In vitro cytotoxicity of silver-impregnated collagen cuffs designed to decrease infection in tunneled catheters.

Abstract

PURPOSE: To examine in vitro the effects of silver-impregnated collagen cuff material from central venous catheters on human fibroblast growth. MATERIALS AND METHODS: In culture flasks, hybrid cells were exposed to silver-impregnated collagen cuff material, and human fibroblasts were exposed to silver-impregnated or silver-free collagen cuff material. After 72 hours of growth, cells were stained and digitally imaged, and the relative areas of cytotoxicity were determined. RESULTS: Flasks containing the silver-impregnated collagen cuff material and hybrid cells or human fibroblasts showed a marked local cytotoxic effect of the cuff material; cell-free zones surrounding the cuff material were demonstrated. No cytotoxic effect was seen in the flasks that contained silver-free cuff material (control group). Mean area of cleared cells was 312 mm2 +/- 130 (range, 156-624 mm2) in the flasks containing human fibroblasts and silver-impregnated cuff material and 0 mm2 in the corresponding control flasks (P < .0001). Mean radius of the area of cleared cells around the silver-impregnated cuff material in the flasks containing human fibroblasts was 9.8 mm +/- 2.0 (range, 7.0-14.1 mm). CONCLUSION: Silver-impregnated collagen cuff material demonstrates a local cytotoxicity on hybrid cells and human fibroblasts in vitro. This finding may explain the phenomena seen clinically of decreased anchorage and inadvertent removal of catheters with silver-impregnated collagen cuffs.