In the clinical setting, polyvinyl chloride (PVC) accounts for 25% of all polymers used in medical device applications. However, medical devices fabricated with plasticized PVC, such as endotracheal tubes, extracorporeal circuits (ECCs), or intravenous catheters, can lead to thrombosis and infection complications. Mortality associated with hospital associated infections (HAIs) exceed 100,000 deaths each year. One method to overcome these challenges is to develop bioactive polymers with nitric oxide (NO) release. Nitric oxide exhibits many physiological roles including antibacterial, antithrombic, and anti-inflammatory activity. In this study, plasticized Tygon PVC tubing was impregnated with a NO donor molecule, S-nitroso-N-acetylpenicillamine (SNAP), via a simple solvent-swelling-impregnation method, where polymer samples were submerged in a SNAP impregnation solvent (methanol, acetone, plasticizer), rinsed, and dried. An additional topcoat of a biocompatible CarboSil 2080A (CB) was applied to reduce SNAP leaching. The SNAP−PVC−CB was characterized for NO release using chemiluminescence, leaching with UV−vis spectroscopy, surface characterization with scanning electron microscopy, tensile strength analysis, stability during storage and sterilization, and antimicrobial properties in vitro. The SNAP−PVC−CB exhibited an NO flux of 4.29 ± 0.80 × 10 −10 mol cm −2 min −1 over the initial 24 h under physiological conditions and continued to release physiological levels of NO for up to 14 d (incubated in PBS buffer at 37 °C). The addition of the CB topcoat reduced the total SNAP leaching by 60% during incubation. Mechanical properties and surface topography remained similar to the original PVC after SNAP impregnation and application of the CB topcoat. After ethylene oxide sterilization and 1 month of storage, the SNAP−PVC− CB demonstrated excellent SNAP stability (ca. 90% SNAP remaining). In a 24 h antibacterial assay, SNAP−PVC reduced viable bacteria colonization (ca. 1 log reduction) of S. aureus and E. coli compared to PVC controls. This simple method for SNAP impregnation of medical grade plasticized PVC holds great potential for improving the biocompatibility of postfabricated, plasticized PVC medical devices.
Many Type 1 diabetes patients utilize insulin pumps, which rely on a small subcutaneous insulin infusion cannula. However, insulin cannulas still suffer from infection and inflammation, which impacts the wear time of the insulin cannula, reduces the efficiency of insulin infusion, and requires frequent rotation of the insulin infusion site. Infection and inflammation of continuous insulin infusion pump therapy are growing issues and are estimated to cost billions of dollars globally each year. This study aims to develop a potent antibacterial and antifouling insulin cannula with a synergistic effect of bioinspired polymers, integrating antifouling slippery, liquid-infused porous surface technology with an active nitric oxide (NO) releasing polymer. The cannulas were developed by impregnating the NO donor molecule S-nitroso-N-acetylpenicillamine (SNAP) and silicone oil (Si) in commercial medical-grade silicone rubber (SR) tubing (SR-SNAP-Si) via a solvent-impregnation process. The efficiency of the SR-SNAP-Si to reduce protein adsorption and provide antibacterial properties against Staphylococcus aureus and Staphylococcus epidermidis were studied using in vitro bioassays. The SR-SNAP-Si cannula released NO for more than 14 d at physiological levels and were stable during storage for 30 d at room temperature. Scanning electron microscopy images revealed no observable changes to the material surface after the solvent impregnation process. The infusion of silicone oil significantly reduced the protein adsorption on the cannula by 66.40%, and the NO release reduced the viable bacterial cell adhesion of S. epidermidis and S. aureus after 24 h by 94.89% and 99.77%, respectively, as compared to SR controls. This insulin cannula provided continuous NO release and an antifouling interface for more than 14 d and exhibited significant reduction in protein and bacterial adhesion. This method of developing dual-function nitric oxide releasing and antifouling surface for subcutaneous insulin infusion cannulas holds great potential to reduce infection and inflammation associated with insulin pump delivery systems.
Sustainable textile dyeing technology using nanofibrillated cellulose is developed that would significantly reduce wastewater and potential environmental costs.
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