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PubMedDate not supplied

Cuff Cath: an initial experience of cuffed polyurethane central venous catheters in children.

The tendency of medium- and long-term silicone central venous catheters (CVCs) to block, fracture, and become displaced has led to the evaluation of a polyurethane CVC, Cuff Cath (Viggo Spectramed, Swindon, Wilts, United Kingdom) as a possible alternative because polyurethane is smoother and stronger. We report the first prospective study of polyurethane cuffed CVCs in children. Sixty Cuff Caths were placed in 53 children, mean age 4.7 years (range, 4 days to 16.3 years), mean weight 15.6 kg (range, 3.1 to 58 kg). All CVCs were tunnelled (mean tunnel length, 12 cm; range, 5 to 20 cm) and inserted either into the subclavian vein (n = 28) or internal jugular vein (n = 32). In a total of 6363 catheter days (mean, 111 days per patient; range, 15 to 364 days), three (5%) CVCs had to be removed because of sepsis and one (2%) because of blockage. All other Cuff Caths remained patent to infusion and blood sampling. No Cuff Caths were pulled or fell out, fractured, or migrated. This study demonstrates significant advantages of polyurethane compared with previous series using silicone CVCs with respect to blockage, fragmentation, and dislodgement. A prospective, randomized, controlled trial of Cuff Cath compared with a silicone CVCs in children is required.

Adolescent↗

PubMed1987

Antithrombogenic heparin-bound polyurethanes.

Many kinds of heparin-bound polyurethanes have been developed. Polyurethanes are a family of elastomers displaying better blood-compatibility than other polymeric materials. It is useful to modify this material by heparinization. Several approaches to heparinization have been devised: 1) a general method of heparinization, applicable to all polymeric materials, 2) a heparinization method specific to polyurethanes, and 3) the design of heparinizable polyurethane derivatives. These three approaches are first explained in detail. Then, the antithrombogenic mechanism of the heparinized polymers is discussed. Finally, the interactions of the heparinized polymers with blood coagulation factors, plasma proteins, and platelets are discussed.

Biocompatible Materials↗

PubMed2003

In-vitro and in-vivo antibacterial activity evaluation of a polyurethane matrix.

Various in-vitro and in-vivo methods for evaluation of the duration of antibacterial activity were compared using a controlled-release polyurethane matrix developed for the prevention of surface bacterial adhesion and growth. Cefadroxil was incorporated into this polyurethane matrix by a solvent casting method before the matrix was coated with polyurethane in tetrahydrofuran solution. The release of cefadroxil from the matrix into distilled water at 37 degrees C was measured by HPLC. The morphological change of matrices before and after release studies was investigated by scanning electron microscopy (SEM). The duration of antimicrobial activity of the matrix against Escherichia coli and Staphylococcus aureus was evaluated by measuring the diameters of the inhibition zone and the optical density of the broth. The matrices were also implanted subcutaneously in rats and the duration of the antibacterial activity was determined by measuring the inhibition zone. The results showed that duration of antibacterial activity of the polyurethane matrix was successfully determined in-vitro by these methods, and the results differed from the conventional in-vitro release study. It was also possible to determine the duration of action of the matrix in-vivo by implanting the matrix in rats, and then measuring the antibacterial activity of the matrix at predetermined time intervals. While a good correlation was observed between the in-vitro and in-vivo methods used in this study to evaluate the duration of the antibacterial activity of the polymeric matrix, the conventional in-vitro release study did not coincide with these results.

Animals↗

PubMedDate not supplied

Evaluation of an aliphatic polyurethane as a microsphere matrix for sustained theophylline delivery.

In spite of several biomedical applications of polyurethanes, very little attention has been focused on these polymers for controlled drug delivery. In this study, an aliphatic polyurethane, Tecoflex, was evaluated as a microsphere matrix for the controlled release of theophylline. Polyurethane microspheres containing theophylline were prepared using a solvent evaporation technique from a dichloromethane solution of the polymer containing the drug. A dilute solution of poly(vinyl alcohol) served as the dispersion medium. Microspheres of good spherical geometry having theophylline content of 35% could be prepared by the technique. The release of the drug from the microspheres was examined in simulated gastric and intestinal fluids at 37 degrees C. While a large burst effect was observed in gastric fluid, in the intestinal fluid a close to zero-order release was seen. Attempts were made to modulate the release by incorporating poly(ethylene glycol) in the matrix and also coating the spheres with paraffin wax. Preliminary data indicate that polyurethanes could be interesting matrices for controlled drug delivery.

