Experimental Investigations on Dissolution of Incrustations on the Surface of Catheters (With 1 color plate)

Hesse, Albrecht; Schreyger, F.; Tuschewitzki, G.-J.; Classen, Alexander; Bach, Dieter

doi:10.1159/000281541

Cited by 29 publications

(7 citation statements)

References 1 publication

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“…26 Several model systems have used Jack Bean urease 7,[11][12]40 producing encrustation similar in composition to clinically retrieved stent sections. 12 However, assessing encrustation behavior associated with materials loaded with an active agent (such as an antimicrobial), numerous authors propose the inclusion of a bacterial urease source such as P. mirabilis 18,25,41 to more closely simulate the infectious process; hence, this study has been designed similarly.…”

Section: Discussionmentioning

confidence: 99%

Validation of the CDC biofilm reactor as a dynamic model for assessment of encrustation formation on urological device materials

Gilmore¹,

Hamill²,

Jones³

et al. 2010

J Biomed Mater Res

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Contemporary medical science is reliant upon the rational selection and utilization of devices, and therefore, an increasing need has developed for in vitro systems aimed at replicating the conditions to which urological devices will be subjected to during their use in vivo. We report the development and validation of a novel continuous flow encrustation model based on the commercially available CDC biofilm reactor. Proteus mirabilis-induced encrustation formation on test biomaterial sections under varying experimental parameters was analyzed by X-ray diffraction, infrared- and Raman spectroscopy and by scanning electron microscopy. The model system produced encrusted deposits similar to those observed in archived clinical samples. Results obtained for the system are highly reproducible with encrustation being rapidly deposited on test biomaterial sections. This model will have utility in the rapid screening of encrustation behavior of biomaterials for use in urological applications.

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Section: Discussionmentioning

confidence: 99%

Validation of the CDC biofilm reactor as a dynamic model for assessment of encrustation formation on urological device materials

Gilmore¹,

Hamill²,

Jones³

et al. 2010

J Biomed Mater Res

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“…Due to the importance of encrustation on the performance of urinary medical devices, the conditions that are encountered by urinary tract prostheses in-vivo resulting in encrustation have been investigated by many workers in the field (Gorman & Tunney 1997;Gorman & Jones 2003). Some models have tested biomaterials in relatively static urine (from healthy subjects) to which infecting microorganisms had been added (Hesse et al 1989). Others have employed infected-patient urine (Gleeson et al 1989) or infected artificial urine (Schmitz et al 1993) and some have employed artificial urine designed to mimic infected urine (Cox et al 1987(Cox et al , 1988Tunney et al 1996b).…”

Section: Introductionmentioning

confidence: 99%

Design and validation of a dynamic flow model simulating encrustation of biomaterials in the urinary tract

Gorman

Garvin

Quigley³

et al. 2003

Journal of Pharmacy and Pharmacology

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A number of models exist for assessing encrustation on biomaterials employed as devices in the urinary tract. However, static urine models are suitable only for assessment of biomaterials residing in the bladder and the dynamic models available suffer from a number of disadvantages, notably their complexity and limitation to short-term assessment. The dynamic model described herein is a relatively simple design incorporating the ability to assess a large number of biomaterials in replicate fashion and over long periods of time. The biomaterials tested in the dynamic model conform to the urethral catheter and ureteral stent devices that experience urine flow within the urinary tract. The model was initially validated using Percuflex as a test biomaterial. The mass of calcium and magnesium, representing hydroxyapatite and struvite encrustation, respectively, on Percuflex was detected by atomic absorption spectrometry. No significant differences in encrustation levels were detected either between vessels or between biomaterial positions on any mandrel within the vessels, indicating the suitability of the dynamic model for reproducible determination of biomaterial encrustation. The dynamic model was then used to compare the encrustation of biomaterials commonly employed in urinary-tract devices, namely polyurethane, Percuflex and silicone. Calcium and magnesium levels on polyurethane and Percuflex were shown to be statistically similar, whereas silicone exhibited significantly reduced encrustation. When, subsequently, comparisons were made of biomaterial encrustation between the dynamic model and a static model, calcium and magnesium levels arising from the latter model were significantly higher on each of the biomaterials. However, the same rank order of encrustation resistance was observed for the biomaterials in both models, with silicone performing better than polyurethane or Percuflex. The prediction of in-vivo performance based on in-vitro models of encrustation is often difficult, although the model described provides a more accurate method for assessing the potential of novel and existing biomaterials for use in urinary medical devices requiring flow of urine.

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“…The potential bene®ts of mild agitation of the washout solution might also be more apparent over a shorter retention time and warrants further examination. This study builds on previous work which showed the ef®cacy of acidic bladder washout solutions in dissolving catheter encrustations in laboratory models [5,6] and on experience from clinical practice [1,7]. The study was designed to examine the most effective ways in which bladder washouts may be used and thereby to inform practice decisions.…”

Section: Discussionmentioning

confidence: 98%

“…There is evidence from laboratory studies using models of the catheterized bladder that these mineral deposits can be dissolved by acidic bladder washout solutions (e.g. Suby G, Solution R and mandelic acid) [5,6] and this is supported by clinical experience [1,7]. However, there is currently little research evidence on which to base decisions on the optimum volume and frequency of bladder washouts.…”

Section: Introductionmentioning

confidence: 99%

The dissolution of urinary catheter encrustation

Getliffe¹,

Hughes

Claire

2000

BJU International

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Objectives To identify the optimum volume of acidic bladder washout solution to dissolve catheter encrustations and to compare the effectiveness of different bladder washout delivery devices. Materials and methods Urinary catheter encrustation was generated in vitro using a model of the catheterized bladder adapted from previous work. An acidic bladder washout solution (Suby G) was applied via the catheter in the model and retained for 15 min. The amount of encrusting material dissolved was measured by colorimetric analysis of the magnesium and calcium content of the solution returned after the washout procedure. The relative effectiveness of different volumes of washout solution and different washout delivery devices (Optiflow, Bard Ltd, Crawley; UroTainer, B/Braun Medical Ltd, Aylesbury; and a bladder syringe) in dissolving catheter encrustations was compared to the ‘standardized’ conditions commonly used in practice. Results There was no statistically significant difference between washouts with 100 mL and washouts with 50 mL for any of the delivery devices tested. Gentle agitation with 50 mL Suby G did not significantly improve the dissolution of encrustation but the total amount of material dissolved when two washouts with 50 mL Suby G were used sequentially was significantly better than a single washout with either 100 mL or 50 mL. Conclusions Under controlled laboratory conditions, smaller volumes of acidic bladder washout solution (50 mL) are as effective as the 100 mL commonly used in practice, but two sequential washouts with 50 mL are more effective than a single washout. The newly designed Optiflow delivery device is at least as effective as the other devices tested. This study provides new evidence which may contribute to decision‐making by practitioners in relation to cath‐eter care.

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Experimental Investigations on Dissolution of Incrustations on the Surface of Catheters (With 1 color plate)

Cited by 29 publications

References 1 publication

Validation of the CDC biofilm reactor as a dynamic model for assessment of encrustation formation on urological device materials

Validation of the CDC biofilm reactor as a dynamic model for assessment of encrustation formation on urological device materials

Design and validation of a dynamic flow model simulating encrustation of biomaterials in the urinary tract

The dissolution of urinary catheter encrustation

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