness, type and angle of spacer yarn.11,23,24 In dressings. The pores on the spacer fabrics make the
taking into consideration that all of the spacer fabrics water vapor penetrate more readily. Also, Spacers 3
in this study are made of polyester, the results showed and 4 have the lowest bulk density, so that water
that the thermal conductivity of spacer fabrics increases vapor will not easily be trapped inside the fabric.
with increasing areal density and angle of spacer yarn. Therefore, they have the highest WVP. Also, when
A higher areal density will have a better thermal con- Spacers 1, 2, 5, 6 and 7 are compared, it can be
ductivity, as there will be less space to trap air inside, observed that Spacers 1 and 2 have more pores on
implying better thermal ventilation. On the other hand, the fabric back, which will facilitate the penetration
the angle of spacer yarn may also affect thermal con- of water vapor even though their bulk density is greater
ductivity. A larger angle of spacer yarn will enlarge the than that of Spacers 5–7. On the other hand, with the
gap between two fabrics and provide better ventilation greatest bulk density, Dressings 1 and 3 have relatively
of heat. Dressing 3 has the highest thermal conductivity low WVP as water vapor is easily trapped inside the
and Dressings 1 and 2 also have higher values of ther- dressing and cannot readily penetrate the dressing.
mal conductivity in comparison to the others. This Dressing 2 has no WVP, which means that water
proves that the thermal conductivity of fabric is related vapor cannot pass through it.
to its bulk density. A higher bulk density will have less WVP or moisture transmission is important for
space to trap air; therefore, it will be easier to transfer wound dressings. In considering that extrudes or
heat away from the fabric. sweat will be produced in some types of wounds, it is
Apart from air permeability, thermal conductivity is vital that the wound dressing can transport extrude or
also one of the critical properties of a good wound sweat from the surrounding skin in order to maintain
dressing as it helps to promote good thermal regulation ventilation. The results show that the average WVP of
of the wound environment and prevent the accumula- the spacer fabrics is better than that of the wound dres-
tion of heat building up from underneath. Based on the sings due to their fabric structure.
results obtained, the thermal conductivities of the
spacer fabrics are similar to one another, but lower
than those of the dressings, especially Dressing 3.
Absorbency
Absorbency is the ability of a material to absorb liquid
into its body. A higher absorbency value means that
Water vapor permeability more water can be absorbed and, therefore, the mater-
The WVP is used to calculate the amount of water ial has better absorbency ability. Figure 4 shows the
vapor that penetrates from the skin to the outside absorbency of all the test samples by using water and
through the fabric. A larger WVP value shows that

1.80
Thermal conductivity (W/mK)

2.50
0
Water vapor permeability

1.60

2.00
0 1.40
1.20
(g/m2/day)

1.50
0 1.00
0.80
1.00
0
0.60

0.50
0 0.40
0.20
0
0.00
0 0.00

mple
Sam Sample

Figure 2. Thermal conductivity of test samples. Figure 3. Water vapor permeability of different test samples.

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Tong et al. 7

0.9% saline water as the testing liquids. Figure 4 shows all of the spacers so there is less space to retain fluid
that all spacers and dressings have better absorbency inside the fabric. However, when 0.9% saline water is
ability in water rather than 0.9% saline solution. This is used, the absorbency of Spacers 5–7 is even poor than
because in 0.9% saline water, the presence of the par- that of Spacers 1–4. This is because the back surface
ticles of NaCl is larger than that of H2O particles. structure of Spacers 5–7 is different to that of Spacers
When using 0.9% saline solution as the testing solution, 1–4. The mesh of Spacers 5–7 is denser and the pores on
in the beginning, small water particles will enter the them are smaller. Therefore, it will be further affected
spacers and dressings according to the difference in con- by the presence of salt particles and it will be more
centration gradient between test specimen and the solu- difficult for water to pass through them.
tion. However, due to the presence of salt particles in Absorbency is important in wound dressings as some
the solution, a hypertonic solution will be formed. wounds will have different amounts of extrude.
Water cannot further enter the test specimens as there Therefore, the ability to absorb fluid is particularly
are more solute molecules outside the specimens and important for wounds with different amounts of
water will start to move out from it to the solution. extrudes. Also, the absorbency will affect the number
Therefore, the absorbency ability of all specimens in of times that the wound dressing will need to be chan-
0.9% saline solution is poorer than that of pure distil- ged, as all extrudes emitted should be entirely absorbed
lated water. from the wound by the dressing. So, better absorbency
Dressing 1 has the best absorption ability as it is can reduce the number of times needed to change the
made of a highly absorbent material (hydrocellular dressing. Based on the results, the absorption ability of
polyurethane) in which fluid can be directly absorbed spacers is better than that of dressings with a water
into the fibers themselves rather than into the space proof layer, that is, Dressings 2 and 3. Although
between the fibers. Although Dressings 2 and 3 are spacer fabrics, which comprise polyester, have less
also made of absorbent materials, which are hydrocol- absorbency than the dressing that consists of highly
loid and hydro-active polyurethane matrix, they have absorbent materials, that is, Dressing 1, the wicking
poor absorbency in this study. This is because the sur- ability of the polyester spacer fabrics enhances their
face of Dressing 3 has a waterproof polyurethane film strength as wound dressings as extrudes may be
that may greatly reduce its absorbency as the film pre- drawn through the fabrics to the outside instead of
vents the dressing from absorbing wound extrudes. trapped within the fabrics, which may increase the
This is also true for Dressing 2, which also contains chances of bacteria growth.
an adhesive layer.2 For spacer fabrics, their absorbency
is similar as they are made of polyester fibers, which
have poor water absorbency. When distillated water is
Compression
used as the testing liquid, the absorbency abilities of A typical compression stress–strain curve of a warp-
Spacers 1–7 increase with their increasing thickness. knitted spacer fabric is shown in Figure 5. From the
Also, the pores on their surface mean that fluid can curve, the compression behavior of spacer fabrics can
easily pass through the fabric. Spacers 1 and 2 have be divided into three stages according to their proper-
the least absorbency as they are the bulkiest among ties and configuration of the spacer yarns between the

