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PubMed1978

[Studies on orthodontic polyurethane ringlets. (Part 1) Examination of its physical properties (author's transl)].

The purpose of this study was to develop orthodontic ringlets from polyurethane which have maximum flow resistance. The two types of polyurethane involved were thermoplastic and thermosetting polyurethane. The former included Paraprene 22, 25, 4805 + 4806, Biomer, Elastollan 585 (E-585) and improved Elastollan 590 (E-590). Thermosetting type incorporated Adiprene, Loyler 2170, Colonate 4080 and DC-4978. Using these materials as its base, a ring device was developed. Under two conditions, tests were conducted for tensile strength, aging effects on 50% and 100% modulus and permanent elongation. One group was stored in air at 20 degrees C and the other in water at 37 degrees C. The results were as follows; It was found that the thermoplastic polyurethane possessed high tensile strength. However, the modulus upon aging resulted in a lower reading with the exception of E-590 and Biomer. In the thermosetting polyurethane group, most of the rings except DC-4978 broke down during storage at 100% elongation in water at 37 degrees C. In the case of DC-4978, there was maximum flow resistance. Upon comparing it with E-590 and Biomer, it appeared that DC-4978 was the most effective for orthodontic purposes.

Elasticity↗

PubMed1988

In vivo evaluations of a new thromboresistant polyurethane for artificial heart blood pumps.

To reduce the risk of thromboembolic complications in prosthetic blood pumps, we have developed a new segmented polyurethane elastomer. This material is unique because its mechanical properties for long-term durability and surface properties for biocompatibility have been separated and developed in two distinct materials. Improved thromboresistance is then obtained by a 1% concentration of a new polymeric surface-modifying additive blended with the base polyurethane before fabrication of the blood pump. To evaluate this material in vivo, we performed 10 implants, in calves, of the Pierce-Donachy prosthetic ventricle with blood-pumping sacs and cannulas fabricated from the new surface-modifying additive copolymer blend (Thoratec's BPS-215M). In four control implants the blood sacs and cannulas were fabricated from Ethicon's Biomer segmented polyurethane, which is the present clinical standard for most artificial hearts and circulatory support devices. The blood pumps were connected from the apex of the left ventricle to the descending aorta in male Holstein calves weighing 82 to 108 kg and were driven pneumatically in the full-to-empty mode with flows averaging 5 to 6 L/min. Each calf was medicated with aspirin and dipyridamole throughout the study period and was electively put to death after 4 weeks for evaluation of explanted blood sacs and for examination of the kidneys for infarction. All 10 explanted blood sacs made with the surface-modifying additive copolymer blend were shiny and completely free of thrombus. Three of the four explanted Biomer blood sacs showed visible red thrombus, and all four showed small areas of white thrombus. The average surface area of the Biomer blood sacs covered with thrombus was 45 +/- 32 mm2. Use of a semiquantitative scale to assess renal infarction demonstrated that nine of 10 animals with a surface-modifying additive copolymer blend blood sac had infarction less severe than the mean infarct score of the animals with a Biomer sac. The surface-modifying additive copolymer blend has excellent mechanical and physical properties necessary for use in artificial heart blood pumps. From these experiments, we conclude that the surface-modified polyurethane blend is superior to Biomer polyurethane in blood compatibility and in freedom from thromboembolic risk. This material is now approved by the Food and Drug Administration for investigational device exemption studies in the Pierce-Donachy prosthetic ventricle.

Animals↗

PubMed1978

Tissue reactions to breast implants coated with polyurethane.

The histological features noted in the capsules from 7 polyurethane coated silicone breast prostheses are described. The polyurethane provoked a definite foreign body reaction and was slowly degraded, with some particles ejected from the capsule into the surrounding tissues. Separation of the polyurethane coating from the silicone prosthesis and the degradation of the polyurethane took about two years. Another much more resistant foreign material was found to occur in conjunction with the polyurethane in the capsules. It may be an adhesive or flakes off the silicone shell. Vacuolated spaces were noted in the inner layers of 3 capsules; it was assumed that they contained liquid silicone.

Breast↗

PubMed1991

Thrombocytopenia associated with environmental exposure to polyurethane.

