CA2149216C - Iontophoretic structure for medical devices - Google Patents
Iontophoretic structure for medical devices Download PDFInfo
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- CA2149216C CA2149216C CA002149216A CA2149216A CA2149216C CA 2149216 C CA2149216 C CA 2149216C CA 002149216 A CA002149216 A CA 002149216A CA 2149216 A CA2149216 A CA 2149216A CA 2149216 C CA2149216 C CA 2149216C
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- Prior art keywords
- galvanic
- metal particles
- catheter
- conductive polymer
- conductive
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/20—Applying electric currents by contact electrodes continuous direct currents
- A61N1/30—Apparatus for iontophoresis, i.e. transfer of media in ionic state by an electromotoric force into the body, or cataphoresis
- A61N1/303—Constructional details
- A61N1/306—Arrangements where at least part of the apparatus is introduced into the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/20—Applying electric currents by contact electrodes continuous direct currents
- A61N1/30—Apparatus for iontophoresis, i.e. transfer of media in ionic state by an electromotoric force into the body, or cataphoresis
- A61N1/303—Constructional details
Abstract
An iontophozetic structure for medical devices is provided that uses controlled electrical current derived from two dissimilar galvanic materials to drive oligodynamic metal ions (38) into olution to kill bacteria on and near the device to which the structure is affixed. In one embodiment, a first galvanic material (32) separated from a second galvanic material (34) by a resistive material (30) produces an anti-bacterial current flow when placed in contact with an electrolytic fluid. In another embodiment, a cylindrical elastomeric catheter (10) incorpotates a first and a second galvanic material separated by a resistive material which controls a current flow between the galvanic materials when the catheter is immersed in an electrolytic fluid. The galvanic materials can be dissimilar metal powders embedded in a conductive polymer substrate that forms an iontophoretic composite material, or dissimilar metals arranged in layers (76; 80) separated by a resistive layer (78). In yet another embodiment, the iontophotetie composite material is configured as an infection control sleeve (60) that covers a portion of an ordinary catheter or cannula. Methods of protecting implantabte medical devices and body structures with the iontophoretic strucriaxes are also provided.
Description
dV~ 9d11105~° ' ~ ~" ~ ~ ~ ~ ~ PC'I tU~~3/1091 ~
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~j.l~~' g TONTOP~iQRETIC STRUCTURE FOR MEDICAL DEVICES
FIELD OF THE INVENTION ,w The invention relates to oligoclynamic iontophoresis, and ,.
more particularly to an electrically conductive structure for medical devices that reduces or eliminates bacterial infection by killing bacteria with controlled oligodynamic iontophoresis.
BACKGROUND OF THE INVENTTON
Oligodynami~ metals, such as silver, are effective in minute quantities as bacteriostats and bactericides. The , most active form of these oligodynamic metals is as ions in solution. While the precise nature of 'the bactericidal effect is unknown, it is believed to involve altering the function of the cell membrane orlinking to the cell's DNA
to disrupt cell function. The bactericidal action is effective agaihst a broad spectrum of bacteria, including all of the common strains which cause infection. When these metals are used in the minuteaconcentratzons required t~ kill i or stem the growth of bacteria, they do not~:have any !, detrimental effect an normal mammalian cells.
Silver is used routinely in antibacterial salves, suci~
i ' as si3ver sulfadi;azine, and has also been used in clinical trials '~o coat gauze for burn dressings. Medical de~rices, such as catheters, with silver impregnated in a soluble collagen or polymer coating'are also known. After these catheters are placed, the~coating'slo~aly dissolves and the silver ~is released over time~into the environment. The infect~.on rates: with these products are reported to ~e twc~
to four times lower than sta~adard catheters, One catheter that uses silver as ~.n antibacterial. agent has had only limited success because the device, c~nsisting ' cuff whieh is inserted just of a silver impregnated collagen below the skin, is difficult to place correctly. The cuff ; v _ ._...___............. ..
;~ ~~..,~~t ~..~yvo ~~n~~s$ ~ . ~ 1 ~ ~ ~ ~ ~ PG'f/US93/10911 is also expensive, increasing he cost of a central venous catheter almost three-fold. Other catheters for reducing infection rates use well known approaches, most of them varying only in tho type and soluibility of the silver or ~ silver-alloy coating.