12.00
250
water
10.00
Absorbency (L/kg)

Compression stress (gf/cm²)

200
8.00 0.9% saline
soluon
I II III
6.00 150

4.00 100

2.00
50
0.00
0
0 10 20 30 40 50 60 70
Sample Compression (%)

Figure 4. The absorbency using water and 0.9% saline solution Figure 5. Typical compression stress–strain curve of a spacer
of spacers and wound dressings. fabric.

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8 Textile Research Journal 0(00)

200 Spacer 1
Spacer 2
180
Spacer 3

Compression stress (gf/cm²)

160 Spacer 4
Spacer 5
140
Spacer 6
120 Spacer 7
Dressing 1
100 Dressing 2
80 Dressing 3

60
40
20
0
0 20 40 60 80
Compression strain (%)

Figure 6. Compression stress–strain curve of spacers and wound dressings.

two surface fabrics.16,18,25 Stage I is the initial and elas- same knitting structure. This is because the angle of
tic stage, Stage II is the plateau stage and Stage III is their spacer yarns is different. The results show that
the densification stage. In Stage I, the loose outer layers increasing angles of spacer yarns in the wale-wise dir-
are first compressed. With increasing compression ection increase compression resistance, which has also
force, the spacer yarns buckle and are fastened by been proven by the research of Armakan and Roye.12
multifilament stitches. Therefore, the slope of Stage I In addition, this is also true for Spacers 5–7, which have
immediately increases the most. After that, as the bend- the same knitting structure, but the spacer yarn angle of
ing of the spacer yarns nearly reach their elastic limit, Spacer 7 is the largest and that of Spacer 6 is the smal-
the spacer fabric easily compresses even when a small lest. Moreover, in terms of Spacers 1 and 3, sometimes
amount of pressure is added and a nearly constant pres- the compression resistance of Spacer 1 is better than
sure is obtained. Finally, by gradually increasing the Spacer 3, but at other times, this is not true. The
pressure exerted, the compression also rapidly increases reason could be attributed to the somewhat larger
because of the swift densification of the fabric and the spacer yarn angle of Spacer 1 in the wale-wise direction
collapse of the spacer yarns within the fabrics.16,25 In as opposed to that of Spacer 3; however, in the course-
this study, a pressure of 200 gf/cm2 is exerted onto all of wise direction, the reverse is true.
the spacer fabrics and wound dressings. In considering For wound dressings, it was found that the overall
that spacer fabrics are expected to provide a cushioning compression resistance of Dressing 1 is good as its com-
effect as wound dressings for burns, ulcers and surgical pression strain gradually increases with increasing com-
wounds, the force that they suffer is not very high. pression stress. This is because Dressing 1 is made of a
Previous researches have pointed out that pressure foam with better ability to absorb energy. On the other
greater than 32 mmHg (around 43.50 gf/cm2) is gener- hand, the compression resistance of Dressing 3 is the
ally considered as the breakdown pressure that exceeds poorest. From the results, a small force of less than
the capillary closing pressure in healthy individ- 10 gf/cm2 is required to obtain a large compression
uals.10,26,27 Therefore, in this study, the compression strain. Also, further increases in the compression
behavior of spacer fabrics around 50 gf/cm2 will be stress will not further increase the compression strain.
given more focus. Figures 6 and 7 show the compres- This indicates that Dressing 3 is stiffer than all of the
sion stress–strain and compression stress–thickness other spacer fabrics and wound dressings and, unlike
curves of all the spacer fabrics and wound dressings. Dressings 1 and 2, Dressing 3 does not contain foam or
Figure 6 shows that the overall compression resist- a sponge layer to absorb energy. At the beginning,
ance performance of Spacer 2 is the best and Spacers 1 Dressing 2 started to compress when a small force
and 3 are the worst among Spacers 1–4, which have the was exerted onto it. However, when its compression

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Tong et al. 9

Compression
Spacer 1 stress (gf/cm²)
Spacer 2 200
Spacer 3
Spacer 4
Spacer 5
Spacer 6 150
Spacer 7
Dressing 1
Dressing 2
100
Dressing 3

