title: A novel percutaneous barrier device that permits safe subcutaneous access.
abstract: Successful subcutaneous access is important for optimal management of internal artificial organs and treatment of many diseases. However, skin downgrowth and tissue infection are still significant problems in the use of devices that require long-term subcutaneous access. The authors developed a new percutaneous device that provides a unique biologic boundary with surrounding connective tissue while minimizing the risk of complications. This new percutaneous device is made of a circumferential, strong, thin, and flexible mesh collar with millimeter size holes for connecting the structure. It has two distinct functional portions: a connecting zone and a sealing line. The most important features of the structure are: 1) Connective tissue grows through the millimeter size pores of the connecting zone to form a strong bond between the device and healthy tissue. 2) The millimeter size pores of the connecting zone allow capillaries to grow through its entire surface, ensuring sufficient blood supply. 3) The tissue of the connecting zone and the device surface form a biosealed junction (sealing line). This sealing line is protected by the connecting zone and is free from external forces acting on local skin. 4) The device is generally functional immediately after surgical implantation. The subcutaneous perimeter of the functional dome contains extruded rigid rings of millimeter size holes permitting growth of subcutaneous tissue through the device. This functions as the minor connecting structure of the device. Four of five implanted rabbits have remained healthy 8 months postimplantation without antibiotic administration. The fifth rabbit died 4 months postimplantation for reasons unrelated to the device. Gross or histopathologic inspection revealed no signs of tissue injury or inflammation. Growth of healthy connective tissue was clearly observed. These results indicate this percutaneous device can provide a strong, stable, and effective connection to internal organs without bioboundary damage, skin downgrowth, or tissue infection.
authors.affiliation: Department of Pediatrics, East Carolina University School of Medicine, Greenville, North Carolina 27834, USA.
authors.forename: C
authors.initials: C
authors.lastname: Yu
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.forename: J
authors.initials: J
authors.lastname: Bradfield
authors.forename: I
authors.initials: I
authors.lastname: Fiordalisi
authors.forename: G D
authors.initials: GD
authors.lastname: Harris
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000517:prevention & control; D002196:Capillaries / Q000502:physiology; D062109:Dermatologic Surgical Procedures; D004867:Equipment Design; D007279:Injections, Subcutaneous; D008422:Materials Testing; D018919:Neovascularization, Physiologic; D019736:Prostheses and Implants; D011817:Rabbits; D012867:Skin / Q000098:blood supply / Q000382:microbiology; D014945:Wound Healing