Abstract

Abstract Shunt-valves made of silicone rubber are placed between the trachea and the oesophagus in order to allow patients after laryngectomy to produce voice again. The oesophageal side of the shunt-valve, however, becomes rapidly colonized by a biofilm, consisting of bacteria and yeasts. Electron microscopy on explanted shunt-valves demonstrates that the yeast show ingrowth into the silicone rubber. Surface treatment of the silicone rubber is often suggested to be a pathway to reduce adhesion and ingrowth of yeasts to prostheses. An effective development of such a treatment requires an in vitro system by which similar defects as found in vivo can be created under laboratory conditions. Candida tropicalis , isolated from an explanted prosthesis, could be made to grow into the silicone rubber under laboratory conditions by the removal of all nutrients using a modified Robbins device. After the removal of all nutrients, the yeast cells adapted a filamentous growth form. Only filamentously growing yeasts appeared to be able to penetrate the silicone rubber.

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