Chemistry, Pharmaceutical↗

PubMed2005

Clinicopathologic findings after nasolacrimal polyurethane stent implantations.

PURPOSE: To evaluate the results of nasolacrimal polyurethane stent implantations for the treatment of primary acquired nasolacrimal duct obstruction, and to determine the effects of various surgical procedures, including stent removal, in subsequent nasolacrimal duct obstruction. METHODS: This study included 15 patients who had nasolacrimal polyurethane implantations for the treatment of primary acquired nasolacrimal duct obstruction. Occluded stents were removed either by nasal endoscopy or during dacryocystorhinostomy (DCR). Cultures and biopsies were performed on the removed stents, and the results of the secondary DCR were analyzed for a 6-month follow-up period. RESULTS: During stent removal surgery, various degrees of chronic inflammatory reaction and fibrous tissue formation were detected in the lacrimal sac and nasolacrimal duct. Formations of granuloma and fibrous tissue were found in 15 eyes, and culture-positive reaction were found in nine of the 15 eyes. Conventional dacryocystorhinostomy surgery was performed in nine of the 15 eyes and a silicone tube was located at the canaliculi. Subjective and objective outcome were favorable in 13 of the 15 eyes. CONCLUSIONS: The success rate of nasolacrimal polyurethane stent implantation for the treatment of primary acquired nasolacrimal duct obstruction is low. This may result from a chronic inflammatory reaction. Despite the low success rate of nasolacrimal polyurethane stent implantation, the success rate of endonasal DCR as a subsequent surgery is favorable.

Adult↗

PubMed1992

Biostable polyurethane elastomers.

The generic term polyurethane represents the most versatile family of synthetic polymers. The unsurpassed physical and chemical properties of polyurethanes, coupled with their biocompatibility, have led to their use in a wide range of biomedical applications. Although polyurethanes have been shown to be stable in vitro for many years, they can undergo rapid microcracking when implanted. These microcracks not only weaken the polymer but also serve as nucleation sites for thrombus formation and lead to catastrophic failure. In this article, the authors report on the development and testing of a new ether-free polyurethane that does not exhibit surface microcracking under accelerated in vivo condition.

Animals↗

PubMedDate not supplied

Exit-site care with ciprofloxacin otologic solution prevents polyurethane catheter infection in peritoneal dialysis patients.

OBJECTIVE: Mupirocin ointment and antiseptics are standard cleansing agents in routine exit-site care of peritoneal dialysis (PD) catheters, but these agents have a deleterious effect on polyurethane devices. We assessed the effectiveness of topical use of ciprofloxacin otologic solution for preventing exit-site infection (ESI) in PD patients with polyurethane catheters. DESIGN: Prospective study. SETTING: Service of Nephrology of an acute-care teaching hospital in Galdácano, Bizkaia, Spain. PATIENTS: A total of 164 patients with polyurethane catheters inserted was studied from start of continuous ambulatory PD to the end of a 24-month period. Patients were divided into two groups according to exit-site treatment protocols. INTERVENTION: Patients in group 1 (n = 86) were instructed on daily exit-site care with soap and water only; whereas patients in group 2 (n = 78) cleansed with soap and water, followed by application of a single-dose vial of 0.5 mL ciprofloxacin (1 mg) for application around the insertion site. MAIN OUTCOME MEASURES: Episodes of ESI and peritonitis. RESULTS: There were 67 episodes of ESI among patients in group 1 versus 9 episodes among patients in group 2 (p < 0.05), resulting in a rate of 0.41 and 0.06 episodes per patient-year of exposure, respectively (p < 0.001). Staphylococcus aureus ESI rate was 0.34 in group 1 versus 0.06 in group 2 (p = 0.001). Infections caused by Pseudomonas aeruginosa and other pathogens occurred in 11 patients in group 1 and in no patients in group 2 (p = 0.05). Peritonitis due to S. aureus ESI was significantly less frequent among patients treated with ciprofloxacin (1 vs 9 cases, p = 0.001). Removal of the catheter was necessary in 5 patients in group 1 and in no patients in group 2 (p < 0.05). CONCLUSION: Daily application of ciprofloxacin otologic solution at the exit site of PD patients with polyurethane catheters inserted significantly reduces the rate of ESI caused by S. aureus and other organisms, particularly P. aeruginosa.

