AU2009349693A1

AU2009349693A1 - Improved fabric for preventing and reducing skin wounds

Info

Publication number: AU2009349693A1
Application number: AU2009349693A
Authority: AU
Inventors: Neil Blanton; W. Allen Leonard; Jones Mccall; Terry Montgomery
Original assignee: Precision Fabrics Group Inc
Current assignee: Precision Fabrics Group Inc
Priority date: 2009-07-13
Filing date: 2009-07-30
Publication date: 2011-09-22
Anticipated expiration: 2029-07-30
Also published as: CA2754068A1; IL215084A0; JP5642173B2; MX2011010458A; JP2012532002A; CN102395718B; WO2011008220A1; EP2454404A1; AU2009349693B2; IL215084A; EP2454404A4; CA2754068C; CN102395718A

Abstract

A fabric for the prevention and treatment of skin wounds, and pressure wounds in particular, which includes a woven fabric having warp yarns and filling yarns woven to provide a smooth fabric surface. One of the warp or filling yarns is at least about 40% by weight of the fabric of continuous filament nylon, and the other of the warp or filling yarns is from about 0% to about 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections. The fabric includes a conductive yarn at about 0% to about 2% by weight to control static dissipation, and an antimicrobial substance is topically applied or inherently available in the fabric. The fabric can be used in bedding, including underpads, and patient gowns. Methods of preventing and treating skin wounds, and pressure wounds in particular, are also disclosed.

