focuses on developing multifunctional textiles that enhance safety, therapeutic performance, and environmental

sustainability while minimizing cross-infection risks in healthcare settings. In this context, the incorporation of

herbal bioactives has gained attention due to their inherent antimicrobial, anti-inflammatory, antioxidant, and

wound-healing properties. Extracts derived from medicinal plants such as Azadirachta indica (neem), Aloe

vera, Curcuma longa (turmeric), and Ocimum sanctum (tulsi) offer natural, biocompatible, and biodegradable

alternatives to conventional synthetic finishes used in medical textiles. The intention of this review article is to

critically examine recent developments in medical textiles, with a specific emphasis on the medical

classification, requirements, and performance of healthcare textiles. It covers various techniques involved in

the finishing of fabrics with herbal extracts, such as coating, grafting, microencapsulation, sol-gel processing,

and nanotechnology-assisted delivery systems. This review presents future opportunities for herbal-

wound dressings, surgical apparel, sutures, implants, hygiene products, and tissue scaffolds. These materials

are required to satisfy stringent criteria related to biocompatibility, sterility, mechanical integrity, comfort, and

durability under clinical use (El-Ghazali & Sofia). The sector has expanded steadily, driven by increased

demand for hygiene products, rising surgical interventions, and heightened infection-control requirements,

with nonwoven textiles dominating due to their cost efficiency, disposability, and superior barrier performance

(Precedence Research, 2025).

The global medical textiles market is growing at a robust rate, valued at USD 26.17 billion in 2025 and

expected to reach USD 38.71 billion by 2034, with a compound annual growth rate of 4.45%. The major

reason behind this major surge in the medical textiles market is the growing need for hygiene products,

increased surgical procedures, awareness regarding infection control in medical institutions, along with the

derived bioactive compounds, including polyphenols, terpenoids, and polysaccharides from medicinal plants

such as Azadirachta indica, Aloe vera, Curcuma longa, and Ocimum sanctum, have emerged as candidates for

imparting bioactivity to textile substrates (Ahmed et al., 2025; Anand et al., 2022; Popescu & Ungureanu,

2023).

Recent advances in textile processing—such as microencapsulation, electrospinning, sol–gel coating, and

surface grafting—have enabled improved incorporation, stabilization, and controlled release of these

bioactives (Sharma et al., 2021; Salehi et al., 2024). From a materials perspective, the performance of herbal-

functionalized medical textiles is governed primarily by incorporation strategy, interfacial stability, and

durability rather than intrinsic bioactivity alone. This review critically evaluates these material-level

considerations, highlighting current limitations and research directions for the development of reliable and

interaction with the human body. Medical textiles can be categorized into non-implantable, implantable,

extracorporeal, and healthcare & hygiene textiles, depending on their end-use product and interaction with the

human body (Anandjiwala, 2006).

Figure 3- Types of Medical Textile Non-implantable devices

Non-implantable medical textiles are designed for external use and may come into temporary contact with

intact or wounded skin. Typical examples include wound dressings, bandages, medical gauze, compression

textiles, sanitary napkins, and baby diapers. These materials must exhibit high absorbency, breathability,

antimicrobial performance, and skin compatibility, particularly in wound-contact applications (Saha et al.,

2022).

The incorporation of herbal bioactive into non-implantable medical textiles has been investigated as a strategy

dressings, surgical gowns and masks, and protective textiles such as gloves. Wound dressings typically employ

hydrogel coatings, fibre embedding, or encapsulation techniques to achieve sustained release of herbal

bioactives, with aloe vera and turmeric frequently used to support wound healing and antimicrobial protection

(Chelu et al., 2023; Salehi et al., 2024). Surgical gowns and face masks require surface antimicrobial

functionality without compromising breathability or mechanical integrity; accordingly, chemical grafting or

surface coating with neem, turmeric, or green tea extracts has been explored (Wylie & Merrell, 2022;

Schneider et al., 2023). Protective textiles such as gloves generally incorporate herbal agents through grafting

or encapsulation to maintain flexibility and user comfort.

The successful integration of herbal bioactives into non-implantable medical textiles depends on several

material-level considerations. These include extraction efficiency and stability of bioactive compounds,

and soothing effects in wound dressings (Chelu et al., 2023). Neem leaf extracts and oils exhibit broad-

spectrum antimicrobial activity and are commonly applied as coatings on bandages and dressings (Wylie &

Merrell, 2022). Curcumin from Curcuma longa, incorporated either directly or via nano-encapsulation, offers

antioxidant and anti-inflammatory activity with demonstrated wound-healing potential (Salehi et al., 2024).