Many of tha prior art catheters that use oligodynamic metals as bacteriostats fail to adequately prevent infection for one or more o~ the following r~ason~: l) Silver released from soluble coatings is not always in the same charge state 1.0 and often is not charged at aZl, therefore its bactericidal potential ~.s not optimized; 2) With soluble-coated catheters, once the coating dissolves,. usually over about two weeks there .is no further antibacterial protection; 3) A non-soluble silver, silver alloy.'or silver-oxide coating can prevent colonization of the cathetex to a limited extent; but the ol~,godynamic metal is not reloased into the surrounding;
fluid or tissue; 4) Due o the substantaal change ire the catheter placement, procedure; the uee of these catheters requires additional personnel training; and 5) Altixough 20 infection can enter the body through-either the interior or the exterior of the cathe~~r;~ not all catheters provide both interior and exterior protection. Furthormr~re, despite the capability of silvex-alloy coated devicos to produce ~ two to four fold reduction in bacterial colonization, their ha;gh 2a cost greatly detracts from their modest capabilities.
Research from the 19'70's onward has been d~.rected 'toward improving the antibacterial effects c~f o3.igodynam.ic metals by electrically injecting the metal ions into solution. 'This process,,known as oligodynamic iontophoresis-; is capable of 30 reducing bacterial colonization fifteen ~o one-hundred fold.
Iontophoresis describes the movement of ions in a conductive fluid under 'the inf luence of law-strength electric fields, and in ;his context xefers to the (arcing of ions .into a conductive.~auid environment using'minute electric currents-:
35 For example,: if two electrodes made of a metal; such' as s2l~rer, 'are introduced into a conductive medium, such as W~,94/1145 , 2 ~ ~ ~ ~ ~ 6 PC.°T/US93/10911 ..' ;
_ 3 _ saline, blood or urane, and an electrical potential is . applied across the electrodes, silver dons are driven into solution creating an enhanced bactericidal effect., The current required to safely drive a sufficient amount of silver ions into solution to control infection is in the s .
range of 1 to 400 microAmperes. This current range does not cause localized cell necrosis arid it is below the sensory or pain thresh~o~d.
Despite its great potential, the oligodynamic iontophoresis phenomenon has found limited use in conjunction with medical devices, although urological. or Foley catheters have progressed to animah experiments. With respect to Foley catheters, researchers have identified several deficiencies ' i in prior art devices. Foremost is that the electrodes used to force ions into solution wear out, or corrode, at the 1 interface between air and the conductive medium. This problem probably also arises in blood-or saline environments as well as urine: Other s~;gnificant draw~aacks wiah prior art iontophoretic devices inoludc bulky, current-contro~.led power sources required for driving the electrodes; electrode configurations that do not protect both the outside axad the inside of the catheter; and manufacturing processes that are labor intensive.
An example of an infection control catheter hat. uses separate electrodes on the catheter and an ext~rr~al 'power supply to drive ions into solution is U:S. Patent N~:
4,412,648 to l7avis. Other prior art oligodynamic iontophoresis devices do not use ex~erna~ power supplies.
't ~ For example, ~3.S. Patent No. 4r886,505 to Haynes, teaches 3Q placing two meals in direct physical contact to produce electrical currents. The currents produced, however, are ~;ikely to be too large t~ be safely used and possibly will alter the pH of the environment. In German Patent Docuanent D~ 3,g3a,359, two dissimilar metal powders not in electrical c~ntact with each other are embedded in a nonconductive catheter material,'such as electrically in~u3ating polymers.
s, , , ~ ' i :y Ck~ ~ . .. _ . ~. . .~__. ,...., . _..
,p. ~," . , .,.. _ . .
v .~-,..lr' WV~ 9~/1105~ . ~ ~ ~ ~ ~ ~ ~ P4.'f/US93/10911 ~,~:,;:,.a ~ !.l' w~ (~ a Hecause of the separation of dissimilar metals by an insulator, it is not likely that there is any iontoghoresis effect in this device as a result of a potential being created by the dissimilar metals, except for the possibility of when a biofilm forms on the catheter surface to complete the circuit. Were an electr~.cal circuit to be foxmed in this manner, the current density would not be regulated or predictable, arid the current produced therefore could be either too high to be safe or too ldw ~o be effective.