Description

WO 2011/008220 PCT/US2009/052285 IMPROVED FABRICS FOR PREVENTING AND REDUCING SKIN WOUNDS Background of the Invention 5 [000 1]The present invention relates generally to therapeutic fabrics, and more specifically to articles that include a woven fabric having advantageous antimicrobial, anti-static, wicking and drying properties, to aid in the prevention and treatment of dermatitis, skin wounds, pressure wounds and other skin ailments. Medical research in support of the technology disclosed in these applications has been published in Pediatric 10 Dermatology, Vol. 25, No. 4, 439-433, July/August 2008, in an article entitled "Use of a Silklike Bedding Fabric in Patients with Atopic Dermatitis", the entire disclosure of which is hereby incorporated by reference. On January 25, 2007, the U.S. Food and Drug Administration granted 510(k) clearance as a Class 1 medical device (registration number K061242), the entire disclosure of which is hereby incorporated by reference. 15 [0002]A significant portion of the world's population is afflicted with skin problems. Nearly 15 million Americans have eczema, a chronic skin condition marked by itchy, red patches of inflamed skin. Six to seven million Americans have psoriasis, which is a skin disease that causes unsightly sores and skin scales. Such skin diseases account for a large portion of annual healthcare costs. For instance, psoriasis accounts 20 for about $3 billion dollars a year in healthcare costs. Of course this doesn't include non financial costs such as time spent in treatment, sleep deprivation, intractable itching, skin damage, soreness, the social stigma of a visible skin disease, and inconvenience associated with treatment, avoidance of certain clothing, using special detergents on clothing and bedding, and controlling environmental conditions to maintain the proper 25 level of moisture on the affected skin. [0003]Likewise, skin wounds, and in particular pressure wounds, continue to be a growing problem for healthcare systems around the world, particularly concerning the population which is aged, bedridden, unconscious, unable to sense pain, or immobile. Pressure wounds, also known as bedsores, are areas of localized tissue destruction caused 1 WO 2011/008220 PCT/US2009/052285 by the compression of soft tissue between a bony prominence and an external surface for a prolonged period of time. They develop when blood supply to the skin is cut off for more than two to three hours. As the skin dies, the pressure wound starts as a red, painful area, which eventually turns purple. They often occur on areas of the skin that are under 5 pressure from the patient lying in bed, sitting in a wheelchair, and/or wearing a cast for a prolonged period of time. Common areas include the buttocks (on the sacrum or iliac crest), or the heels of the feet. An untreated wound can break open and become infected, and/or extend deep into the muscle. Once a pressure wound develops, it is often very slow healing. Known methods of prevention include inspecting the skin for areas of 10 redness (the first sign of skin breakdown), frequent turning and repositioning, providing soft padding in wheelchairs and beds to reduce pressure, and/or providing good skin care by keeping the skin clean and dry. Treatment may include removing pressure on the affected area, protecting the wound with medicated gauze or other special dressings, keeping the wound clean, transplanting healthy skin to the wound area and/or medication 15 (i.e., antibiotics to treat infections). [0004]More than 1 million persons in the US develop pressure wounds each year, approximately 7% of which are acquired in a hospital. The average cost of treating a person admitted to the hospital for pressure wounds is $37,288, which translates to approximately $2.2 to $3.6 billion dollars per year spent on treating pressure wounds in 20 an acute care setting. Again, this does not account for the physical or emotion toll on the afflicted, their families and caretakers. [0005]Moisture, friction and shearing can cause or exacerbate skin problems such as dermatitis, eczema, psoriasis and pressure wounds. For example, a person who has been exposed to too much moisture will have vulnerable skin. When this person moves 25 across a coarse moist surface such as a bed sheet, their skin is subjected to shear force injuries caused by friction. Likewise, they can be injured by their apparel, or another item of bedding which is in contact with their skin, particularly where that article has increased frictional force or decreased shear force resistance. The problem is further compounded insofar as skin that has been damaged by moisture, friction and/or shearing 2 WO 2011/008220 PCT/US2009/052285 is much more likely to develop pressure-related damage such as ulcers or pressure wounds. Moreover, the likelihood of injury increases when the skin is in the presence of biological substances such as urine, stool, perspiration or wound drainage, which may contain factors other than moisture that irritate the skin. 5 [0006]Accordingly, it is not only important to provide bedding and apparel with properties that prevent skin disorders, it is important that the bedding and apparel actually treat disorders that may present themselves. Unfortunately however, fabrics for constructing bedding and apparel to prevent and treat skin disorders, and pressure wounds in particular, are not prevalent in the art. 10 [0007]Hospital linens such as bottom sheets, top sheets, and pillow cases are generally considered by hospitals to be housekeeping commodities, as opposed to therapeutic items. Accordingly, these bedding items are typically constructed of low-tech and low cost fabric, such as conventional cotton-polyester blends. A typical conventional hospital bedding fabric is a plain weave construction of 120 warp yams per inch and 74 15 filling yams per inch, producing a fabric that is 4.12 ounces per square yard. The warp yams are 39/1 spun yams, equivalent to 136 denier, in a blend of 50% cotton and 50% staple polyester. The filling yams are 35.6/1 spun yams, equivalent to 149 denier, in a blend of 50% cotton and 50% staple polyester. These fabrics have no special finishes, moisture handling characteristics, antimicrobial properties, anti-static characteristics, or 20 soil-release properties. In short, these are low-end bedding products similar to what one might find in a home or hotel, and are not made to prevent or treat skin disorders. [0008]Another bedding item often used in a hospital is an underpad, also known as a protective pad, which provides a means for shielding mattresses from biological fluids that emanate from a person in bed. They range from a very simple sheet of 25 waterproof material such as rubber, to more a complex multi-layered device. They may be intended for one use (disposable), or may be reusable. Underpads are intended to be positioned between the bottom sheet and top sheet of a bed, so a person in the bed is laying directly on the underpad, with gravity carrying the emanating biologicals to the 3 WO 2011/008220 PCT/US2009/052285 underpad. To varying degrees this protects the bottom sheet and mattress thereunder. Since the underpad is typically in direct contact with the patient, efforts have been made to make the underpad more comfortable. For example, rubberized pads may include flocking to contact the patient, or vinyl backing may include a quilted cloth. 5 [0009]Like sheets, underpads are considered by hospital administration to be housekeeping articles - commodities which are intended to maintain patients' cleanliness and protect furniture, at the lowest possible cost. However, in situations where patients are at risk for the development of pressure wounds, commodity products are insufficient and ineffective. Research indicates that standard hospital-issue commodities actually 10 exacerbate wound development. Specifically, with conventionally gowned patients using conventional bedding, including underpads, the average number of wounds per patient increased 41% between admittance and discharge. [00 10]Underpads may comprise an absorbent material that is covered in the conventional hospital bedding fabric discussed above. While an underpad of this 15 construction may effectively protect the mattress, and possibly even be relatively comfortable, it does not rise to the level of being therapeutic insofar as it doesn't prevent or treat skin problems, and pressure wounds in particular. [0011 ]Another example of a hospital article that is commoditized to the detriment of patients is the patient gown, also known as a hospital gown. These garments are 20 typically constructed of cotton/poly blends, for example the aforementioned conventional bedding fabric. They are typically relatively inexpensive and easy to wash, but do not possess properties which would actually prevent or treat skin disorders, and particularly pressure wounds. [0012]Although the majority of technological advances in the patient gown art are 25 directed towards improved patient coverage for privacy purposes, some progress has been made in treating disease with garments. For example, US Patent 6,868,854 to Kempe teaches a method of treating fibromyalgia with a radiation-shielding gown, and US Patent 7,003,804 to Lewis teaches a surgical gown with a skin wellness agent applied that rubs off onto the wearer. 