Anti-Infective Agents↗

PubMed2002

[The advance of research for biocompatibility of medical polyurethanes].

Polyurethanes are popularly used in cardiovascular and other biomedical fields due to their good biocompatibility as well as mechanical properties. But they are subject to biodegradation in vivo for a long time, and cause inflammation, so improving the biocompatibility of medical polyurethanes is an important subject of biomaterials. Recent researches have focused on biological modelling of biomaterials for improving the biocompatibility of polyurethanes. This paper reviews two main methods for improving biocompatibility of polyurethanes-endothelial cells seeding and mimic biomembrane (phospholipid surface), and summarizes the main procedures and questions of these two methods.

Biocompatible Materials↗

PubMed2005

[Intraperitoneal placement of composite implants--polyester mesh coated with polyurethane in experimental study].

INTRODUCTION: Polyester and polypropylene are currently the most frequently materials for repair of abdominal wall hernias. Most of the mesh materials used intraperitoneally in repair of hernias lead to considerable adhesion formation, as well as the resultant bowel obstruction and intestinal fistula formation. Some newer composite products can reduce risk of adhesion formation. The aim of this experimental study is testing properties of patch, composite structure, characterised by the association of a non-woven textile structure made from polyester multifilaments, and a fine coat of polyurethane on one side, placed intraperitoneally in rat. MATERIALS AND METHODS: The experiment was carried out with 21 laboratory rats. Laboratory animals were divided into 3 groups - 7 animals in a group. In the first group the check-up laparotomy was realized the 7th day, in the second group the 14th day and in the third group the 28th day after the intraperitoneal implantation of a composite mesh. All animals were sacrificed and adhesion scoring and histological evaluation of tissue specimens with implanted mesh were done. RESULTS: A macroporous polyester mesh component supported an early and huge fibrous proliferation with a good adhesion onto the abdomen wall. On the other hand, a microporous polyurethane layer led to the creation of a fibrous pocket. During the check-up laparotomy, the larger adhesion of omentum to the fibrous layer, covering the polyurethane side of implanted mesh, were located in most laboratory rats - in all the groups. CONCLUSION: We can presume that the protective polyurethane layer does not eliminate risk of adhesion formation in rat.

Animals↗

PubMedDate not supplied

Applications and complications of polyurethane stenting in urology.

BACKGROUND: As surgeons working in a developing country, we decided to review our experience with polyurethane stents instead of the more expensive ones on common urological procedures and analyzing our experience with respect to their usefulness versus their problems and outcome. METHODS: This stusy was carried out at Armed Forces Institute of Urology, Rawalpindi and Combined Military Hospital, Kharian Cantonment, Pakistan through March 2002 through May 2004. During this period 342 of patients were operated requiring stent and 220 patients out of these had polyurethane as stent material for different urological operations. RESULTS: Among the 220 patients who underwent polyurethane stenting, early complications included fever, infection, voiding symptoms while stent migration, encrustation and stent stiffness was encountered as later complications. CONCLUSION: The benefits of Polyurethane stents are its strength, versatility and low cost. Poor biodurability and biocompatibility only limit its use; these are reasonably effective in our setup but should only be used for short duration.

Biocompatible Materials↗

PubMed1991

Detection of toluenediamines in the urine of a patient with polyurethane-covered breast implants.