l0 An oligodynamic iontophoresis catheter which uses the properties of metals to generate a'current and to form an ion barrier for killing bacteria at a' localized body ' entry is disclosed in U.S. patent No.-4,569,6?3 to Tesia Tesi teaches placing a strip of an oligodynamia metal on a nonconductive substrate. The oligodynamiG metal acts es a sacrificial galvanic anode and gives off ions whan placed in conductive contact with a dissimilar metal by placing the catheter in r an electrolytic solution. because the conductivity and pH
of urine, far example, varies over time within the same person, as well as from indi~r.~dual to individual, it would be extremely difficult tea achn.eve a specific au~rrent density at a given time with 'any p=ecision or predictability. i Additionally, the Tesi device only provides localized infection control.
Thus, none of these devices fulfill the promise held out j by oligodynamic iontophoresis for reducing infection in ~.ong-term indwelling medical devices.
'i SUMMARY OF THE INVENTION
The present inventionprovides an iontophoretic ~30 structure'for a medical device that reduces the risk of ~,nfectzon associated with pxolonr~ed medical device implantation in the bodyo Specifically, the invention is v dixacted toward meting performance goals of general antibacterial effectiveness; ma.nimal electgode corrosion;
precise control of electrical current; portability -of the K
T
' :.c,, V1~0 94/11~5~~ ' ~ ~ ~ (~ ~ ~ ~ PCT/LJS93/10911 YJ'~ ~;~
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current source; and ease of manufacture. These performance requirements can be readily addressed by a number of embodiments in which a controlled electrical current drives oligodynamic metal zone into solution to kill bacteria on and near the iontophoretic structure.
In one embodiment, an ~on~ophoretic structure for a medical device includes a first and second' galvanic material separated by a- resistive material, which when placed in contact with an electrolytic solution creates a current flow which injects anti-bacterial oligodyriamic metal ions into the solution:
_ In another embodiment; an elastomer incorporates a first and a second galvanic material separated by resistive material which controls a current flow between the galvanic materials when the elastomer is immersed in an electrolytic fluid. The first and second galvanic materials can be, metal powders in a conductive polymer that forms a composite material which may be dip-~craated over an existing catheter or extruded to form the catheter i~s~lf. Alternativel~r, the galvanic materials can be configured in layered structures, wherein each metal layer is separated from the other by a resistive layer. The layered structuxes can be placed on surfaces of the catheter where antibacterial action is desired.
~25 In another embodianent, two dissimilar metal paw~ders embedded in a conductive polymer substrate create an infection control sleeve that covers ~n ordinary catheter.
Whcn the sleeve is placed in anelectrolytic fluid to complete a circuit between the metal,powders, metal ions are driven .into solution where they have an antibactera.al effect catheter introducer This embodiment is else useful as a ' sheath.
In yet another embodiment, a method is provided for giving an, implantable medical device antibacterial properties by placing an ioritophore~ic structure on its surface prior to implantation. The iontophoretic structure can be either W~,94/110~5 ' ~ ~ /~ ~ ~ 1 6 ~G°T/U593/1~911 a coating including two dissimilar metal powders in a conductive polymer substrata, or a layered structure having two dissimilar metal layers separated by a conductive layer.
Tn still another embodiment, a method is grovided for protecting a naf:ural body structure with an iontophoretic structure comprising,two d~.ssimilar metal powders in a , conductive base material. The iontophoretic structure is painted c~nta the body structure when tie base material is in a softened or uncured state. The base material is then allowed to harden ar cure.
DFSCRIPTTUN QF THE DRAWINGS
The invention will be more fully understood from the following detailed desaription'taken in conjunction with the accompanying drawings in which: .
Fief. 1 is a perspective view of an iontophoresis ' catheter incorporating a composite material comprising metal powders in a conductive elastbmeric matrix;
Fig. 2 is a partial secti~nal view of the ~.on~.c~phoresis catheter o~ Fig. 1;
Fig. 3 is a depictiox? of the iontophoresis effect created by the composite material in the catheter of Fig. 1, Fig. 4 is a perspective view, of a pacing lead coated with the camp~site material of Fig. 1, Figl: 5 is a perspect~;ve view of an art~.ficial hip joint partially coated with the composite material of Fig. 1;
Fig. 6A is a perspective view of an infusian pump coated with the composite material of Fig. ~L;
Fig. 68 is a perspectiveview of a tooth coatod with the composite material of Fig. 1;
Fig. 7 is a perspective view ~f a catheter with an iorrtophoresis infection 'cont~oI sheath;
Fig. 8 is a perspective view of a catheter ~tith an ir~ntophoresis infection control intr~ducer sheath;
Fig. 9 is a perspective view of an iontophoresis catheter having a plurality of layered elect~odest - _ .. _..