4 WO 2011/008220 PCT/US2009/052285 [0013]A line of products marketed under the trade name DermaSilkTM has applications in skin care apparel. Specifically, the DermaSilk technology has shown excellent clinical results in helping to heal atopic dermatitis and psoriasis, as well as skin ulcers that form as a result of diabetes. DermaSilk therapeutic apparel include 5 undergarments and body wraps knitted of 100% silk yarns and treated with a durable antimicrobial agent. [0014] Silk is effective in this case since silk fibers have a chemical structure very similar to that of human hair (97% protein, 3% fat, and wax matter). Silk fibers are perfectly smooth and cylindrical. As such, they do not create mechanical friction with 10 the skin. Further, silk is naturally hygroscopic, absorbing up to 30% of its own weight in sweat without becoming wet. This is important in aiding the cure of atopic dermatitis because silk is able to maintain the moisture balance of the skin, providing a softening and soothing micro-climate next to the skin. Silk is also capable of absorbing and releasing moisture without causing irritation, because the diameter of silk's cylindrical 15 fibers simply increase or decrease as moisture is absorbed or released. Since silk yarns are made up of tiny continuous filaments, delicate skin is not disturbed as the moisture content changes. Silk helps to reduce heavy sweating (common in children affected by atopic dermatitis), as well as minimize the loss of moisture that can aggravate skin dryness and itching. Silk is also naturally elastic. When used in a knitted construction, 20 silk fabrics allow garments to move with the body and to remain closely bound to the skin, thereby reducing friction. [001 5]DermaSilk fabrics and apparel also incorporate a topical antimicrobial agent that provides protection to the silk fibers against a broad range of bacteria, germs, molds, and fungus. This antimicrobial treatment inhibits the survival of bacteria on the 25 fabric and is highly effective against Staphylococcus aureus, one of the major factors of worsening atopic dermatitis. [0016]While silk has been proven effective in apparel and body wraps, there are inherent deficiencies in the use of silk fibers, yarns, and fabrics as they relate to therapeutic bedding and patient gowns. Unlike knitted apparel and wraps, hospital 5 WO 2011/008220 PCT/US2009/052285 articles such as sheets, pillowcases, underpads and patient gowns must withstand continuous use exceeding 8 to 9 hours per day, and extensive laundering and drying. Also, hospital articles are typically subjected to various chemicals and stains associated with personal hygiene, and must withstand much greater stresses and strains associated 5 with sleeping adults. Chloride salts in perspiration and deodorants weaken silk, and alcohol-based products such as hairspray and perfumes, and chemical products like nail polish remover easily damage silk fabrics. Water applied to a stain on silk can set the stain or cause a permanent stain ring. Silk cannot be presoaked in detergents or bleaches, as both will damage silk. Further, silk fabrics cannot be air-dried in the sun, since 10 ultraviolet rays degrade silk. Therefore, silk fabrics are less than ideal for widespread use in therapeutic hospital articles. [0017]An inventor of the present invention developed a new fabric technology for therapeutic bedding which overcame some of DermaSilk's shortcomings by employing synthetic fibers, some of which possess non-round cross-sectional shapes. This fabric has 15 shown great promise in treating mild atopic dermatitis, which is the most common type of eczema. Indeed, on January 25, 2007, the U.S. Food and Drug Administration granted 510(k) clearance on the invention as a Class 1 medical device (registration number K061242) for the treatment of mild atopic dermatitis. Notably, that invention represented the first therapeutic bedding to be granted FDA marketing clearance as a Class 1 medical 20 device for skincare therapy. [0018]While impressive, this FDA marketing clearance was not for use within the context of preventing and treating pressure wounds, because dermatitis and pressure wounds are considered to be different disorders. In fact, one would not expect a dermatitis treatment fabric to provide substantial anti-pressure wound properties, 25 particularly since the fabric itself does not alleviate pressure or otherwise cushion bony prominences. [0019]Since the prevention and treatment of pressure wounds remained a serious medical need with no clear solution, there remained a need for a woven fabric having advantageous antimicrobial, anti-static, wicking and drying properties, which is capable 6 WO 2011/008220 PCT/US2009/052285 of preventing and treating dermatitis, skin wounds, pressure wounds and other skin ailments. This fabric should be non-abrasive, cost effective, and should be able to withstand many washings, detergents, autoclaving, irradiation, and nightly wear as necessary. There was also a need for hospital articles, including sheets, underpads and 5 patient gowns, constructed of this fabric and suitable for continuous use in a hospital or other care facility. 7 WO 2011/008220 PCT/US2009/052285 Summary of the Invention [0020]The present invention fulfills one or more of these needs in the art by providing a fabric for bedding, including underpads, and patient gowns, that utilize a unique combination of polymer types and fiber configurations to form woven fabrics that 5 are like silk in terms of aesthetics, smoothness, elongation, and moisture handling, but more durable, more stain resistant, and more suitable for articles such as bedding and patient gowns. Further, the fabric is also superior to cotton-containing fabrics because it dries more quickly and stays smooth when wet. [0021]The fabric includes a woven fabric having warp yarns and filling yarns 10 woven to provide a smooth fabric surface. In the preferred embodiment, one of the warp and filling yarns is at least 40% by weight of the fabric of continuous filament nylon. The other of the warp and filling yarns may be from about 0% to 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections. Preferably the fabric includes a conductive yarn from about 0% to about 2% by 15 weight of the fabric. Preferably, an antimicrobial substance is topically applied or inherently available in the fabric. [0022]Also, the warp yarns may be 100% nylon, and the filling yarns may be polyester or nylon. [0023]The fabric is preferably woven as a twill weave or plain weave. The plain 20 weave is preferred and if a twill weave is used, preferably it is balanced so that both sides of the fabric are the same. The warp yarn may be a 40 denier, 34 filament, five twist per inch, continuous filament nylon 6-6 yarn, with the filling yarn a 75 denier, 48 filament, continuous filament textured polyester. In the most preferred embodiment, the warp yarn is a 70 denier, 48 filament, continuous filament textured nylon yarn, the filling yarn a 75 25 denier, 36 filament, non-round cross-section continuous filament textured polyester, and the conductive yarn is from about 0% to about 2% by weight of the fabric. [0024]Preferably, the continuous filaments have a non-round fiber cross section, such as fibers with a star shaped, clover leaf, trilobal or bowtie cross section. The continuous filaments with non-round fiber cross sections typically have a cross section 8 WO 2011/008220 PCT/US2009/052285 such that adjacent filaments form wicking channels that enhance moisture wicking and rapid drying. [0025]Also preferably, the fabric is finished to produce a fabric with an elongation greater than about 30% per ASTM D5034-95 test for breaking strength and 5 elongation of textile fabrics. [0026]In the preferred embodiment, the fabric has a soil-release topical finish. [0027]In one aspect, the present invention provides a therapeutic woven fabric for preventing and reducing skin wounds having warp yams and filling yarns woven to provide a smooth fabric surface and made into a sheet sized to cover a bed. The sheet 10 typically has hems to prevent raveling of the woven fabric. One of the warp and filling yams is at least 40% by weight of the fabric of continuous filament nylon, the other of the warp and filling yams is from about 0% to 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections, and the conductive yarn from about 0% to about 2% by weight of the fabric. Preferably, an antimicrobial 15 substance is topically applied or inherently available in the fabric. [0028]Another aspect of the present invention is to provide a therapeutic woven fabric for use in articles that contact the skin. One of the warp and filling yams is at least 40% by weight of continuous filament nylon, the other of the warp and filling yarns is from about 0% to 60% by weight of continuous filament polyester or nylon having non 20 round filament cross sections, and a conductive yarn is from about 0% to about 2% by weight of the fabric. In the preferred embodiment, an antimicrobial substance is topically applied or inherently available in the fabric. [0029]Still another aspect of the present invention is to provide a therapeutic woven fabric with a smooth surface for constructing bedding, including underpads and/or 25 garments such as patient gowns. The warp and filling yams are continuous and substantially free of hairiness. One of the warp and filling yarns is preferably a continuous filament yam having a non-round filament cross section such that adjacent filaments form wicking channels, and a conductive yarn is integrated to control static. An antimicrobial substance may be topically applied or inherently available in the fabric. 