Patent Application
20240207569
The aspects of the disclosed embodiments belongs to the field of medical devices for introducing media into the body or for taking media from the body. More precisely, the aspects of the disclosed embodiments belongs to the field of catheters and methods for their production and treatment. The present aspects of the disclosed embodiments relates to methods for the deposition of a thin film of chitosan with hydrophilic character on the outer surface of urinary catheters made from polymers or polymer blends.
Urinary catheters are medical devices used by patients to drain the bladder before, during, or after surgery, for patients having problems with urinary incontinence, urinary retention, problems with the prostate, and for patients having other health problems causing patients' inability to urinate on their own. Urinary catheters are long flexible tubes made from medical-grade polymers with appropriate mechanical properties, chemical inertness, and biocompatibility. The choice of polymers satisfying these requirements is limited to polymer blends of moderate hydrophobicity. The hydrophobicity is a drawback at any attempt to be soaked with a water solution and/or suspension of a material to be used as a coating. The coating should be approved in medical practice and should exhibit appropriate biocompatibility and hydrophilicity. The surface of the catheter must be hydrophilic to enable easier insertion into the urethra and to avoid mechanical irritation, pain, and injury of the urinary tract during its insertion leading to inflammation. Furthermore, it is also desirable that the coating has antibacterial properties since bacterial infections are one of the most frequent complications resulting from bacteria entering the bladder during the insertion of the catheter. Natural polysaccharides are among the best candidates for the coating because of their proven biocompatibility, relatively low price, and ability to be soaked with water in order to make a lubricant-like coating useful as the final surface finish. Among natural polysaccharides, alginate is a common material that exhibits excellent swelling properties. A drawback of alginate is the formation of biofilms of alginate-tolerable bacteria. Some bacteria use pure polysaccharides as a growth medium, so alginate may not be an appropriate coating for application in urinary catheters.
An excellent substitute for alginate is a bacteriostatic polysaccharide. Chitosan exhibits not only bacteriostatic but even antibacterial properties due to the presence of the amino groups on the polysaccharide chain. It is extracted from chitin, a naturally abounded polysaccharide. Chitosan is soluble in water at reasonable concentrations. The dried chitosan, however, wets slowly upon soaking with water, which may be a drawback at any attempt when the coating on a catheter should swell quickly upon wetting, for example, in a few seconds after wetting. Such a fast absorption of water is needed because a sterile packed catheter should be dry, and the wetting is performed just before using the catheter.
The use of chitosan as a catheter coating is thus limited because of two drawbacks: first, the water solution of chitosan will not adhere to the raw catheter because of the hydrophobic character of the polymer blends used for manufacturing catheters, and second, the dry chitosan exhibits the slow soaking of water and thus inadequate swelling in a reasonable time. The aspects of the disclosed embodiments aims to solve these problems. The technical problem is thus the development of a method for the treatment of catheters that will result in uniformly and efficiently coated catheters with chitosan.
Various solutions have been proposed to overcome at least one of those drawbacks. For example, CN201510170429 proposes dipping the urinary catheter into a solution containing numerous chemicals, including a variety of polysaccharides, among them also chitosan. CN201510170429 discloses a super-lubricant antibacterial catheter. In a preferred embodiment, the catheter is first coated with a chitosan antibacterial layer, followed by a hydroxypropyl cellulose lubricating layer. A similar solution is also proposed in CN204684403.
Subsequent deposition of chitosan and other coatings is also disclosed in CN104721890. The inventors disclose that chitosan has the action of reducing drug resistance and adverse effects caused by the medicinal antibacterial agent to users, hydroxypropyl cellulose and hydroxypropyl methylcellulose have lubricating action, whereas acetylcysteine has antibacterial and phlegm-reducing actions.
A catheter made from plastics and coated with a chitosan-containing lubricant is also disclosed in EP2468319. Catheters made from polyvinyl chloride were first coated by dipping into a water solution of chitosan salts, triclosan, and dicarboxylic acid; the solution also contained silver nanoparticles and at least two vitamins. Such a water solution exhibits good wetting properties, much better than a water solution of pure chitosan. After drying at room temperature in an ambient atmosphere, the coating was optionally cured by exposure to ultraviolet radiation. The nanostructured layer prevented the formation of biofilms, the development of irritation, and inflammatory states, according to EP2468319.
