Smart polyurethane endosponges for endoluminal vacuum therapy: Integration of a bacteria sensor

Abstract

The development of smart biomedical devices as efficient tools in early diagnosis and therapy monitoring has recently witnessed unprecedented growth, becoming an emerging field in biomedical engineering. Sponges for endoluminal vacuum therapy, which are intended for transmitting negative pressure as trigger for tissue regeneration and for draining infections in anastomotic leakages, are massively used implants with very complex geometry and high risk of infection. In this work, commercial polyurethane (PU) sponges have been converted into smart biomedical devices by incorporating an electrochemical sensor to monitor the growth of bacteria. Such innovative approach, which allows to track the tissue healing process avoiding further infection development, has been performed applying a three-step process: 1) activation of PU using low pressure oxygen plasma; 2) incorporation of conducting polymer (CP) nanoparticles (NPs) at the surface of the activated PU by chemical oxidative polymerization; and 3) formation of a homogeneous electroactive coating using the CP NPs obtained in 2), as growth nuclei in an electrochemical polymerization. The functionalized PU sponge is able to monitor the bacteria growth in the surrounding media by detecting the concentration of nicotinamide adenine dinucleotide (NADH) from respiration reactions in the cytosol (i.e. bacteria do not have mitochondria). Conversely, respiration in normal eukaryotic cells takes place in the mitochondria, whose double membrane is not permeable to NADH. The sensing performance of the CP-coated PU sponges (limit of detection: 0.06 mM; sensitivity: 1.21 mA/cm2) has been determined in the lab using NADH solutions, while a proof of concept have been conducted using Escherichia coli bacteria cultures.