9 WO 2011/008220 PCT/US2009/052285 [0030]An invention can also be considered as providing a method of patient therapy including covering the patient's bed with sheets having surfaces that are smooth even when wet; and allowing the patient to rest between the sheets. Preferably, the patient's bed includes an underpad, and the patient is wearing a patient gown, with both 5 the underpad and gown constructed of a fabric having these same properties as the sheets. The surface roughness between the sheets, underpad and patient gown, and the patient's skin is reduced in comparison with the surface roughness that would exist between cotton or polyester/cotton blend fabric sheets and the patient's skin. [003 1]An invention can also be considered as providing a method of patient 10 therapy including dressing or providing a patient with a patient gown having smooth surfaces even when wet. Preferably the patient's bed includes bedding, including an underpad, constructed with the same fabric as the patient gown. The surface roughness between the patient gown and the patient's skin is reduced in comparison with the surface roughness that would exist between cotton or polyester/cotton blend fabric sheets and the 15 patient's skin. [0032]Other aspects of the invention provide methods of preventing or treating skin wounds and disorders by dressing or providing a patient with a patient gown constructed of a therapeutic fabric, and replacing the article when it becomes soiled. Alternatively, the article may be replaced according to hospital protocol, for example 20 every 24 hours. Desirably, the therapeutic fabric is constructed from a woven fabric having warp yarns and filling yarns woven to provide a smooth fabric surface, with one of the warp and filling yarns being at least 40% by weight of the fabric of continuous filament nylon, the other of the warp and filling yarns being from about 0% to 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament 25 cross sections, and including a conductive yarn from about 0% to about 2% by weight of the fabric. Preferably the patient is also provided one of at least a bottom bed sheet, top bed sheet, pillowcase, and/or underpad. The article should have an average geometric surface roughness of 1.0 to 1.75 microns when dry as measured by the Kawabata Evaluation System FB4 Surface Tester. Preferably, the article or articles provide an 10 WO 2011/008220 PCT/US2009/052285 antimicrobial reduction of Escherichia coli, Staphylococcus aureus, and Staphylococcus epidermidis of at least 98.0% after 24-hour contact time. [0033]Another aspect of this invention is a patient gown comprising a textile fabric woven of 100% continuous synthetic yams, with the fabric finished to achieve 5 antimicrobial reduction of greater than 99% of Staphylococcus aureus and Enterococcus faecalis after 24-hour contact time when tested by the AATCC Test Method 100, having an average surface roughness of about 1.75 microns using the Kawabata Surface Roughness Evaluation, having a moisture wicking rate of greater than 15mm/minute, and having a drying rate of greater than 1.0% per minute. 10 [0034]In one aspect, the present invention provides a therapeutic woven fabric for constructing an underpad capable of preventing and reducing skin wounds having warp yams and filling yams woven to provide a smooth fabric surface, and sized to fit on a bed. The underpad may have hems or seams to prevent unraveling of the woven fabric, include a liquid impermeable bottom layer and/or a fluid absorbing middle layer, and 15 may be at least 34 inches in width along the top edge, at least 42 inches at the bottom edge, and a total length of 65 inches so as to increase protection for patients' knees and feet. [0035]An invention can also be considered as providing a method of patient therapy including covering the patient's bed with an underpad whose top fabric layer has 20 a smooth surface, even when wet; and allowing the patient to rest upon this underpad. Preferably the patient's bed includes at least one other bedding article such as a bottom sheet, top sheet, and/or pillow case, and/or the patient is wearing a patient gown, with the article(s) and patient gown constructed of the same fabric as the underpad's top fabric layer. The surface roughness between the top fabric layer and the patient's skin is 25 reduced in comparison with the surface roughness that would exist between a conventional underpad's top fabric layer constructed of cotton or polyester/cotton blend fabric, and the patient's skin. [0036]Other aspects of the invention provide methods of preventing or treating skin wounds and disorders by providing an underpad to a patient and replacing the 11 WO 2011/008220 PCT/US2009/052285 underpad when it becomes soiled. Alternatively, the underpad may be replaced according to hospital protocol, for example after 24 hours of use. Desirably, the top fabric layer of the underpad is constructed from a woven fabric having warp yarns and filling yarns woven to provide a smooth fabric surface, with one of the warp and filling 5 yarns being at least 40% by weight of the fabric of continuous filament nylon, the other of the warp and filling yarns being from about 0% to 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections, and including a conductive yarn from about 0% to about 2% by weight of the fabric. The top fabric layer of the underpad should have an average geometric surface roughness of 1.0 10 to 1.75 microns when dry as measured by the Kawabata Evaluation System FB4 Surface Tester. Preferably, the top layer of the underpad provides an antimicrobial reduction of Escherichia coli, Staphylococcus aureus, and Staphylococcus epidermidis of at least 98.0% after 24-hour contact time. [0037]Another aspect of this invention is an underpad with a top fabric layer 15 comprising a textile fabric woven of 100% continuous synthetic yards, with the fabric finished to achieve antimicrobial reduction of greater than 99% reduction of Staphylococcus aureus and Enterococcusfaecalis after 24-hour contact time when tested by the AATCC Test Method 100, having an average surface roughness of about 1.75 microns using the Kawabata Surface Roughness Evaluation, having a moisture wicking 20 rate of greater than 15mm/minute, and having a drying rate of greater than 1.0% per minute. Preferably this underpad also includes a liquid impermeable bottom layer and fluid absorbing middle layer, with all three layers secured together. [0038]Other aspects of the invention provide methods of preventing or treating skin wounds and disorders by providing an article to a patient and replacing the article 25 when it becomes soiled. Desirably, the article is constructed from a woven fabric having warp yarns and filling yarns woven to provide a smooth fabric surface, with one of the warp and filling yarns being at least 40% by weight of the fabric of continuous filament nylon, the .other of the warp and filling yarns being from about 0% to 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross 12 WO 2011/008220 PCT/US2009/052285 sections, and including a conductive yarn from about 0% to about 2% by weight of the fabric. The articles of this method could be one or more of a bottom bed sheet, top bed sheet, pillowcase, underpad and/or patient gown. The article should have an average geometric surface roughness of 1.0 to 1.75 microns when dry as measured by the 5 Kawabata Evaluation System FB4 Surface Tester. Preferably, the article or articles provide an antimicrobial reduction of Escherichia coli, Staphylococcus aureus, and Staphylococcus epidermidis of at least 98.0% after 24-hour contact time. [0039]These and other aspects of the present invention will become apparent to those skilled in the art after a reading of the following description of the preferred 10 embodiment when considered with the drawings. 13 WO 2011/008220 PCT/US2009/052285 Brief Description of the Drawings [0040]FIG. 1 is an illustration of a bed having a top sheet and pillow cases constructed of fabric of the present invention; [0041]FIG. 2 is an illustration of a bed having a bottom sheet and underpad 5 constructed of fabric of the present invention; [0042]FIG. 3 depicts a patient wearing an embodiment of the patient gown of the present invention; [0043]FIG. 4 is a schematic representation of an underpad in cross-section; [0044]FIG. 5 is a schematic representation of a patient gown blank; 10 [0045]FIG. 6 is a photomicrograph of yam whose fibers are star-shaped in cross section; [0046]FIG. 7 is a photomicrograph of yarn whose fibers are cloverleaf-shaped in cross section; [0047]FIG. 8A is a photomicrograph of an embodiment of the fabric of the 15 present invention; and [0048]FIG. 8B is a photomicrograph of conventional hospital bedding fabric. 14 WO 2011/008220 PCT/US2009/052285 Description of the Preferred Embodiments [0049]A therapeutic fabric for the prevention and treatment of skin wounds and disorders is disclosed. As used herein "the fabric" or "the therapeutic fabric" shall refer to this fabric unless the context implies differently. The fabric is used to form articles 5 that contact the skin, such as bedding and patient gowns. Used herein "bedding" shall refer to bottom bed sheets, top bed sheets, pillow cases and/or underpads, and "articles" shall refer to bedding and patient gowns. The therapeutic fabric includes warp yams and filling yams woven to provide a smooth fabric surface. In the preferred embodiment, one of the warp or filling yams is at least 40% by weight of the fabric of continuous filament 10 nylon, and the other of the warp or filling yams is from about 0% to about 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections. The most preferred embodiment includes about 1% to about 2% of a conductive yam to control static electricity. [0050]Preferably, an antimicrobial substance is topically applied or inherently 15 available in the fabric. In the preferred embodiment, an antimicrobial substance such as )EGIS Microbe Shield, manufactured by IEGIS Environments, Inc., is topically applied to the woven fabric in a standard textile finishing operation. The antimicrobial substance is preferably applied at 0.25% to 2.0%-weight of the active ingredient to 100%-weight of the fabric. LEGIS Microbe Shield works well against the following common microbes: 20 Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa. The antimicrobial substance may also prevent odors in the fabric. [0051 ]The warp yams may be 100% nylon, and the filling yams may be polyester or nylon. [0052]In one embodiment, the fabric is woven as a twill weave (typically a 2X1 25 twill) or, in another embodiment, as a plain weave. Yams are woven into fabric constructions that have 80% to 100% coverage. The warp yam may be a 40 denier, 34 filament, five twist per inch, continuous filament nylon 6-6 yam, and the filling yam may be a 75 denier, 48 filament, continuous filament textured polyester. In another embodiment, the warp yam is a 70 denier, 48 filament, continuous filament, textured 15 WO 2011/008220 PCT/US2009/052285 nylon, and the filling yarn is