KR102235362 discloses a catheter with a chitosan chemostatic material that is adhered to a warped surface of a balloon. The chitosan chemostatic material is in the fabric form, including at least one external skin and one internal part. A similar catheter with the balloon is also disclosed in CN111420245, except that nano-chitosan is in the form of molecular sieves.
EP1846051A2 discloses a method for attaching chitosan to a polymer comprising: (a) providing a wettable surface of a polymer; (b) contacting a chitosan acid salt solution comprising chitosan and at least one volatile organic acid to the wettable surface of (a) to produce a chitosan-coated polymer. An option for providing a wettable surface of a polymer is plasma treatment.
EP1744836A2discloses a method for forming an active material containing a coating on a substrate, wherein the substrate is pre-treated with plasma. The active material is sprayed on the substrate, wherein the spraying is performed upon plasma conditions, i.e. the active material is introduced into the plasma discharge. Various active materials could be introduced in the plasma discharge to benefit from deposition on a substrate, including enzymes, proteins, vitamins, agrochemicals, and catalysts. The substrate may be a catheter. The long list of substrates includes chitosan.
EP0808181A1 discloses the pre-treatment of an object with a gaseous plasma sustained in a variety of gases, and coating the pre-treated surface with a solution containing a reaction product of the hyaluronic acid, or the derivative thereof, and the alkoxy silane coupling agent. In another embodiment, the plasma pre-treated object is coated with a solution containing the reaction product of the semisynthetic polymer and the alkoxy silane coupling agent, wherein the semisynthetic polymer may be an ester of chitosan. The object may be a catheter.
A common technique for increasing the wettability of polymer blends before depositing chitosan is treatment with non-equilibrium gaseous plasma. The plasma consists of reactive species such as molecular radicals and free atoms, which may bond chemically on the polymer surface, thus increasing the wettability and adhesion of chitosan [Ren Y., et al., Influence of DBD plasma pretreatment on the deposition of chitosan onto UHMWPE fiber surfaces for improvement of adhesion and dyeing properties, Appl. Surf. Sci. 396 (2017) 1571, Terpiłowski K., et al., Influence of nitrogen plasma treatment on the wettability of polyetheretherketone and deposited chitosan layers, 37 (2017) 1557]. A complex method for the treatment of medical-grade polyvinyl chloride is disclosed in [Asadinezhad A., et al., A physicochemical approach to render antibacterial surfaces on plasma-treated medical-grade PVC: Irgasan coating, Plasma Process Polym. 7 (2010) 504]. The samples were treated with a diffuse coplanar surface barrier discharge plasma in the air at ambient temperature and pressure, followed by radical graft copolymerization of acrylic acid onto the surface and deposition of irgasan as a potent biocide. A moderate hydrophilicity of the polyvinyl chloride with a water contact angle of 65° was reported. Plasma treatment enabled a good adhesion of the acrylic acid but was not useful for the adhesion of a chitosan film. However, the plasma used in mentioned treatments differs from the present aspects of the disclosed embodiments, particularly in the ratio between the ion and neutral radical densities.
The problem of poor adhesion of the water solution of chitosan is overcome by the present aspects of the disclosed embodiments as defined in the independent claim. Preferred embodiments are defined in dependent claims. The aspects of the disclosed embodiments is based on treatment with gaseous plasma, wherein the outer surface of a catheter is subjected to a flux of reactive species and radiation. Both cause bond scission and, thus, the formation of dangling bonds. The reactive species from gaseous plasma will occupy the dangling bonds and thus interact chemically on the surface of the catheter. If reactive species are oxidative species such as O atoms or OH radicals, they will cause the formation of oxygen-containing functional groups on the catheter's surface. The plasma treatment will also cause the degradation (calcination) of any organic impurity on the catheter surface.
The essence of the method according to the aspects of the disclosed embodiments is that it comprises four key steps:
This method enables the hydrophilic character of the chitosan coating on hydrophobic raw urinary catheters and, thus, excellent lubrication properties of catheters treated according to the methods of the aspects of the disclosed embodiments. The present aspects of the disclosed embodiments discloses a four-step method for the optimal surface finish of catheters with a thin chitosan film of optimal wettability and, thus, the swelling properties which are preferred for urinary catheters made from medical-grade polymer blends.