Few chemicals in the environment have been implicated as causes of isolated thrombocytopenia, and the evidence is usually less than convincing because the patients were not rechallenged with the chemical in vivo. In the present paper, a child is reported with the onset of thrombocytopenia in temporal association with environmental exposure to polyurethane. Five years after the initial thrombocytopenia had resolved, an inadvertent in vivo rechallenge with environmental polyurethane resulted in recurrence of the thrombocytopenia. This recurrence, together with the fact that only 1-4% of cases of idiopathic thrombocytopenic purpura in children recur, provided strong evidence for a causal role for the polyurethane exposure in this patient's thrombocytopenia. In summary, environmental exposure to polyurethane should be considered in the differential diagnosis of acquired thrombocytopenia in childhood.

Child, Preschool↗

PubMed1990

Small-caliber polyurethane and polytetrafluoroethylene grafts: a comparative study in a canine aortoiliac model.

In vivo stability of a new small-caliber polyurethane graft (n8) was assessed in a canine aortoiliac model and compared to that of a conventional expanded polytetrafluoroethylene (ePTFE) graft (n8). Six months following implantation, marked aneurysmal dilatation to 230 +/- 80% (mean +/- SD) of the original diameter occurred in polyurethane grafts, while dilatation to 110 +/- 8% of the original diameter occurred in ePTFE grafts (p less than 0.005). Interval patency was 75% for each graft type. Luminal thrombus affected 59% of polyurethane graft surfaces compared to 22% of ePTFE graft surfaces (p less than 0.01). Qualitative examination of representative sections of polyurethane conduits demonstrated thick inner capsules with numerous small islands of graft material surrounded by macrophages and bands of mature fibrous tissue, in contrast to the thinner neointima and limited anastomotic pannus ingrowth observed in ePTFE grafts.

Animals↗

PubMed1991

Physical and blood-contacting properties of polyurethanes based on a sulfonic acid-containing diol chain extender.

Polyurethanes chain extended with N,N-bis (2-hydroxyethyl)-2-aminoethane-sulfonic acid (BES) were synthesized. The effect of the sulfonic acid group on the polymers' bulk, surface, and blood-contacting properties was evaluated by comparing the BES-based polymers with polyurethanes based on N-ethyldiethanolamine (EDEA). In addition, the effect of soft-segment polarity was addressed by comparing polyurethanes based on polytetramethylene oxide (PTMO) (MW = 1000) with polymers based on polyethylene oxide (PEO) (MW = 1000). The EDEA control samples had physical properties similar to a viscous fluid. The presence of the sulfonic acid group dramatically enhanced the degree of microphase separation and the mechanical strength of all the polymers. The more polar PEO soft segment resulted in polymers which were more phase mixed than the PTMO-based polyurethanes. Surface characterization studies revealed that in vacuum, all the surfaces were enriched in the polyether soft-segment phase. After 24-h equilibration in water, all the surfaces had similar surface polarities independent of the SO3H content. The canine ex vivo blood-contacting results showed that the sulfonic acid group in the PTMO-based polymers significantly reduced the number and activation of the adherent platelets. Fibrinogen deposition, however, increased with increasing sulfonic acid content. In contrast, platelet and fibrinogen deposition on the sulfonic acid-containing PEO-based polymers was greatly enhanced.

Adsorption↗

PubMed1991

In vivo biocompatibility of an aliphatic crosslinked polyurethane in rabbit.

A cage implantation technique has been adopted in a rabbit animal model to investigate the biocompatibility of an aliphatic crosslinked polyurethane based on hexamethylene diisocyanate (HDI). In this study, four cages are represented; the cage containing the candidate polyurethane material, biomedical grade polyurethane (Tecoflex), the commercial grade polyvinylchloride (PVC), and an empty cage which were implanted subcutaneously in rabbits. Exudates were aspirated from these cages at 4, 7, 14, and 21 days postimplantation. Exudates were analyzed for variations in proteins, cell counts, and extracellular enzymes. Results with the four types of cage implants showed that the candidate polyurethane caused an inflammatory response comparable to that caused by medical-grade Tecoflex and the empty cage control.

Alkaline Phosphatase↗

PubMed1992

Effect of sulfonation of segmented polyurethanes on the transient adsorption of fibrinogen from plasma: possible correlation with anticoagulant behavior.