a 75 denier, 36 filament, continuous filament, textured polyester. Continuous filament yams are preferred because those yams do not have short fibers extending beyond the fabric's planar surface, thereby decreasing irritation to sensitive skin. The smooth fabric surface also accentuates this effect. Continuous 5 filaments forming a smooth surface and short fibers forming an irritating surface are shown in the photomicrographs of FIGS. 8A and 8B, respectively. Warp yams of about 30 denier to 100 denier, and filling yams of about 30 denier to 100 denier may be used. [0053]Preferably, the continuous filament has non-round filament cross-sections such as a star-shaped cross section or a clover-leaf cross section. The clover-leaf cross 10 section also improves the fabric's smoothness and softness. Examples of these are seen in FIGS. 6 and 7. With non-round cross sections, adjacent filaments form wicking channels along filament surfaces to promote and enhance moisture transport away from contact with the skin. The moisture moves along the fabric away from its original source, from whence it can evaporate or wick further. Thus, moisture more quickly evaporates 15 and dries from the fabric surface, reducing the amount of moisture contacting the skin. As such, the wicking channels also help the user to maintain body temperature by reducing excess sweating. [0054]In the preferred embodiment, nylon is used because it has one of the highest moisture regains of any synthetic fiber. Nylon absorbs moisture, and aids in 20 wicking and evaporation. Although nylon is preferred, polyester can also be used if a durable auxiliary hydrophilic treatment is applied as a post finish. [0055]In the preferred embodiment, the fabric may also contain a soil-release topical finish, such as HydroWick T M NA, from HydroTex USA, Inc., at 40% solids applied at 8% exhausted on the weight of the fabric. Thus, the fabric is able to release 25 stains associated with skin antibiotic creams and ointments, wound drainage, and tissue detritus. [0056]In the preferred embodiment, the fabric may also include a conductive yam such as carbon, silver or other metal. The conductive yam is not critical to the therapeutic properties of the present invention, but it is useful in reducing the potential 16 WO 2011/008220 PCT/US2009/052285 for static electricity which can occur during institutional laundering processes. Specifically, the conductive yam controls static dissipation by conducting static charges away and preventing a static charge accumulation. The conductive yam is preferably included as various ends of the warp and/or courses of filling yams. Preferably, the 5 conductive yam is about 1% to about 2% by weight of the fabric. [0057]As would be understood by those in the art, when conductive yam is included in the fabric, the percentage of nylon, non-round filament and conductive yam would add up to 100%, not 102%. Accordingly, the other yams in the final fabric will be reduced proportionally. For simplicity herein, however, ranges are set forth as the nylon 10 being at least 40% by weight, the non-round nylon being from about 0% to about 60% by weight, and the conductive yam being about 0% to about 2% by weight. [0058]The fabric provides exceptional antimicrobial, anti-static, wicking and drying properties, and is capable of preventing and treating dermatitis, skin wounds, pressure wounds and other skin ailments. Moreover, the fabric is non-abrasive, cost 15 effective, and able to withstand many washings, detergents, autoclaving, irradiation, and nightly wear. Accordingly, this fabric is exceptionally well suited for people who bed ridden, receiving rehabilitation, assisted living or nursing care, and particularly those who are exposed to biologicals including sweat, urine, feces, vomitus, wound drainage. [0059]Preferably, the fabric is finished to produce a fabric with an elongation 20 greater than about 30% as measured by ASTM D5034-95. Those of ordinary skill in the art are familiar with suitable finishing technologies to achieve this result. [0060]The fabric lends itself to the construction of various articles that come in skin contact including top sheet 10 which includes hem 14 to prevent raveling, and pillowcase 12 also having a hem (not shown), both shown in FIG. 1. As shown in FIG. 2, 25 the fabric may also be used to construct bottom sheet 20, underpad 60, and patient gown 30, as shown in FIG. 3 [0061]Referring to FIG. 2, underpad 60 is positioned on bottom sheet 20, which preferably includes fitted comers 21. Typically, a patient (not shown) lays directly on top of underpad 60 with top sheet (not shown) draped over the patient. Underpad 60 is 17 WO 2011/008220 PCT/US2009/052285 preferably trapezoidally shaped with top edge 62 being less wide than bottom edge 64 when positioned on a bed. Most preferably, underpad 60's top edge 62 is at least 34 inches wide, bottom edge 64 is at least 42 inches wide, and length 68 is approximately 65 inches. These dimensions advantageously provide the pad with sufficient area to extend 5 under the patients' knees and feet, which are particularly susceptible to pressure wounds. [0062]FIG. 4 shows a cross-sectional view of underpad 60 including top fabric layer 75, which is comprised of therapeutic fabrics discussed herein, middle layer 77, and bottom layer 79. Absorbent middle layer 77 is preferably constructed of a nonwoven or foam material. Bottom layer 79 is preferably liquid impermeable, and can be constructed 10 of materials such as vinyl, rubber, polyurethane-coated materials, and other liquid barriers known in the art. Top fabric layer 75, middle layer 77 and bottom layer 79 are preferably secured together to form underpad 60 by perimeter stitching 85, shown in FIG. 2. [0063]The fabric also lends itself to the construction of patient gown 30, shown in 15 FIG 3, including arm panels 32 and body 33. FIG. 5 depicts a preferred blank for constructing patient gown 30. Preferably, a continuous piece of therapeutic fabric comprises body 33. There are preferably two sets of two arm panels 32 (for a total of four), all of which are comprised of the therapeutic fabric. Each individual panel 32 is attached to another arm panel 32 via arm hole seams 35. Each pair of two arm panels 32 20 are attached to body 33 via arm panel seams 36. Arm panels 32 define arm holes 34, through which arms extend when the assembled gown is worn by a patient, as shown in FIG. 3. [0064]Running along the upper edge of arm panels 32 are first fasteners 40 and second fasteners 42, each mating one with another, for example as male and female snaps 25 or buttons, loop and hook attachments, and the like. The innermost arm panels 32 define neck hole 37 (shown in FIG. 3) which may be a v-neck, semi-circular, or the like. Ties 38 secure to one another (such as by tying) behind the patient, as shown in FIG. 3. Alternative means for securing patient gown 30 to the patient include snaps, buttons, loop and hook assemblies, hooks, zippers, adhesives and the like. As shown with respect to 18 WO 2011/008220 PCT/US2009/052285 the bottom right tie 39 of FIG. 5, tie 39 may be attached to body 33 in a position other than outermost edge 50. [0065]Preferably patient gown 30 includes hem 48 and/or piping 52 to finish edges, pocket 44 for holding small personal or medical items, and identification 46 which 5 indicates name of hospital, department, brand of item or any other desirable indicia. [0066]One comparative example of the fabric is a construction of 84 warp yams per inch and 96 fill yams per inch, to produce a fabric which is 2.36 ounces per square yard. The warp yam is a 70 denier, 49 filament continuous textured nylon, with the primary filling yam a 75 denier, 36 non-round cross-section continuous filament textured 10 polyester. A secondary filling yam is a two-ply yam made by twisting a 25 denier, 3 filament, carbon yam with a 70 denier, 68 continuous filament polyester yam, and woven into the fabric at 2.5 picks per inch or 1% of the total weight of the fabric. For purposes of interpreting Tables 1-3 below, this construction shall be referred to as the therapeutic fabric, which is but one embodiment of the present invention. 15 [0067]In contrast, typical hospital bedding fabric is a plain weave in a construction of 120 warp yams per inch and 74 filling yams per inch, producing a fabric that is 4.12 ounces per square yard, or 75% heavier than the present invention. The warp yams are 39/1 spun yarns (equivalent to 136 denier) in a blend of 50% cotton and 50% staple polyester. The filling yams are 35.6/1 spun yams (equivalent to 149 denier) in a 20 blend of 50% cotton and 50% staple polyester. These cotton-blend fabrics have no special finishes, moisture handling characteristics, antimicrobial properties, or soil release properties. For purposes of interpreting Tables 1 and 2, this construction shall be referred to as "Cotton Blend". [0068]As indicated in the leftmost column of Table 3 below, conventional 25 hospital bedding fabric constructions, not limited to "Cotton Blend" of Tables 1 and 2, are used for comparison purposes in Table 3. 19 WO 2011/008220 PCT/US2009/052285 [0069]Preferred fabrics have the following properties: * [0070]High moisture regain. Nylon, with one of the highest moisture regains of any synthetic fiber, absorbs moisture and aids in wicking and evaporation. This 5 contributes to the superior wicking ability to the present invention, which is demonstrated in Table 1: Wicking Com pa rison Cotton C' I I 0 5 10 15 20 Wikin~g Rate ( mmr/miunutes ) Table 1 20 WO 2011/008220 PCT/US2009/052285 [0071]Excellent moisture transport. Non-round fiber cross sections create channels along fiber surfaces to promote and enhance moisture transport away from contact with the skin. Moisture more quickly evaporates and dries, and thereby reduces the 5 amount of wetness next to the skin. The therapeutic fabric's ability to be greater than 95% dry after 45 minutes is a considerable improvement over the cotton blend, as shown in Table 2. Drying Comparison 0% 0 15 3U 45 6 Y 75 10 Table 2 21 WO 2011/008220 PCT/US2009/052285 0 [0072]Minimal friction with the skin. Continuous-filament yarns have no short fibers extending beyond the fabric's planar surface to irritate sensitive skin. A smooth fabric surface accentuates this effect. Preferably, the fabric has an average 5 geometric roughness of less than about 1.7 microns as measured by the Kawabata Evaluation System FB4 Surface Tester. Photomicrographs of the present invention and cotton blend, FIGS. 8A and 8B respectively, demonstrate their substantial surface differences. 