Chamomile extracts are used for their mild antimicrobial and soothing properties in sensitive skin applications

(El Mihyaoui et al., 2022), while green tea polyphenols contribute antioxidant and antimicrobial effects in

hygiene textiles (Schneider et al., 2023). Other botanicals, including pomegranate peel extracts, Moringa

oleifera, and tea tree oil, have also been explored for antimicrobial functionality using coating, encapsulation,

and composite approaches (Paczkowska-Walendowska et al., 2024; Gheorghita et al., 2023; Zhou et al., 2024).

When integrating herbal bioactives into non-implantable medical textiles, several key material and

performance considerations must be addressed. Bioactive extraction methods should preserve compound

efficacy and ensure stability during textile processing and storage. The selected incorporation approach must

enable controlled and sustained release to maintain therapeutic functionality over the intended use period.

Safety and biocompatibility are critical, requiring that both the bioactives and their delivery do not induce

toxicity or adverse skin reactions. Herbal treatments should provide sufficient antimicrobial effectiveness

fabricated from biodegradable or bioresorbable polymers (Liu et al., 2023). Owing to continuous exposure to

physiological environments, these materials must satisfy stringent requirements related to sterility, cytotoxicity,

hemocompatibility, inflammatory response, and long-term stability (Zhou et al., 2024).

Growing interest has emerged in the use of herbal and plant-derived bioactive compounds in implantable

textile systems to impart multifunctionality. Phytochemicals such as curcumin, polyphenols, and natural resins

exhibit antibacterial, antioxidant, and anti-inflammatory activity and have been investigated for reducing

implantassociated infections and modulating host responses (Zhou et al., 2024). Compared with conventional

antibiotics, these bioactives demonstrate broad-spectrum antimicrobial effects and are suggested to present a

lower propensity for resistance development, although supporting clinical evidence remains limited (Sun et al.,

2025).

herbal bioactives, including green tea polyphenols (EGCG) and Centella asiatica extracts, have also been

explored for localized and controlled bioactivity at the implant–tissue interface (Xu et al., 2021; Chen et al.,

2024).

Despite promising laboratory-scale results, the clinical translation of herbal-functionalized implantable medical

textiles remains challenging. Stringent regulatory requirements, long-term biocompatibility assessment,

sterilization stability, and reproducibility continue to limit advancement beyond proof-of-concept studies (Zhou

et al., 2024). Nevertheless, existing evidence suggests that, when carefully integrated into implantable textile

systems, herbal bioactives may contribute to next-generation implants with improved resistance to infection

and support for tissue regeneration.

Silk is widely used as a natural biomaterial for surgical sutures due to its high tensile strength, elasticity, knot

security, and favorable handling characteristics. Silk fibroin also supports cell adhesion and proliferation,

making silk sutures suitable for wound closure applications requiring tissue integration (Altman et al., 2003).

are typically applied as surface coatings or immobilized using biopolymer matrices, forming protective

interfaces that inhibit microbial colonization without compromising the mechanical integrity or

biocompatibility of the sutures.

Biodegradable polymers, particularly chitosan and alginate, are commonly employed as binder matrices for

herbal coatings. Chitosan provides intrinsic antimicrobial activity, improves coating adhesion, and enables

controlled release of herbal constituents at the wound site. Chitosan–herbal composite coatings on silk sutures

have been reported to reduce bacterial load, enhance wound healing, and elicit minimal inflammatory

responses compared with uncoated or conventionally treated sutures (Tummalapalli et al., 2016). Overall,

herbalfunctionalized silk sutures represent a promising approach toward developing multifunctional and

potentially more sustainable surgical sutures, although further evaluation of long-term performance and

multicomponent nature of herbal extracts may further reduce reliance on single-agent antimicrobials,

potentially lowering the risk of resistance development.

devices (Sun et al., 2025).

Microencapsulation is widely applied to protect sensitive or volatile compounds, enabling controlled and

sustained release while enhancing stability during textile processing and storage. This approach is particularly

effective for essential oils such as tea tree oil and neem oil when microcapsules are integrated into nonwoven

or surface-bound textile systems (Sharma et al., 2021).

dressings incorporating compounds such as curcumin, pomegranate extracts, EGCG, and propolis (Salehi et al.,

2024).

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