Abstract
Background: Approximately one quarter of all nosocomial infections can be attributed to the urinary tract. The infections are supposed to be mainly caused by implantations of urethral catheters and stents. A new catheter design is introduced with the aim to lower the high number of nosocomial urethral infections. In order to avoid limitations to use, the design is first applied to conventional commercially available balloon catheters.Results: The main feature of the design is a sandwich layer on both sides of the catheter wall, which is composed of a fragmented base layer of silver capped by a thin film of poly(p-xylylene). This top layer is mainly designed to release a controlled amount of Ag+ ions, which is bactericidal, but not toxic to humans. Simultaneously, the lifetime is prolonged to at least one year. The base layer is electrolessly deposited applying Tollens’ reagens, the cap layer is deposited by using chemical vapor deposition.Conclusion: The three main problems of this process, electroless deposition of a fragmented silver film on the surface of an electrically insulating organic polymer, irreproducible evaporation during heating of the precursor, and exponential decrease of the layer thickness along the capillary, have been solved trough the application of a simple electrochemical reaction and two standard principles of physics: Papin’s pot and the principle of Le Chatelier.
Highlights
In 2014, nosocomial infections caused the death of more than 2000 patients in Swiss hospitals
Silver layer: Depositing a metallic layer atop a material that is electrically isolating and an organic polymer that is classified as elastomer generates at least two interface problems: (1) How can a film of metallic silver be deposited electrolessly on a surface of an insulating material? and (2) How can the very different Young’s moduli be adapted in such a way that bending and torsion, which are inevitable during the implantation process or during usage, do not cause exfoliation of the silver film? The bendability of the polymer is larger by orders of magnitude than that of the coating
Bi et al have shown by X-ray photoelectronic spectroscopy (XPS) that O2 treatment of PPX under similar exposure conditions causes the origin of two new peaks at 287.8 eV and 289.3 eV in the C 1s spectrum, which they attributed to the carbon atoms in the free carbonyl group (C=O) and carbonate group (O2C=O), respectively [36]
Summary
In 2014, nosocomial infections caused the death of more than 2000 patients in Swiss hospitals. About one quarter of the deaths were due to infections of the urethral tract. Applying this number to Germany with 10 times the size in population, these infections would have caused the death of approximately 5000 hospitalized patients. As the main reason for these infections, the urethral balloon catheters have been identified, which are implanted into the urethra to almost every sixth hospitalized patient, especially those who undergo a surgery [1]. One quarter of all nosocomial infections can be attributed to the urinary tract. A new catheter design is introduced with the aim to lower the high number of nosocomial urethral infections. In order to avoid limitations to use, the design is first applied to conventional commercially available balloon catheters
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