Mechanical characteristics of plastic base Ports and impact on flushing efficacy

Mechanical characteristics of plastic base Ports and impact on flushing efficacy

Gérard Guiffant,1 Patrice Flaud,1 Laurent Royon,1 Espérie Burnet,2 Jacques Merckx1–3 1University Paris Diderot, Biofluidic Group, UMR CNRS, 2Pulmonary Department and Adult Cystic Fibrosis Centre, Cochin Hospital, 3University Teaching Hospital, Necker-Enfants Malades,...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Guiffant G, Flaud P, Royon L, Burnet E, Merckx J
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2017
Materias:
TIVAD
Plastic port
Polyoxymethylene
flushing
infection
occlusion
Medical technology
R855-855.5
Acceso en línea:https://doaj.org/article/65511fca2ee54fe6a11f2481c425f5fd
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:65511fca2ee54fe6a11f2481c425f5fd
record_format dspace
spelling oai:doaj.org-article:65511fca2ee54fe6a11f2481c425f5fd2021-12-02T00:03:07ZMechanical characteristics of plastic base Ports and impact on flushing efficacy1179-1470https://doaj.org/article/65511fca2ee54fe6a11f2481c425f5fd2017-01-01T00:00:00Zhttps://www.dovepress.com/mechanical-characteristics-of-plastic-base-ports-and-impact-on-flushin-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Gérard Guiffant,1 Patrice Flaud,1 Laurent Royon,1 Espérie Burnet,2 Jacques Merckx1–3 1University Paris Diderot, Biofluidic Group, UMR CNRS, 2Pulmonary Department and Adult Cystic Fibrosis Centre, Cochin Hospital, 3University Teaching Hospital, Necker-Enfants Malades, Paris, France Background: Three types of totally implantable venous access devices, Ports, are currently in use: titanium, plastic (polyoxymethylene, POM), and mixed (titanium base with a POM shell). Physics theory suggests that the interaction between a non-coring needle (NCN, made of stainless steel) and a plastic base would lead to the stronger material (steel) altering the more malleable material (plastic). Objectives: To investigate whether needle impacts can alter a plastic base’s surface, thus potentially reducing flushing efficacy. Study design and methods: A Port made of POM was punctured 200 times with a 19-gauge NCN. Following the existing guidelines, the needle tip pricked the base with each puncture. The Port’s base was then examined using a two-dimensional optical instrument, and a bi-dimensional numerical simulation using COMSOL® was performed to investigate potential surface irregularities and their impact on fluid flow. Results: Each needle impact created a hole (mean depth, 0.12 mm) with a small bump beside it (mean height, 0.02 mm) the Reynolds number Rek≈10. A numerical simulation of the one hole/bump set showed that the flushing efficacy was 60% that of flushing along a flat surface. Discussion: In clinical practice, the number of times a Port is punctured depends on patient and treatment characteristics, but each needle impact on the plastic base may increase the risk of decreased flushing effectiveness. Therefore, the more a plastic Port is accessed, the greater the risk of microorganisms, blood products, and medication accumulation. Conclusions: Multiple needle impacts created an irregular surface on the Port’s base, which decreased flushing efficacy. Clinical investigation is needed to determine whether plastic base Ports are associated with an increased risk of Port infection and occlusion compared to titanium base Ports. Keywords: TIVAD, plastic Port, polyoxymethylene, flushing, infection, occlusionGuiffant GFlaud PRoyon LBurnet EMerckx JDove Medical PressarticleTIVADPlastic portPolyoxymethyleneflushinginfectionocclusionMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 10, Pp 11-15 (2017)
institution DOAJ
collection DOAJ
language EN
topic TIVAD
Plastic port
Polyoxymethylene
flushing
infection
occlusion
Medical technology
R855-855.5
spellingShingle TIVAD
Plastic port
Polyoxymethylene
flushing
infection
occlusion
Medical technology
R855-855.5
Guiffant G
Flaud P
Royon L
Burnet E
Merckx J
Mechanical characteristics of plastic base Ports and impact on flushing efficacy
description Gérard Guiffant,1 Patrice Flaud,1 Laurent Royon,1 Espérie Burnet,2 Jacques Merckx1–3 1University Paris Diderot, Biofluidic Group, UMR CNRS, 2Pulmonary Department and Adult Cystic Fibrosis Centre, Cochin Hospital, 3University Teaching Hospital, Necker-Enfants Malades, Paris, France Background: Three types of totally implantable venous access devices, Ports, are currently in use: titanium, plastic (polyoxymethylene, POM), and mixed (titanium base with a POM shell). Physics theory suggests that the interaction between a non-coring needle (NCN, made of stainless steel) and a plastic base would lead to the stronger material (steel) altering the more malleable material (plastic). Objectives: To investigate whether needle impacts can alter a plastic base’s surface, thus potentially reducing flushing efficacy. Study design and methods: A Port made of POM was punctured 200 times with a 19-gauge NCN. Following the existing guidelines, the needle tip pricked the base with each puncture. The Port’s base was then examined using a two-dimensional optical instrument, and a bi-dimensional numerical simulation using COMSOL® was performed to investigate potential surface irregularities and their impact on fluid flow. Results: Each needle impact created a hole (mean depth, 0.12 mm) with a small bump beside it (mean height, 0.02 mm) the Reynolds number Rek≈10. A numerical simulation of the one hole/bump set showed that the flushing efficacy was 60% that of flushing along a flat surface. Discussion: In clinical practice, the number of times a Port is punctured depends on patient and treatment characteristics, but each needle impact on the plastic base may increase the risk of decreased flushing effectiveness. Therefore, the more a plastic Port is accessed, the greater the risk of microorganisms, blood products, and medication accumulation. Conclusions: Multiple needle impacts created an irregular surface on the Port’s base, which decreased flushing efficacy. Clinical investigation is needed to determine whether plastic base Ports are associated with an increased risk of Port infection and occlusion compared to titanium base Ports. Keywords: TIVAD, plastic Port, polyoxymethylene, flushing, infection, occlusion
format article
author Guiffant G
Flaud P
Royon L
Burnet E
Merckx J
author_facet Guiffant G
Flaud P
Royon L
Burnet E
Merckx J
author_sort Guiffant G
title Mechanical characteristics of plastic base Ports and impact on flushing efficacy
title_short Mechanical characteristics of plastic base Ports and impact on flushing efficacy
title_full Mechanical characteristics of plastic base Ports and impact on flushing efficacy
title_fullStr Mechanical characteristics of plastic base Ports and impact on flushing efficacy
title_full_unstemmed Mechanical characteristics of plastic base Ports and impact on flushing efficacy
title_sort mechanical characteristics of plastic base ports and impact on flushing efficacy
publisher Dove Medical Press
publishDate 2017
url https://doaj.org/article/65511fca2ee54fe6a11f2481c425f5fd
work_keys_str_mv AT guiffantg mechanicalcharacteristicsofplasticbaseportsandimpactonflushingefficacy
AT flaudp mechanicalcharacteristicsofplasticbaseportsandimpactonflushingefficacy
AT royonl mechanicalcharacteristicsofplasticbaseportsandimpactonflushingefficacy
AT burnete mechanicalcharacteristicsofplasticbaseportsandimpactonflushingefficacy
AT merckxj mechanicalcharacteristicsofplasticbaseportsandimpactonflushingefficacy
_version_ 1718403987675283456

Ejemplares similares