Aging of silastic peritoneal catheters.
Increasing the survival of patients on CAPD is related to the long-term reliability of the peritoneal access. Six silicone Tenckhoff catheters (with strip or diffuse barium sulphate inclusion) removed after 39-69 months because of the appearance of external segment fissures, were analysed by scanning electron microscopy (SEM) and infra-red spectroscopy with attenuated total refractance (ATR). The extracorporeal portion of the catheters showed (by ATR) a more prominent oxidation peak on the external than the internal surface; SEM showed marks and cracks on the external surface and exfoliation and flattening of the silastic reticle on the intraluminal surface. No evidence of oxidation was found in the intra-abdominal portion of the catheters but biofilm was found. We suggest that barium sulphate may render the silastic brittle and physiological and environmental long-term factors (such as uv-rays, temperature, sweat and disinfectants) could cause oxidation and loss of physico-chemical properties, with critical aging of the silastic and loss of catheter resistance to mechanical injury.
Poisetti
P
P
Renal Unit, General Hospital, Piacenza, Italy.
Bergonzi
G
G
Ballocchi
S
S
Fontana
F
F
Scarpioni
L
L
D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling; D004868:Equipment Failure; D006801:Humans; D008854:Microscopy, Electron; D008875:Middle Aged; D010084:Oxidation-Reduction; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000295:instrumentation*; D012826:Silicone Elastomers / Q000737:chemistry*; D013997:Time Factors
D012826:Silicone Elastomers