The influence of polyurethane sulfonation on fibrinogen adsorption from plasma and on plasma coagulation has been investigated. Sulfonated polyurethanes were synthesized using a two-step solution polymerization in which a diamino disulfonic acid was used as chain extender, thus incorporating sulfonate groups into the hard segments. Polymer molecular weights were determined by size exclusion chromatography and weight average values were in the range of 50,000 to 200,000. Equilibrium water uptake of solid polymer specimens was substantial and was found to increase with increasing sulfonate content. Titration of sulfonate groups allowed an estimate of the retention of free sulfonate in the polymers which ranged from 50 to 85%. Loss of free sulfonate is attributed to reaction of isocyanate with sulfonate groups during chain extension. Both surface chemistry and hydrophilicity were assessed using a combination of ESCA and water contact angle measurements. The ESCA data indicate enrichment of soft segment in the surface. Contact angles show increasing hydrophilicity with increasing sulfur content. Fibrinogen adsorption from plasma to the sulfonated polyurethane surfaces was studied using radioiodine labeling. Fibrinogen surface concentration was found to increase strongly as sulfonate content increased. Fibrinogen adsorption behavior is quite different from that of conventional unsulfonated polyurethanes in the sense that the adsorption levels are much higher and there is little displacement of initially adsorbed fibrinogen (Vroman effect). The data are interpreted in terms of two mechanisms: fibrinogen uptake (i.e., absorption) into a polymer-plasma "gel" hypothesized to exist at the surface of these materials, and adsorption in the usual sense. Thrombin times of human plasma in which polymer particles were suspended were prolonged and were found to increase with increasing sulfonate content of the polymers, suggesting that sulfonate groups confer a measure of anticoagulant activity on these materials.

Adsorption↗

PubMed1989

Hydrophilic polyurethane versus autologous femoral vein as substitutes in the femoral arteries of dogs: quantification of platelets and fibrin deposits.

Hydrophilic, microporous polyurethane vascular prostheses displayed good mechanical characteristics and the behaviour in vitro was excellent. The in-vivo results were, however, disappointing. To obtain a better understanding of the phenomena involved in the acute and early thrombosis, we implanted the polyurethane graft in the canine left femoral artery and an autologous femoral vein in the right for 4 and 24 h. At 4 h, one polyurethane graft was totally occluded and the other two were close to complete occlusion; at 24 h, none was patent. On the other hand, all autologous veins were patent. The thrombotic matrix incorporating both platelets and fibrinogen, quantified by labelling, was anchored along the anastomotic lines. This study confirms that polyurethane occlusion is initiated by hyperplastic reaction, but does not explain why.

Animals↗

PubMed1991

Polyurethane film (Opsite) vs. impregnated gauze (Jelonet) in the treatment of outpatient burns: a prospective, randomized study.

As it has been shown that re-epithelialization of partial skin thickness wounds can be accelerated if the wound is kept moist, a prospective, randomized clinical study compared the water vapour-semipermeable polyurethane film, Opsite, with the conventional impregnated gauze dressing, Jelonet, in the treatment of outpatient partial skin thickness burns. Fifty-five patients were included: 30 were treated with the polyurethane film and 25 with the conventional dressing. The patients were followed at regular intervals until healing had occurred and were seen 3 months later for evaluation of residual scars and pigmentation. The burns treated with polyurethane films healed with a median of 10 days, while the conventionally treated burns healed with a median of 7 days (P greater than 0.05). Residual scars were noted in 21 per cent of the patients treated with polyurethane films and in 8 per cent treated conventionally (P greater than 0.05). Prophylactic methods should be publicly stressed since one-quarter of the patients were children of 3 years or less who were scalded by split hot liquids. Furthermore the patients' wounds were only briefly cooled before attending medical care. With small burns we advise that cooling should be prolonged until the pain fades then professional assistance should be sought.

Adolescent↗

PubMed1990

Natural-Y Même polyurethane versus smooth silicone: analysis of the soft-tissue interaction from 3 days to 1 year in the rat animal model.