10 * [0073]Substantial antimicrobial properties. Per AATCC Test Method 100, the preferred embodiment of the present invention demonstrates substantial microcidal efficacy (>99.9%) against Staphylococcus aureus, and Enterococcusfaecalis in a variety of articles, while various conventional hospital fabrics do not. This is shown in Table 3: 15 Percent reduction (%) at 24-hrs contact time Staphylococcus Enterococcus faecalis aureus (MRSA) Therapeutic Fabric > 99.90 % reduction > 99.95 % reduction Hospital Top Sheet of Woven No reduction No reduction cotton blend 1,865 % growth 5,015 % growth Hospital Fitted Bottom Sheet of No reduction No reduction Knitted cotton blend 5,560 % growth 16,389 % growth Hospital Patient Gown of Woven No reduction 71 % reduction cotton blend 1,615 % growth Table 3 22 WO 2011/008220 PCT/US2009/052285 * [0074]A good degree of stretch and recovery. Such fabrics help bed sheets to fit tighter and thereby reduce wrinkles that cause skin irritation. Such fabrics also better conform to the body and reduce the shear forces on sensitive skin. Preferably, the fabric is finished to produce a fabric with an elongation greater than about 30% as 5 measured by ASTM D5034-95. The superior elongation properties are demonstrated in Table 4. * [0075]Durability to extended laundering and drying. Such fabrics will not lose fibers during laundering (in comparison with cotton blends), and are not afflicted with fiber 10 pills that further irritate skin. * [0076]Ability to withstand high wash temperatures and the use of harsh detergents. * [0077]Ability to release stains associated with skin antibiotic creams and ointments, 15 wound drainage, and tissue detritus. This is demonstrated in Table 4. 23 WO 2011/008220 PCT/US2009/052285 [0078]The data relating to various properties of star and cloverleaf cross-sectional yams, and one embodiment of the invention are compared with typical 55/45 polyester/cotton and 100% cotton bedding fabrics in Table 4: Units Star Coverleaf Embodiment Conventional Conventional cross- cross- of Invention Sheet Sheet section section yam yarn Warp Yam 40/34 40/34 70/48 55/45 100% 7z 7z Nylon textured Poly/cotton Cotton Nylon nylon Fill Yam 75/48 70/72 75/36 55/45 100% textured textured textured Poly/cotton Cotton polyester nylon polyester Fabric Weight osy 2.53 2.51 2.43 3.72 3.44 Yarns per Inch, epi 180 173 102 111 113 machine direction Yarns per Inch, ppi 110 107 104 79 84 cross-machine direction Avg. Elongation % 37.6 37.4 39.6 17.2 12.8 Air Permeability cfm/ft 2 10.7 9.2 30.5 39.5 39.4 Circular Bend N 0.7 0.6 0.3 0.9 0.7 Thermal Insulation Value Clo 0.49 0.50 n/a 0.53 0.55 Soil Release to Oily Stains 3.0 2.5 5.0 3.5 3.0 Kinetic Coefficient of 0.53 0.35 0.22 1.10 1.00 Friction (COF) Warp direction Kinetic COF - Fill 0.50 0.56 0.23 1.08 1.03 Avg.Surface Roughness p 1.4 1.1 1.5 3.7 2.3 Fabric Dryness after 1 hour % 100% 100% 100% 51% 52% 5 Table 4 [0079]While the physical properties of the fabric are significantly superior to conventional fabrics, the inventors, textile experts and medical experts were surprised by the dramatic clinical results obtained when the therapeutic fabric was tested in a clinical 10 study in a hospital on actual patients. In short, patients who used articles constructed of the present invention fabric were significantly less likely to develop pressure wounds, 24 WO 2011/008220 PCT/US2009/052285 and significantly less likely to be discharged with pressure wounds, versus patients who used standard hospital-issue articles. [0080]In the study, 307 patients in the Medical Renal Ward of a regional hospital were enrolled in the study. This patient population was selected because of their 5 affliction with multiple co-morbidities in addition to renal failure, and because they were at high risk for pressure wound development. The purpose of the study was to evaluate 1) the reduction in friction, shear, and pressure damage to the skin, and 2) the reduction in maceration and skin fold breakdown, where the bedding, including underpads, and patient gowns help protect moist skin folds caused by sweat and incontinence. Hospital 10 bedding, including underpads, and patient gowns made with the fabric invention (hereafter referred to as the "invention ensemble") were compared with the incumbent cotton-blend sheets, including underpads, and patient gowns used in the hospital (hereafter referred to as the "standard ensemble"). [0081 ]For the duration of the trial, all newly admitted patients received either the 15 invention ensemble or standard ensemble, depending on when they were admitted. Specifically, all patients admitted during the first eight weeks of the study used the standard ensemble, patients admitted during the second eight weeks received the invention ensemble, and patients admitted during the final seven weeks received the standard ensemble. The 307 test subjects were statistically similar with respect to 20 demographic factors such as weight, age, and co-morbidities. Their average length of stay was just over five days. Study data was analyzed used the t-test statistical method to determine whether two sample means were equal. Statistical significance was indicated when p < 0.05; that is, when there was a 95% chance or greater that the differences in the means were not due to chance. The key findings are given below. 25 WO 2011/008220 PCT/US2009/052285 e [0082]61.7% fewer wounds were developed using the invention ensemble, as compared with the standard ensemble. The results had a p-value of 0.0137, and were considered statistically significant. 5 * [0082]39.6% fewer wounds were found at patient discharge using the invention ensemble, as compared with the standard ensemble. The results had a p-value of 0.0315, and were considered statistically significant. * [0083]Normalizing the data to account for patients' length of stay in the renal ward, 56.8% fewer wounds per 1,000 patient days were developed using the invention 10 ensemble, as compared with the standard ensemble. The results had a p-value of 0.0137, and were considered statistically significant. e [0084]32.0% fewer wounds per 1,000 patient days were found at discharge using the invention ensemble, as compared with the standard ensemble. The results had a p value of 0.0315, and were considered statistically significant. 15 [0085]The foregoing results demonstrated that the inventors have successfully conceived and reduced to practice an effective therapy for the prevention and treatment of pressure wounds in healthcare settings. [0086]To prevent or treat skin wounds or disorders, a patient is provided one or more articles which are constructed of the fabric. Suitable articles include a bottom bed 20 sheet, top bed sheet, pillow case, underpad and/or patient gown. These articles are considered to be in "substantial skin contact" with the patient insofar as it is foreseeable that the skin of a bed-ridden patient will come in contact with the article within a 24 hour period in the hospital. The article or articles should be replaced when they become undesirably moist or soiled, or otherwise according to standard hospital procedures which 25 require, for example, complete bedding changes every 24 hours. [0087]Pressure wounds may also be prevented or cured by obtaining a bottom sheet, top sheet, pillow case, underpad, and/or patient gown marketed as a pressure wound preventative or curative, providing that article for use, and optionally providing 26 WO 2011/008220 PCT/US2009/052285 instructions or information. "Marketed" as used herein, refers to the written or electronic dissemination of information about the sheet, pillowcase, underpad or gown. [0088]The invention also covers a method of preventing and/or treating pressure wounds by obtaining an article marketed as a pressure wound preventative, employing 5 the article in connection with the care of a patient would subject to the development of pressure wounds under conventional therapies, and monitoring the patient for the development of pressure wounds. This article may be replaced when undesirably moist or soiled, may have an average geometric surface roughness of about 1.0 to 1.75 microns when dry, and/or may have a conductive yarn. 10 [0089]The invention also covers a method of preventing and treating pressure wounds by marketing at least one article as a pressure wound preventative and treatment, providing the article to the healthcare provider, and providing information to the healthcare provider on use of the article to prevent or treat pressure wounds. [0090]The invention also covers weaving a fabric, applying an antimicrobial to 15 the fabric, cutting and sewing the fabric to form an article, promoting the sale of the article as a pressure wound preventative or treatment, and providing the article to a health care provider. This article may include a conductive yarn. [0091 ]Certain modifications and improvements will occur to those skilled in the art upon a reading of the foregoing description. For example, the invention may be 20 carried out with weaves other than plain weaves or twill weaves. The weaves of the invention create a smooth flat surface, without any three-dimensional surface structures that might unduly abrade skin. Other weaves that could be substituted include satin, sateen, or duck weaves. It should be understood that all such modifications and improvements have been deleted herein for the sake of conciseness and readability but 25 are properly within the scope of the following claims. 27