Breast prostheses are implanted for augmentation or during reconstructive surgery. One of the more commonly used prostheses is the polyurethane-sponge-covered silicone gel implant. Some clinicians are concerned about the safety of this product because the polyurethane foam disintegrates in vivo, and its subsequent fate is not known. Polyurethane is a polymer formed by reacting diisocyanates and polyols. This study indicates that the polymer sponge breaks down into its reactive monomers, 2,4- and 2,6-toluenediisocyanate, which are converted into their corresponding diamines. We present evidence of the excretion of the diamine metabolites in the urine of a patient implanted with polyurethane-covered prostheses.

Adult↗

PubMed1991

Heparinized polyurethane surface through ionic bonding of heparin.

Surface heparinization through an ionic bond is one of the methods used to improve polyurethane blood compatibility. Chains of poly(amido-amine), a tertiary aminic polymer capable of forming stable complexes with heparin, were either surface-grafted on polyurethane or interconnected with polyurethane chains using hexamethylenediisocyanate as cross-linking agent. In the latter case, a new material (PUPA) is formed with a heparin adsorbing capacity higher than poly (amido-amine) surface-grafted polyurethane. By changing the percentages of the components, different series of PUPA materials can be obtained with different physico-chemical properties. The ATR/FT-IR technique was used to characterize the new materials in the native and in the heparinized state. PUPA solution was used to coat commercial biomedical devices and they were also characterized physicochemically using ATR/FT-IR.

Animals↗

PubMed1989

[Experimental pancreatic duct occlusion with polyurethane].

Pancreatic transplantation requires an effective method to manage exocrine secretion. A new technique to eliminate the exocrine function of the pancreas by obstruction of the duct with polyurethane was investigated in terms of function, outcome and morphology. Polyurethane is an alcoholic solution of block copolymers with the property of polymerizing within 5-10 min. In this study the in-situ pancreatic tail model in dogs was utilized, the pancreatic duct was cannulated and injected with 2-3 ml of polyurethane. As a result, complete atrophy and fibrosclerosis of the exocrine tissue was obtained leaving islets well vascularized and functioning for the entire experimental periods. All animals remained normoglycemic and showed normal K-values. Amylase levels were found to be maximally elevated at 24 h and returned to normal within 2 weeks after duct occlusion. Insulin, glucagon and somatostatin levels remained normal. Because of its ability to effect a complete occlusion of the pancreatic ducts with subsequent atrophy of the exocrine gland and without notable disturbance of endocrine function, we feel that polyurethane solution is superior to previously used materials for this purpose.

Animals↗

PubMed1988

Polyurethane implants: a 6-year review of 416 patients.

The author reviews 6 years of experience and 416 patients in whom polyurethane implants were used for augmentation and reconstruction of the breast. As with many other plastic surgeons, early use was confined to "salvage cases." Owing to the impressive results, use was extended to routine augmentation. Polyurethane implants are now used exclusively for aesthetic breast surgery. Results are evaluated for replacement of gel capsules and simple and radical mastectomy reconstruction. Gel capsules (Baker stages III to IV), in which prostheses were removed and replaced with polyurethane-covered implants, improved in 29 of 32 patients (87 percent). For reconstruction, placement of polyurethane implants in unscarred situations gives far superior results than following repeated procedures. The incidence of infection is no higher than with gel implants. Removal without capsulectomy was not a problem in most instances. However, on two recent occasions capsulectomy was extremely difficult.

Breast↗

PubMedDate not supplied

[Enzymic splitting of polyurethanes containing dipeptide links in the main polymeric chain].

The paper deals with the proteolytic enzyme induced destruction of new types of segmented polyurethanes, the main chain of which contains dipeptides links: L-phenylalanyl-L-serine and glycyl-glycine. It is established that the chymotrypsin treatment decreases essentially the molecular mass of polyurethane containing the Phe--Ser links and does not affect the molecular mass of polyurethane with Gly--Gly links. Trypsin has no effect on the both types of polymers. Specificity of the chymotrypsin effect on the polymers is confirmed by the data of IR-spectroscopy. Destruction of the both types of segmented polyurethanes, mainly of the dipeptide fragments, is observed when the polymers are implanted into the animal organism.

Chymotrypsin↗

PubMed1994

The effects of soft segment structure on the fatigue crack propagation of model polyurethanes.