In the first step, the catheters are treated with a low-pressure non-equilibrium gaseous plasma to make the surface hydrophilic, i.e., the water contact angle is approximately 50° or even below. The hydrophilic surface finish of the raw catheter will ensure good wetting with any liquid, particularly with polar liquids. Preferably, the hydrophilic surface finish of the catheters treated with the plasma in the first step is achieved by careful selection of the treatment parameters.
In the second step, a water solution or suspension of chitosan is applied to the catheters. The solution may be applied by dipping, spraying, or any other method. The preferred concentration of chitosan is between 1 and 5% w/v, most optimally around 2 to 2.5% w/v, as the viscoelastic properties of the solution, surface tension, as well as polydispersity index are favourable at those concentrations. After applying the water solution, the catheters are hung vertically so that the excessive solution is removed. The catheters are then dried by any method, including vacuum drying, fanning, or heating until the water evaporates. After the second step, a thin continuous film of dry chitosan with a uniform thickness is obtained. The adhesion between the chitosan film and the catheter is good because the catheters were previously treated according to the first step.
It has been noticed by the inventors that the wettability of dry chitosan on catheters is not optimal because the water contact angle is approximately 85°. Therefore, the fourth step d) is employed to make the chitosan highly wettable and thus enable rapid swelling upon contact with water. The fourth step is exposure to non-equilibrium gaseous plasma sustained in molecular gases. The inventors have surprisingly observed that even a brief plasma treatment (shorter than the treatment in step a)) leads to improved properties of polymer catheters. Preferably, treatment in step d) is performed for 0.1 to 10 seconds, most preferably 1 to 3 seconds. The chitosan film will absorb water deposited onto the sample treated with all four steps within a few seconds after the incubation of the chitosan-coated catheter with water, thus making the catheter useful for application in a quick and efficient manner.
Both plasma treatments (in the first and the fourth steps) can be performed at any pressure useful for sustaining gaseous plasma in the non-equilibrium state. Low-pressure plasma is preferred because it enables a rather uniform flux of reactive plasma species onto the entire outer surface of a catheter and because the non-equilibrium gaseous plasma does not cause significant heating of catheters during the exposure to plasma species. In a preferred embodiment, the gas pressure is between 1 and 100 Pa. Much lower pressure will make the whole process longer because of the lower flux of gaseous species. Much larger pressures will make it difficult to sustain a uniform plasma in a large volume, so uniform treating of many catheters in a batch would be difficult. Furthermore, elevated pressures will cause significant heating of the catheters during the plasma treatment.
The type of gas used for sustaining plasma is not particularly limited. Single gasses or mixtures can be used, wherein plasma treatment may be performed in a single step or sequentially. An example of the latter is treatment with hydrogen plasma followed by oxygen plasma. Both noble gases and reactive gases could be used. The residual atmosphere in a hermetically-tight vacuum chamber will contain water vapor, so when employing noble gases, the atmosphere in the vacuum chamber will be a mixture of noble gas and water vapor. Mixtures of a noble gas and a reactive gas are preferred because the large concentration of a noble gas would help spread uniform plasma throughout the vacuum chamber. Plasma in the first and the fourth step can be sustained in a reactive gas in the absence of a noble gas. The list of suitable reactive gases includes but is not limited to water vapor, oxygen, ozone, nitrogen, carbon oxides, ammonia, and mixtures of these gases, including air.
The type of discharge used for sustaining gaseous plasma is not particularly limited. Both continuous and pulsed discharges are useful. If the treatment is performed at atmospheric pressure, pulsed discharges (such as corona or dielectric barrier discharge) capable of sustaining plasma streamers are preferred. Low-pressure discharges are preferred. Radio-frequency and pulsed direct current discharges are preferred for sustaining plasma at low pressure.
The method may be used for all polymeric catheters to produce ready-to-use chitosan-coated catheters with supreme wettable properties. Usually, catheters are made of a medical-grade polyvinyl (PVC) blend and from a thermoplastic elastomer (TPE) blend, and the method is efficient for the treatment of both preferred materials. The chitosan-coated catheters are characterized in that the chitosan layer is highly wettable and the water contact angle is approximately 50° or lower, preferably 40 °±5° or lower.