Claims

1. A bed linen fabric comprising: a woven fabric having warp yams and filling yams woven to provide a smooth fabric surface; 5 one of the warp or filling yams being continuous filament nylon and making up at least 40% by weight of the fabric; the other of the warp or filling yams being continuous filament polyester having non-round filament cross sections or nylon having non-round filament cross sections and making up substantially all of the remainder of the weight of the 10 fabric.

2. The fabric according to Claim 1, wherein the warp yams are 100% nylon. 15

3. The fabric according to Claim 2, wherein the filling yams are 100% polyester.

4. The fabric according to Claim 1, wherein the filling yams are 100% nylon.

5. The fabric according to Claim 1, wherein the fabric is woven as a twill weave 20 or plain weave. 28 WO 2011/008220 PCT/US2009/052285

6. The fabric according to Claim 1, wherein the warp yam is a 70 denier, 48 filament, textured, continuous filament nylon yam.

7. The fabric according to Claim 1, wherein the filling yam is a 75 denier, 36 5 filament, continuous filament textured polyester.

8. The fabric according to Claim 1, wherein the continuous filament having non round fiber cross sections has a star shaped cross section. 10

9. The fabric according to Claim 1, wherein the continuous filament having non round fiber cross sections has a clover leaf cross section.

10. The fabric according to Claim 1, wherein the continuous filament having non-round fiber cross sections has a cross section such that adjacent filaments form 15 wicking channels.

11. The fabric according to Claim 1, further comprising a soil-release topical finish. 29 WO 2011/008220 PCT/US2009/052285

12. A bed linen fabric as claimed in Claim 1 wherein: the woven fabric is woven as a twill weave or plain weave; the warp yams are continuous filament 70 denier, 48 filament, textured nylon yam 5 nylon and making up at least 40% by weight of the fabric; the filling yams are up to about 60% by weight of the fabric of continuous filament 75 denier, 36 filament, textured polyester having non-round filament cross sections that are star shaped or clover leaf shaped and make up the remainder of the weight of the fabric 10

13. The fabric according to Claim 12, further comprising a soil-release topical finish.

14. A bed linen fabric as claimed in Claim 1 further comprising an antimicrobial 15 substance topically applied or inherently available in the fabric.

15. The fabric according to Claim 1, wherein the finished fabric has an elongation (per D5034-95) greater than about 30%. 20

16. The fabric according to Claim 1, wherein the fabric has an average Kawabata geometric roughness of less than about 1.7 microns. 30 WO 2011/008220 PCT/US2009/052285

17. The fabric according to Claim 1, wherein the fabric has a percent (%) dryness after 45 minutes of greater than 95%.

18. The fabric according to Claim 1, wherein the fabric has an antimicrobial 5 reduction of Escherichia coli, Staphylococcus aureus, and Staphylococcus epidermidis of at least 98.0% after 24-hour contact time (per AATCC 100).

19. A sheet for a bed cut and sewn of the fabric of Claim 1 comprising; a smooth fabric surface and sized to cover a bed and having hems to 10 prevent raveling of the woven fabric.

20. The sheet as claimed in Claim 19 wherein fabric has an average geometric surface roughness of about 1.0 to 1.75 microns when dry as measured by the Kawabata Evaluation System FB4 Surface Tester. 15

21. A pillow case cut and sewn from the fabric of Claim 1 to form a pocket to encase a pillow with an opening on one end to enable insertion of the pillow therein. 20 31 WO 2011/008220 PCT/US2009/052285

22. A therapeutic woven fabric for preventing and reducing skin wounds comprising the fabric of Claim 1 wherein a conductive yarn is woven into the fabric, the conductive yarn being in the warp or filling yarns and being from about 0% to about 2% 5 by weight of the fabric.

23. The fabric according to Claim 22, wherein the conductive yarn is carbon.

24. The fabric according to Claim 22, wherein the composite conductive yarn 10 is 25/3 carbon yarn plied with 70/68 textured polyester yarn.

25. A therapeutic woven fabric as claimed in Claim 22 for use in articles which contact the skin, wherein: the warp yarns and filling yarns are woven as a twill weave, the warp yarns are 15 continuous filament 70 denier, 48 filament, textured nylon yarn, the filling yarns are from about 0% to about 60% by weight of the fabric of continuous filament 75 denier, 36 filament, textured polyester having non-round filament cross sections that are star shaped or clover leaf shaped; a conductive yarn is integrated with the warp and filling yarns. 20

26. The fabric according to Claim 25, further comprising a soil-release topical finish.

27. A therapeutic woven fabric as claimed in Claim 22, wherein the fabric is 25 used for constructing bedding or garments.

28. The fabric according to Claim 27, wherein the fabric is finished to produce a fabric with an elongation (per D5034-95) greater than about 30%. 32 WO 2011/008220 PCT/US2009/052285

29. The fabric according to Claim 27, wherein the fabric has an average Kawabata geometric roughness of less than about 1.7 microns.

30. The fabric according to Claim 27, wherein the fabric has a percent (%) 5 dryness after 45 minutes of greater than 95%.