.i . ~ _.~...._ . . . ,:... _ ..:.. .__: .. . ._._._. _ ~._,m.. -...
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....., .."-.; ~. .~.,: . ,:::.. .....~~,.~;'..
~.:~u"..~.~,v .... . "..,,... . ,. -.. " .:..,. ., ., ..,.:...,. ,, :, ,, ;:.;,.
o '.:..,.. ~,..~.,. -::--:'. .,.:;..~.;.; . .. -, . ,.;.,...:, , ,,,,.,.:.
;...,,;,.,,;;.
,. . .,., , .., . . .. . ~...:.... ~.. . -.. ,. , .. ... . ... , .... . .
...
.,.. w... "...v.. . ,...
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,,. >;. ' .:..:~ ..:~' :''; ;: :.., ;;:._; ::: .,.v .
i ;, ., ,. ; , , ~.;,,:. , ... ','. , ' . .. , ~ . . ::....~.. ~ , ~; .. ,...
.... ;, .. ; . .,...: . ,.,... .., .: ,.... r.. . . ',. ~...~.~... . ... , .
.. .
W~ 9~t/l lti5~~ ' ~ ~ ~ ~ ~ ~ ~ PC'T/US93/10911 :, ~r.
Fig. 10 is a perspective view of an alternative embodiment of an iontophoresi~' catheter having a plurality of layered electrodes arranged in strips; and Fig. 11 is a partial sectional view of the iontophoresis catheter of Fig: 10.
DETAILED DESCRIPTION OF THE TNVENTION
Iontophoretic structures in accordance with the invention may be divided into two categories: a composite material used to coat a medical device, or a 'plurality of discrete layered electrodes placed on the medical device,, _ both of which categories are disclosed hereinbelow. The medical device can be a short-term, long-tsrm, ar permanent implant and includes such devices as:~ urinary catheters, vascular access catheters and introduces sheaths, fluid x5 introduction tubing and fittings such as intra-venoustubing, a:
urinary drainage bags and tubing; chest drainage tubes, infusion pumps, pacing~leads, tracheotomy tubes,: ventilation tubes, prosthetic joints, heart valves, wound dressings,-orthopedic pins or plates,, or any other medical device used ZO in an environment or apppication where anti--bacterial properties are a consideration. however, because urinary catheters are an especially attractive application for the iontophoretic structures, the ensuing datailed description is directed hereto.
25 With respect to the first category 'of i~ntapho=etic' structure for a medical device,; Fig. 1 illustrates an exemplary iontophnresis catheter 10 that uses the composite' material approach to kill bacteria: The iontophoresis catheter 10 is substantially identical to a normal: or non-3,0 infection controlling catheter in that it is a hollow flexible tube comprising an elastomeric wall 12 having an inner surface 14 and an outer surface l5, a proximal end 18;
' and a distal end 20. The generally cylindrical inner surface 14 defines a lumen 22 for the passage' of fluid. both the 35 j~roximal, end 18 and the distal end 20 are provided with one ,.X,. W~ 94!11058' . ~ ~ 4 ~ ~ ~ ~ PCT/US93/109I1 ax~.~
~ $ s or more openings 26 to allow the fluid to be introduced or evacuated from the lumen 22. The distal end 2o is shaped to facilitate insertion or placement o~ the iontophoresis' catheter 10 into thebody. The iontophoresis catheter 10 may also be fitted with a retention device 28, such as a balloon f fitting, - to prevent unintentional withdrawal of the iontophoresis catheter 10 from the body.
Fig: 2 is a partial sectional view of the iontephoresis ;' catheter 10 of Fig. 2, taken along the line A-A', that depicts details of a composite'material comprising galvanic materials, such as metal powders, ix~ a conductive elastomeric ' matrix 3O that distinguishes the iontoph;oresis catheter 10 from prior art Catheters. The wall ~:2 of the catheter comprises the Conductive base material 3'0, and a first and a second dissimilar metal powder, 32 and 34 respectively.