Embodiments and examples illustrating the methods of the aspects of the disclosed embodiments will now be discussed with reference to the accompanying figures, which show:
While the methods of the aspects of the disclosed embodiments may be used for all types of polymer catheters, the usefulness is demonstrated for two types of catheters, one made from a medical-grade polyvinyl (PVC) blend and the other one from a thermoplastic elastomer (TPE) blend. These materials exhibit appropriate properties and are standardly used for the synthesis of urinary catheters. Both materials are moderately hydrophobic with a water contact angle of approximately 98° and 100° for PVC and TPE, respectively. These materials do not swell upon wetting: a water droplet will dry rather than be absorbed by the PVC or TPE blends. If immersed in water or a water solution of chitosan and pulled from the water, some randomly distributed water droplets will remain on the surface of the catheters, but the vast surface will remain dry. This is a consequence of an imbalance between the surface energy of catheters and water. If catheters are dipped into a water solution of chitosan and pulled out and dried, chitosan will be scarce and non-evenly distributed on a catheter surface. Furthermore, when a catheter previously dipped in a chitosan solution and then dried is dipped into water, the chitosan deposited on the untreated catheter will dissolute in the water. The term untreated catheters here means that they were not pretreated by any means to improve their wettability or adhesion before immersion into a water solution of chitosan The untreated catheters are, thus, impractical for application because of the high friction due to the lack of a uniform chitosan coating.
The effect of the first step of the method, i.e., treatment with non-equilibrium oxygen plasma, is illustrated in
In the second step (5), a water solution of chitosan is deposited on the catheter to form a layer (6) of water solution of chitosan, as the surface with polar functional groups (4) will attract water upon application of the water solution of chitosan (5). As a result, a thin layer of water solution of chitosan (6) will remain evenly distributed on the entire surface even after pulling the catheter out from the water solution of chitosan, as illustrated in
The wettability of dry chitosan is sometimes inadequate, so the catheters with the solid layer of dry chitosan (8) are treated with the fourth step, i.e., with gaseous plasma (9). The properties of gaseous plasma (9) may differ from the properties of gaseous plasma (3) in the first step. Typically, the treatment time in the fourth step of plasma treatment (9) is shorter than in the first step of plasma treatment (3), preferably the second plasma treatment (9) is approximately 0.1 to 10 seconds long, which is about 10-times shorter than the first plasma treatment (3). The second plasma treatment (9) causes the formation of polar groups (10) on the surface of the solid layer of dry chitosan (8). The catheters with the solid layer of dry chitosan (8), functionalized with polar groups (10), are ready for packaging, sterilization, and transportation. The shelf time of catheters with a solid layer of dry chitosan (8) is very long, usually several years. Before application, the catheters with the solid layer of dry chitosan (8), functionalized with polar groups (10), are soaked (11) with water to form a lubricant layer (12) resembling chitosan gel.
The methods of the aspects of the disclosed embodiments are further disclosed in the following examples. In all examples, a catheter or a bunch of catheters were assembled into the system shown schematically in
PVC catheters were mounted in a plasma reactor, shown schematically in
PVC catheters were mounted in a plasma reactor, shown schematically in
PVC catheters were mounted in a plasma reactor, shown schematically in
TPE catheters were mounted in a plasma reactor, shown schematically in
TPE catheters were mounted in a plasma reactor, shown schematically in
Example 6: A Catheter Made from TPE Blend, the First Step Using Subsequent Treatment with Nitrogen and Oxygen Plasmas
TPE catheters were mounted in a plasma reactor, shown schematically in
The examples are provided just as a few embodiments. A skilled person will be able to use other embodiments. For example, treatment times and discharge power densities could be altered. The gas pressures could also be different from those disclosed in the examples. The reactive gases could be mixed with one or more noble gases to benefit from plasma uniformity. Other reactive gases may be used in different embodiments. The concentration of chitosan in the water solution may be varied, too.
| Number | Date | Country | Kind |
|---|---|---|---|
| 22216671.2 | Dec 2022 | EP | regional |