31. The fabric according to Claim 27, wherein the fabric has an antimicrobial reduction of Escherichia coli, Staphylococcus aureus, and Staphylococcus epidermidis of at least 98.0% after 24-hour contact time (per AATCC 100). 10

32. A method of preventing or treating pressure wounds in a patient comprising the acts of: obtaining at least one article marketed as a pressure wound preventative selected from the group consisting of bottom sheets, top sheets, pillow cases, underpads, 15 and patient gowns constructed of therapeutic woven fabric having warp yams and filling yams woven to provide a smooth fabric surface, with one of the warp or filling yams being at least 40% by weight of the fabric of continuous filament nylon, the other of the warp or filling yams being from about 0% to about 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections, and an 20 antimicrobial substance topically applied or inherently available in the fabric; employing the article in connection with the care of a patient who would be subject to the development of pressure wounds under conventional therapies; and monitoring the patient for development of pressure wounds. 25

33. The method of Claim 32 further including the act of replacing at least one article when it becomes undesirably moist or soiled. 33 WO 2011/008220 PCT/US2009/052285

34. The method of claim 32 wherein the fabric obtained in the act of obtaining has an average geometric surface roughness of about 1.0 to 1.75 microns when dry as measured by the Kawabata Evaluation System FB4 Surface Tester. 5

35. The method of claim 32 wherein the fabric obtained in the act of obtaining has a conductive yarn in the fabric.

36. A method of preventing or treating pressure wounds as claimed in Claim 32 further comprising the acts of: 10 weaving a fabric having warp yarns and filling yarns woven to provide a smooth fabric surface, with one of the warp or filling yarns being at least 40% by weight of the fabric of continuous filament nylon, the other of the warp or filling yarns being from about 0% to about 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections, 15 applying an antimicrobial substance to the woven fabric, cutting and sewing the woven fabric with antimicrobial substance to make an article selected from the group consisting of bottom sheets, top sheets, pillow cases, underpads, and patient gowns; promoting the sale of the article by indicating that use of the article prevents or 20 treats pressure wounds; providing the article to a health care provider for use by a patient.

37. A method as claimed in Claim 36 wherein weaving comprises the act of including conductive yarn in the fabric. 25

38. A patient gown or underpad comprising textile fabric woven of 100% continuous synthetic filament yarns, said fabric: finished to achieve antimicrobial efficacy of greater than 99% reduction of Staphylococcus aureus for 24-hours per AATCC Test Method 100; 34 WO 2011/008220 PCT/US2009/052285 finished to achieve antimicrobial efficacy of greater than 99% reduction of Enterococcusfaecalis for 24-hours per AATCC Test Method 100; having an average surface roughness of about 1.75 microns using the Kawabata Surface Roughness component; 5 having a moisture wicking rate of greater than 15mm/minute; and having a drying rate of greater than 1.0% per minute.

39. The patient gown according to Claim 38 wherein said fabric includes a conductive yarn at about 1% to about 2% by weight of fabric, said conductive yarn 10 capable of controlling static dissipation..

40. The patient gown according to Claim 38 wherein the filling yarns of said fabric are 100% polyester. 15

41. The patient gown according to Claim 38 wherein said fabric is 100% nylon.

42. The patient gown according to claim 38 wherein said fabric includes a durable stain-release finish. 20

43. A patient gown capable of preventing and reducing skin wounds comprising a garment to be wom by a patient made of a fabric using the fabric of Claim 22.

44. A method of preventing or treating pressure wounds as claimed in Claim 32, wherein: 25 the article obtained is a patient gown or underpad constructed of therapeutic fabric having a smooth finish and the gown is worn by a patient, whereby the patient gown is in substantial skin contact with the patient, and; replacing the patient gown when it becomes undesirably moist or soiled. 35 WO 2011/008220 PCT/US2009/052285

45. The method of Claim 44 wherein the act of providing a patient gown of therapeutic fabric with yams with non-round filament cross sections includes providing fabric of yams with filaments with a star shaped cross section. 5

46. The method of Claim 44 wherein the act of providing a patient gown of therapeutic fabric with yams with non-round filament cross sections includes providing fabric of yams with filaments with a cloverleaf shaped cross section.

47. The method of Claim 44 further comprising wicking moisture along channels 10 between filaments of the yam having non-round filament cross sections.

48. The method of Claim 44 wherein the act of providing a patient gown of therapeutic fabric includes the act of providing a gown made of fabric, the smoothness of which is quantified by the fabric having an average geometric surface roughness of about 15 1.0 to 1.75 microns when dry as measured by the Kawabata Evaluation System FB4 Surface Tester, between the therapeutic fabric and the patient's skin.

49. A method of making a patient gown or underpad comprising the acts of: obtaining a fabric having warp yams and filling yams which provide a smooth 20 fabric surface, with one of the warp or filling yams being at least 40% by weight of the fabric of continuous filament nylon, the other of the warp or filling yams being from about 0% to about 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections; cutting the fabric according to a pattern to form a blank; and 25 sewing the blank to form a patient gown or sewing the blank as an uppermost layer of an underpad. 36 WO 2011/008220 PCT/US2009/052285

50. The underpad according to Claim 38 wherein said fabric includes a conductive yam at about 1% to about 2% by weight of fabric, said conductive yarn capable of controlling static dissipation.. 5

51. The underpad according to Claim 38 wherein the filling yams of said fabric are 100% polyester.

52. The underpad according to Claim 38 wherein said fabric is 100% nylon. 10

53. The underpad according to Claim 78 wherein said fabric includes a durable stain-release finish.

54. The underpad according to Claim 38 including a top edge and bottom edge, said top edge less wide than said bottom edge. 15

55. An underpad for a bed capable of preventing and reducing skin wounds of a person lying on the underpad on the bed constructed of a fabric as claimed in Claim 22.

56. The underpad according to Claim 55 including a top edge and bottom edge, 20 said top edge less wide than said bottom edge.

57. The method of Claim 44 wherein the article is an underpad of therapeutic fabric woven of synthetic therapeutic fabric having warp yams and filling yams, with one of the warp or filling yams being at least 40% by weight of the fabric of continuous 25 filament nylon, the other of the warp or filling yams being from about 0% to about 60% by weight of the fabric of continuous filament polyester or nylon having non-round filament cross sections, a conductive yam, and an antimicrobial substance topically applied or inherently available in the fabric. 37 WO 2011/008220 PCT/US2009/052285

58. The method of Claim 57 wherein the act of providing an underpad of therapeutic fabric with yams with non-round filament cross sections includes providing fabric of yams with filaments with a star shaped cross section. 5

59. The method of Claim 57 wherein the act of providing an underpad of therapeutic fabric with yams with non-round filament cross sections includes providing fabric of yams with filaments with a cloverleaf shaped cross section.

60. The method of Claim 57 further comprising wicking moisture along channels 10 between filaments of the yam having non-round filament cross sections.

61. The method of Claim 57 wherein the act of providing an underpad of therapeutic fabric includes the act of providing a underpad made of fabric, the smoothness of which is quantified by the fabric having an average geometric surface 15 roughness of about 1.0 to 1.75 microns when dry as measured by the Kawabata Evaluation System FB4 Surface Tester, between the therapeutic fabric and the patient's skin.

62. The method of Claim 57 wherein the act of providing an underpad of 20 therapeutic fabric includes the act of providing an underpad including a top edge and a bottom edge, said top edge less wide than said bottom edge. 38