The base material 30 is a conductive polymer similar to'that used in ~tati'c-proof bags for packaging charge-sensitive electronics in ,which the conductivity ~resistivity) is controlled to a predetermined value 'by its composit~.on.
Exemplary conductive polymers can be madefrom polymers inclur~ing polyvinyl, polyestea~, polyethylene, or a naturally conductive polyvi.nylidene fluoride. When loaded with carbon ' or other conductive fillers-, for example, these po~;ymers can be made conductive and thereby used as the base'material 30 for an iontophoresis catheter 10. Exemplary first and second metal potader combinations having an eleC~rochemical half-cell potential difference .include silver and gold, silver and copper, or silver and platinum mixed' into the polymer at very low volume concentrations grior,to extrusion fabrication of 1 30 the comgbsite.catheter 10. Although these exemplary powders ~;xe ~ela~ively expensive, they are used in such minute quantities that their use does not adversely impact overa~.l cost of the iontophoresis catheter 10.
For catheter applications in which the elastomeric wall 12 is extruded, it is feasible to make the entire 'wall 12 from the composite material 30, 32, 34: Hr~wever, Foley ~~,.
' _ .. _.. ~~. . :._ ....__:., ~_....a~ .,;.. ,, :.: ~. ..;.- -:_:.
;. - e. _;: ..; -.,.. , ; ~~, .., . . ,: ~.... : .. ... . : , . .. :, ., . .;. . ... , .~- ~. . .
, . ... ..:,;.:... .. .... .... . ,,..... ".. ...., ~;T, WO 94t11458' ~ ~ ~ ~ ~ ~ ~ ~ PCTlU~93/14911 ~v~
- g -catheters which are typically made of latex and/or silicone rubber, are not extruded;
but are generally dip-cast, and (finish-coating in a ffinal dip is a natural processing step in their manufacture.
Therefflre, the iontophoresis catheter 10 can be made by finish-coating it with the composite material 30, 32, 34. Since rubber is generally inferior to plastic in terms of infection rates, overcoating with a castable plastic 'is advantageous in and of itself.
When the composite catheter to is placed in contact with or immersed in a fluid.
that is electrolytic, such as saline, blood, drug preparations, or urine, the first and second metal powders 32, 34 become an array of small batteries.
Specifically, each powdered metal . granule embedded in the base material 30 that makes contact with the electrolytic 3.5 fluid 24 becomes either an anode or a cathodes depending on the partioul.ar metals chosen as the first and second metal powders 3 2;, 3 4 Referring to Fig. '3, a depiction= of the iontophoresis effect created by the composite material 30, 32, 34 in the catheter of Fig. 2 is shown. The ffirst and second metal powders 32, 34 act as el ctrodes and create a voltage potential therebetween, whereby electrons 3&
migrate through the base material 3'0 and generate an electric current. Metal ions 38 are thus driven into the canductive fluid 24 by iontophoresis. The electric current is' regulated by the quantity and nature of metal powder 32, 34 embedded in the base material 30 and by the conductivity of the base material 30. These factors are adjusted so that the current and ultimate metal ion densities ale in an efficacious and safe range by use of the following: formula:
r 'AMP y In -, z/~
CM'2 4=p L 1 wh~.re~na "I" is the'total average current per unit surface area (amperes per cm2), ", ' "~",. '.. . ';.: . . ,.; ~.. .' ~~.. ~.~..,.~ ,. ... . . . , ;;~ fVO 9~411105~ 1'CT/1JS93/10911 - is -"p" is the volume resistivity of the conductive base .
.material 30 (~hm-cm), ~
"r" is the average metal powder granule radius (cm);
"V" is the voltage produced by the two dissimilar metals powders 32, 34 in the electrolytic fluid; and "L'! is the metal powder volume loading of the base material as a fractian (ie 0-1).