The present work is a study of the effects of soft segment molecular weight and chemical structure on the fatigue crack propagation of model copoly (ether-urethane-urea)s (PEUU). The PEUU were synthesized using polypropylene glycol (PPG), polytetramethylene glycol (PTMG), and polyethylene glycol (PEG) as the soft segment component. The number average molecular weights of the polyethers were within the range of 1000-2000. Methylene bis (4-phenylisocyanate) (MDI) and ethylene diamine were used as the diisocyanate and the chain extender, respectively. The cyclic loading experiments were carried out using a computerized film stretcher that can conduct sinusoidal operation at a constant strain amplitude, strain rate, and frequency. The Rivlin-Thomas tearing energy, T, and the fatigue crack propagation (FCP) rate were selected to characterize the fatigue behavior of the model polyurethanes. An empirical equation was applied to define the fatigue properties of model polyurethanes and to evaluate the fatigue resistance. To investigate the effect of molecular variables on the FCP, the morphological changes caused by structural differences and cyclic stress were determined using dynamic viscoelastometer (Rheovibron), Small Angle X-ray Scattering (SAXS), and Fourier-Transform Infrared (FT-IR) spectroscopy. Mooney-Rivlin plot was used to determine the crosslink density variation. In addition the orientation behavior at the crack tip was characterized by IR dichroism technique using a polarized FT-IR microscope. The results indicated a reasonable relationship between the FCP rates and the hard segment content, crosslink density, and deformation property at the crack tip. However, the initial stage of phase separation and domain disruption behavior did not show a good correlation with the FCP properties of model polyurethanes. Among the model polyurethanes tested, the PEUU with PTMG (Mn = 1000) exhibited the best fatigue resistance at given test condition.

Biocompatible Materials↗

PubMed1993

Fine bore silicone rubber and polyurethane catheters for the delivery of complete intravenous nutrition via a peripheral vein.

The aim of the study was to evaluate two fine bore catheters for the delivery of complete intravenous nutrition (IVN), of osmolality 1250 mosm/kg, via a peripheral vein. 50 patients were randomised to receive either a 23G silicone rubber catheter or 22G polyurethane catheter. The median duration of feeding was 9 days for silicone rubber catheters and 10 days for polyurethane catheters. Silicone rubber catheters developed complications significantly more frequently (44%) than polyurethane catheters (22%, p < 0.05). There was no significant difference in the median life span of the catheters removed because of complications, nor in the daily risk of thrombophlebitis. 92% of patients who were fed through a polyurethane catheter required only a single catheter for the duration of IVN. The peripheral venous route should be the first choice when the administration of IVN is considered for a period of less than 2 weeks.

Journal Article↗

PubMed2005

Polyurethanes containing oxetane-derived poly(2,2-substituted-1,3-propylene oxide) soft blocks: copolymer effect on wetting behavior.

Hydroxy-terminated poly(2,2-substituted-1,3-propylene oxide) telechelics and co-telechelics bearing semifluorinated (R = -CH(2)OCH(2)(CF(2))(n)CF(3), n = 0, 1) and/or bromomethyl pendant groups were synthesized from the corresponding 3,3-substituted oxetanes. The new telechelics were incorporated in polyurethanes (PUs) with isophorone diisocyanate (IPDI) and 1,4-butanediol (BD) as the hard block. Surface properties were evaluated using tapping mode atomic force microscopy (TM-AFM) and dynamic contact angle (DCA) analysis. Interestingly, polyurethanes containing P(3FOx-BrOx) have higher theta(adv) and lower theta(rec) than the homo-telechelic PUs [P(3FOx) = poly(2-methyl-2-trifluoroethoxymethyl-1,3-propylene oxide; P(BrOx) = poly(2-methyl-2-bromomethyl-1,3-propylene oxide)]. For IPDI-BD(40)/P(3FOx/BrOx-1:1), theta(adv) (116 degrees) is higher and theta(rec) (32 degrees) is lower (Deltatheta, 84 degrees ) than any other homo- or co-telechelic polyurethane. The unusual wetting behavior for P(FOx/BrOx) polyurethanes is correlated with FOx-BrOx dyad content, and a reversible H-bonding mechanism is proposed to explain the results.

Journal Article↗