50

0
7 6 5 4 3 2 1 0
Thickness (mm)

Figure 7. Compression stress–thickness curve of spacers and wound dressings.

strain reached about 10–12%, Dressing 2 showed a However, their changes are still much smaller than that
rapid increase in the compression stress, which means of Dressing 1. At 50 gf/cm2, the thickness of Dressing 1
that it has stiffer mechanical behavior. is 2.5 mm while that of Spacers 6 and 7 is around
As mentioned above, wound dressings generally 0.5 mm. This is also true when the compression stress
cannot endure a compression stress beyond 50 gf/cm2. exerted was increased. The compressional property is
Therefore, the compressive behavior of spacers and vital for wound dressings, as wound dressings that have
dressings under a force of 50 gf/cm2 will be further dis- better compressional resistance can protect wounds
cussed. Figure 6 shows that Dressing 1 has the best from contamination. Based on both the compression
compressive resistance with a force less than 25 gf/ stress–strain and compression stress–thickness curves,
cm2. However, when the force is increased to more it can be seen that even if thinner spacers are used,
than 25 gf/cm2, the compressive resistance of Spacer 7 similar compression resistance results can be obtained.
is the best among all of the spacers and dressings. Also, Therefore, it is proven that spacers have competitive
Spacer 4 excels Dressing 2 when the compression stress compression resistance in comparison to wound dres-
is less than 35 gf/cm2. sings, especially Spacer 7.
Figure 7 shows the change in fabric thickness under
compression stress. The results show that Dressing 1,
which has very good compression strain, has the largest
Conclusions
change in thickness when compared to the others. Its A wound that results from elective surgery is generally
thickness decreases around 2.5 mm under a force of considered to be ‘‘clean’’ and, as a result, often judged
50 gf/cm2 and continued to gradually decrease because as clinically less challenging than other wound types. It
Dressing 1 has a foam structure that is not stiff. On the is now widely accepted that traditional wound dressing
other hand, the decrease in the thickness of Dressing 3 materials, such as gauze and paraffin tulle, may adhere
is not obvious as it is a very stiff material and cannot be to the wound area, causing significant pain during
easily compressed. For Dressing 2, there is a turning removal. Also, many modern types of wound dressings
point at 60 gf/cm2 as its two different layers have dif- may not provide an optimum healing environment, due
ferent compression properties. to inefficiency at managing wound exudates, the nature
For the spacer fabrics, their thickness did not change of the material, which raises the skin temperature and
much under pressure due to the spacer yarns that are in encourages sweat to accumulate, and inelasticity in
between the fabrics. Among all of the spacer fabrics, both directions. In this study, a multi-layered compos-
Spacers 6 and 7 have the largest change in thickness. ite wound dressing that uses three-dimensional spacer

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10 Textile Research Journal 0(00)

Table 6. Summary table of all test results of all spacers and dressings

Water vapor Compression

Air permeability Thermal conductivity permeability Absorbency (under 50 gf/cm2)

Spacer 1 Better than Poorer than Better than all dressings Better than Dressings Poorer than
all dressings all dressings 2 and 3 all dressings
Spacer 2 Better than Poorer than Better than all dressings Better than Dressings Poorer than
all dressings all dressings 2 and 3 all dressings
Spacer 3 Better than Poorer than Better than all dressings Better than Dressings Poorer than
all dressings all dressings 2 and 3 all dressings
Spacer 4 Better than Poorer than Better than all dressings Better than Dressings Similar to Dressings
all dressings all dressings 2 and 3 2 and 3
Spacer 5 Better than Poorer than Better than all dressings Better than dressings Similar to Dressings
all dressings all dressings 2 and 3 2 and 3
Spacer 6 Better than Similar to Dressings Better than all dressings Better than Dressings Similar to Dressings
all dressings 1 and 2 2 and 3 2 and 3
Spacer 7 Better than Similar to Dressings Better than all dressings Better than Dressings Better than
all dressings 1 and 2 2 and 3 all dressings

fabric is proposed that absorbs blood and exudates, is conductivity and absorbency. In addition, their thermal
permeable to oxygen and sweat/moisture and supplies conductivity and some of their compression rates are
mechanical protection to the wound. comparable with those of wound dressings or even
The air permeability, thermal conductivity, WVP, exceed them. Therefore, it is plausible to use warp-
absorbency and compression of seven types of warp- knitted spacer fabrics as a substitute for the absorbent
knitted spacer fabrics were investigated and compared layer of wound dressings.
with existing wound dressings in order to evaluate
whether the former can be used as a substitute for the Funding
latter. The overall results of all the tests for the spacers
This work was supported by a Central Research Grant
and dressings are shown in Table 6. It is found that (G-UC37) and the research studentship of The Hong Kong
these mentioned properties of spacer fabrics are com- Polytechnic University granted to Ms Tong Shuk-fan (RTNH).
petitive with those of existing wound dressings. The air
and water vapor permeabilities of the spacers are better
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