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Unformatted text preview: Kidney International, Vol. 63 (2003), pp. 702–708 DIALYSIS – TRANSPLANTATION Tissue adhesion to bioactive glass-coated silicone tubing in a rat model of peritoneal dialysis catheters and catheter tunnels E DWARD A. R OSS , C HRISTOPHER D. B ATICH , W ILLIAM L. C LAPP , J UDITH E. S ALLUSTIO , and N ADEEN C. L EE Division of Nephrology, Hypertension & Transplantation, Department of Materials Science, and Department of Pathology, University of Florida and Veterans Affairs Medical Center, Gainesville, Florida, USA Tissue adhesion to bioactive glass-coated silicone tubing in a Peritoneal dialysis catheters are manufactured using rat model of peritoneal dialysis catheters and catheter tunnels. highly biocompatible polymers, which has been successful Background. Silicone peritoneal dialysis catheters do not in minimizing the foreign body reaction and enhancing develop tissue ingrowth, lack a mechanical barrier to perilumi- device longevity. A thin fibrous capsule typically devel- nal bacterial migration and need cuffs for anchorage. We hy- ops around the catheter, but there is no tissue adhesion pothesized that a bioactive glass coating composed of silicon, calcium, sodium and phosphorous oxides would cause a bene- to it. The potential space between the device and the ficial tissue reaction causing catheter adhesion, and tested this fibrous layer allows movement of the catheter and can in a rat model. serve as a conduit for infections to spread from the exit Methods. A hexane solvent-based method of coating sili- site to the peritoneum. Anchorage of the catheters hence cone tubes with Bioglass t powder was used, which maintained requires the attachment of one or more cuffs (that is, flexibility, and then the ultrastructure was confirmed with scan- ningelectron microscopy(EM).Segments2.5 cmwereimplanted Dacron t ). These have the disadvantage of being subject subcutaneously in 8 Sprague-Dawley rats, with uncoated tubes to infections that are difficult to eradicate, and can lead as a contralateral control, and histology was done at 2, 4 and to removal of the cuff near the exit site or even loss of 6 weeks, including special stains and EM. the catheter . The application of hydroxyapatite or Results. The uncoated segments grossly had no adherence to surrounding tissue, and were physically separate from a thin ceramics to silicone surfaces has been reported [2, 3], fibrous capsule of approximately 50 m width. Trichrome stains and led to our interest in applying similar technologies demonstrated the capsule was rich in collagen. There was mini- to peritoneal devices. We hypothesized that a bioactive mal adjacent tissue reaction. In contrast, the coated tubes were coating of the catheter surface could lead to tissue adhe- palpably fixed to the soft tissues, and sections demonstrated an sion, which would be very beneficial with respect to an- adjacent prominent layer of macrophages and multinucleated giant cells. Small numbers of lymphocytes were noted. Thisgiant cells....
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- Chemical reaction, Scanning electron microscope, Edward A. Ross, Giant cell, bioactive glass-coated silicone