The polyurethane foam-covered breast prosthesis is experiencing increased clinical use. The polyurethane is felt to be responsible for altering capsule formation and reducing the contracture rate. This study characterizes the soft-tissue response to the Natural-Y Même polyurethane foam versus smooth silicone in a rat model. Implants were fashioned from an unbacked polyurethane foam specimen used to cover the Natural-Y prosthesis, a silicone shell covered with the Natural-Y foam, and a smooth silicone control. Materials were placed subcutaneously into the backs of male Lew/SsN rats (n = 81) for 3, 7, 14, and 28 days and 3, 6, and 12 months. Implants were then harvested with their soft-tissue response and evaluated histologically. Analysis demonstrates that microstructuring of a surface, as opposed to a smooth material, will dramatically alter the early, intermediate, and late wound-healing events. The soft-tissue response was observed to be dependent on implant site, material chemistry, and morphology as characterized by exudate formation, macrophage invasion, multinucleated giant cell formation, collagen deposition, foam degradation, and angiogenesis.

Animals↗

PubMed1991

Comparative experience with smooth and polyurethane breast implants using the Kaplan-Meier method of survival analysis.

Smooth-walled silicone implants have been widely used in breast surgery. Capsular contracture, causing undesirable firmness and spherical deformity, has been a common problem. Recent studies suggest that polyurethane-covered breast implants are associated with a lower incidence of capsular contracture. The statistical methodology employed in some of these studies, however, may be subject to criticism. Between July of 1984 and June of 1990 (72 months), 427 polyurethane breast implants were used in 279 patients and 439 smooth prostheses were used in 250 patients for a variety of aesthetic and reconstructive procedures. The occurrence of capsular contracture was carefully monitored and then analyzed using the Kaplan-Meier method of survival analysis. This method is particularly well suited to analysis of these types of clinical data because it allows for the fact that contractures occur at varying intervals after surgery and that follow-up of patients is incomplete. The probability of capsular contracture with smooth-walled prostheses was found to be significantly greater than with polyurethane-covered implants in each group of patients studied (p less than 0.05). Other complications occurred at a similar rate regardless of prosthesis type. This study supports the belief that polyurethane breast implants have a lower contracture rate; furthermore, it introduces the Kaplan-Meier method for analyzing the outcome of alternative plastic surgical therapies.

Breast↗

PubMed1992

The biomechanical and histopathologic effects of surface texturing with silicone and polyurethane in tissue implantation and expansion.

There has been considerable interest in determining the effect of morphologic alterations of prosthetic surfaces on capsule response in breast surgery. The purpose of this study was to provide a precise, three-dimensional evaluation of soft-tissue response to surface modifications in both implantation and expansion. Expandable 100-cc prostheses were designed with one of three surfaces: textured silicone (Biocell), standard smooth silicone, or polyurethane (Natural-Y, Meme). A new submuscular implantation site in the rabbit was developed. Each animal randomly received a smooth-surface device on one side and either a textured silicone or polyurethane device on the other. In one group of animals, the prostheses were expanded monthly. Capsular response was evaluated monthly in vivo using standardized techniques as well as biomechanical methods for up to 6 months in the expander group (n = 7 to 16) and 8 months in the implant group (n = 7 to 15). Analysis of biomechanical and histologic data revealed that prosthetic surface morphology can specifically alter capsular response. Polyurethane was the only effective surface in preventing capsular contracture in implantation. In expansion, both textured silicone and polyurethane surfaces resulted in significantly less capsular contracture and less resistance to expansion than comparable smooth-surfaced controls. Statistical comparisons reveal that the biomechanical methods utilized in this study provide the most precise and objective method of defining overall soft-tissue contracture around implanted biomaterials.

Animals↗

PubMed1986

Long-term performance of polyurethane pacing leads: mechanisms of design-related failures.

Environmental stress cracking has been identified as a crack propagating mechanism in polyurethane-insulated, heart pacemaker leads, which is directly related to specific lead design parameters. Lead designs imposing excessive stress on the polyurethane insulation through an interference fit between the coil and polymer have demonstrated insulation failures. Conversely, low-stress designs have shown virtually no insulation problems. The higher-stress designs have used organic solvents to facilitate coil placement during manufacturing, which may result in lowering the polymer's ability to resist the higher stress. In addition, a specific silver-containing coil wire composition has been found to galvanically corrode upon body fluid intrusion into the lead, ionizing the silver. These ions interact with the polyurethane polymer resulting in the loss of polymer strength. All polyurethane lead failures to date have been specific to high stress and/or chemical interaction. Leads using low-stress designs and nonreactive coil wire compositions continue to demonstrate a positive clinical experience.

Animals↗

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↗

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↗