Involving users in the design process of new products and services is generally disputed as a prerequisite for fulfilling users' needs and requirements. The importance of user involvement has been argued also regarding the development of new medical technology. Collaboration between users and developers/designers is however not without problems due to differences in, e.g. background, training, perspective, and vocabulary. In order to address these differences, the need for different 'mediating tools' has been emphasized. One type of mediating tools is product representations (PRs). Earlier studies have most often focused on the type of PR that should be used in different phases of the development process in order to get input on different designs. This paper describes instead how and in what situations different PRs mediated communication and collaboration between professional users (medical experts) and designers in an innovation project targeting a solution for long-term monitoring of brain activity based on electroencephalographic (EEG) signals.

BACKGROUNDStudies in product development argue the importance of user involvement when designing products. Benefits include targeting relevant problems, finding usable and innovative solutions, and elicit user needs and expectations that may prove critical when introducing the new product.

However, some difficulties have been identified. These are mainly related to differences between the users and developers in terms of skills, experiences, terminology, goals and perspectives and that the users tend to neglect the value of their input. Typically users are also included too late in the process to have any real opportunities to alter the final product.

The aim of this study was to explore how early inclusion of user competence might influence the development of a novel concept for detection of traumatic injuries in emergency care.

METHODSAmbulance nurses representing car and helicopter ambulance were invited to three consecutive workshops to co-design key products of the new concept together with development personnel from the company behind the new concept and design researchers/engineers. The workshops were held in the ideation, concept generation, and development stages of the project. Each workshop was prepared by the researchers to enable and stimulate interaction within the group by applying design practices and provide mock-ups/illustrations. 

RESULTS Preliminary results from interviews tell that the company representatives report more detailed knowledge about the ambulance personnel’s needs earlier in the process compared to previous projects, and that this knowledge contributed to products with higher usability.

The ambulance personnel were positive and pleased to contribute their knowledge. One response was “it is very interesting to contribute to the development of a future product”.

CONCLUSIONSThe tested co-design process facilitated the ambulance nurses to contribute their knowledge so that needs and requirements was understood and integrated by the engineers in the design of the new concept for emergency care.

INTRODUCTION

Effective ulcer management requires the wound to be in a moist but still breathable environment, to facilitate healing, absorb exudates and prevent maceration. One of the applicable methods to achieve this is the use of composite dressings. Most composite dressings are made of three layers to provide absorption and a bacterial barrier in a non- or semi-adherent cover. Various common textile materials such as cotton, polyester, polypropylene and cellulose can be used as different layers in those wound dressings. In addition to these established dressings, electrical stimulation therapy may be used in treating ulcers. It has been reported that electrical stimulation can reduce the area and depth of the wound in a shortened time compared to conventional treatment. In summary, encouraging wound healing results have been obtained both from using composite wound dressing and from applying of electrical stimulation. The aim of this study is to present a conceptual design based on a woven 3D structure that combines the composite wound dressing properties with electrical stimulation for pressure ulcers healing/management.

METHOD

In the suggested structure, different layers in X, Y and Z led were designed with different materials for different purposes.  The top layer consisting of a low-density web to provide a non-adherent layer combined with two textile electrodes made of conductive threads, the middle layer contributes pressure release and absorption of exudates, and the bottom layer next to the wound for moisture keeping while still allowing adequate ventilation.

Two key properties were addressed in the study: pressure release and the possibility to provide electrical stimulation of the wound. Simulation with COMSOL Multiphysics was used to study pressure distribution according to Hertz contact theory. The surface resistance of the electrodes were also studied using in-house designed four-point measurement probes.

RESULTS

The simulation results show the composite structure to exhibit good pressure release properties. Surface resistance testing proved that the textile electrodes have resistance in the magnitude of 10² indicating that textile electrodes can be used for electrical stimulation in ulcers healing.

The first results from this study demonstrate the feasibility to design a textile system combining established composite dressings solutions with means for electrical stimulation based on 3D weaving technique to be applied in pressure ulcer healing. 

Smart textiles are textiles based on different types of smart materials that can sense or react on environmental stimuli. This new technology is a growing area which exhibits characteristics particularly suitable for capturing (electro) physiological signals, e.g. to monitor ECG, EEG or respiration. These textiles most often form a three dimensional structure where different materials with different characteristics are bound together in different layers. However, in order to take full advantage of these new opportunities the textile industry needs to find new methods to develop innovative smart textile products. One strong and valuable contribution is to involve users early in the development process.

The aim of this paper is to highlight how product representations, e.g. prototypes or material samples, can be used to facilitate the communication between users and developers in the development of new healthcare solutions based on textiles. The study presented in this paper was performed through participatory observation. The case is based on the development of a textile structure with three dimensional properties for long-term monitoring of EEG signals.   

The main findings are that product representations support the exchange of knowledge and experiences between users and developers by five different facilitating roles:

Product representations serve to demonstrate (technical) solutions; to verbalise, i.e. serve to fill in were words are missing or when terms are not understood; to visualise, i.e. facilitating members of the development team to envision or adapt mental images of the intended future product; to stimulate, i.e. to inspire the development team to suggest new ideas or design; and, finally, to integrate, i.e. to unite different perspectives within the development team.

Conclusion: By using product representations during the development process to facilitate the dialogue between users and developers, the textile industry may take full advantage of the opportunities made available by new development of materials and new technology in order to fulfil users’ needs.

The number of 3D textile applications in medicine is rapidly increasing as new technology and procedures are introduced in health care.  A first estimate of current medical applications of both general and 3D textiles is presented based on the medical devices classification system established by the US Food and Drug Administration. The textile specifics for these applications are covered from a textile technique perspective where the different 3D weaving as well as knitting, braiding and non-woven techniques are described and how their properties they can contribute in medical applications. In addition, emerging opportunities based on smart textiles as part of textile systems are described on a general level. The strong application areas of 3D medical textiles, i.e. wound management, vascular grafting and scaffolding for tissue engineering are covered in detail both from the medical and textiles perspective. Finally, some future lines of development are suggested and a short discussion on how new 3D textiles applications can be developed in close cooperation between the textile industry and the health care sector is presented.

Textile-based electrodes show great potential as substitution of conventional electrodes when long-time monitoring is required. The flexibility and high skin-electrode contacting area make it possible to avoid the use of contact gel, which may cause irritation to the patients' skin. In this study, textile-based electrodes were made by combining conductive materials with high absorption nature fibres with the intention to create and maintain a microenvironment that improve the contact between the skin and electrode by local sweating at the electrode site. Alternatively artificial sweat (i.e. saline) may be added for a similar effect. However, by adding nature fibres into the electrodes, the electrical properties of the electrodes are modified due to the ration of conductive yarns is decreased. In this paper, the surface resistivity in the warp and weft directions and its distribution were measured in a four-wire resistance mode. The resistivity of the conductive yarns, the type of nature fibres, the textile construction and the fabric pick density were selected as the independent variables and the surface resistivity in warp and weft measurement directions was the dependent variable to be analysed. Preliminary results show that the conductivity of the conductive yarns are more important than the fabric pick density; surface resistance were not measurable in warp direction of most plain weave fabrics since the conductive yarns were only involved in the weft direction, however, the resistance were measureable in the case of satin fabrics; and that the surface resistivity is more evenly distributed in weft direction than the warp direction