With respect to the above formula, the ~n~tal powders are assumed to be of the same granule size 'and of the same volume 1.0 loading. In practice, they do not have to be the same size ;
,.
and volume loading. To achieve a current density between 10'R
to 10'6 amperes per mm2, which is the desired range to be bacteriostatic or bactericidal and yet not be so high as to cause' pH changes or other' deleteriaus mammalian cell 25 reactions, the following exemplary va~.ues can be used in the above equation to define he composite material specifications V - 0:12 valts (for silver and gold in an NaCl electrolyte);
2 0 r = 10'3cm P
p = 1. 5 X 106 t ~- 5 X X04 ohm-cm; and , ~eQ~.. . ' .
An iontophoreeis catheter 10 incorporating the above described composite material has numerous advantages over the ' 25 prior art with respect to effectiveness, controllability, and ease pf use. Foremost, bacterial potency is maximized because metal is guaranteed to go 'into solution as -icans; thus producing a minimum ten-fold reduction in laacterial I colonization rate. Also, tlae iontophoresis eatheter 10 does 30 not need an external current source or controller because the iontophoresis current is self-generating and self-regulating.
Furthermore, because the metal powders 32, 3~ (electrodes) are dispersed through the base material 3o, az~d because the current ;le~tel is very low, the electrodes are functional for 35 months of use. There is also no place in the circuit where corrosion of the electrodes at the air jelectralyte interface WO 94/11058 PC'fJUS93/10911 214~~~.G
_zz_ can cause the entire catheter to become non-functional with regard to its infection resistance. Finally, there is no change in procedure for placing or maintaining the iontophore~zs catheter l0 because it is in many ways virtually identical to existing non-infection control devices in size and shape:
As previously discussed, the composite material approach finds ready application~on numerous other medical devices where antibacterial properties are desirable. Fig. 4 is an 1.0 illustration of the composite material 30, 32, 34 used to protect a pacing dead 40: The pacing lead 40 cpnnects the heart tissue to the control and monitoring'apparatus of a ;
cardiac pacemaker (not Shown) via a wire 42 and an electrode 44 in' the tissue: The wire 42 is shown covered with the l5 composite matera.al 30, 32, 34. ~Eig. 5 is a depiction of the composite material 30, 32; 34 used with a pr~osthetic.devics, ;
such as an artificial hip jgint 46. The shaft 48 is shown coated with composite material 30, ~2, 34 and implanted into a femur 50. Fig: 6A shown an infusion pump 52 coated with 20 the composite material 30, 32, 34 and connected to tubing 54 which may also be coated. '~ , The composite material 30, 32; 34 can also be coated onto a natural body structure 55, such a~ a tooth, as ~.llustrated in Fig. 6B. This is accomplished by painting the 25 composite material 30, 32, 34 onto the surface to be protected while the base material 30 is in a liquified or softened state and then letting the base n~ater~:al 30 harden.
In an alternative embodiment the base material 30 is binary adhesive, such as a catalytic,,, two-part, conductive epoxy 30 mix.
W~ah further regard to catheters,; a vascular access add . ~on device that benefits from the composite material approach for an iontophcaretic structure is shown in Fig. 7; wherein i an ordinary catheter 56 is shown fated with an ~.nfection 35 g~ntrol kit 58 incor~oratxng the c~m~aosite material 30, 32, 34: The infection control kit 58 is an after-market device ;,, WEl'94/11055 ~ ~ 4 ~ ~ ~ ~ PG~f/US93/10911 _ ~2 which includes a replaceable iontophoretic infection control sleeve 60 and an iontophoretic Luex adaptor 62 for connecting the proximal end 18 of the catheter 5 6 o intravenous ( T : V . ) tubing 64. The sleeve 60, made of or coated with the composite material 30, 32, 34 slips over the outer: surface 16 'of the catheter 56 to be inserted the body. The sleeve 60 covers anly a short section of the catheter'S6 near its proximal end 18, but is' long enough to inter the body: wherein moisture will aeti~rate the iontopharesis process: The sleeve 60 thus protects the catheter surface 16 from infection. The ,.
Luer adaptor 62 may also be made of or coated on the inner surface with the composite material' 30, 32; 34 to protect he inner surface 14 of the catheter 56 fram bacterial colonization progressing down to the -catheter 56 from the 1,5 inside of the T.V: tube 64: The sleeve f,0 is fabricated -from .
3 0 ; and one Qf the above zef erenced conductive base anaterials the Luer adaptor 62 is made of a harder plastic, such as acrylic or po~ycarbonate. The sleeve 60 may be configured to accommodate a variety of catheter sizes:
An adaptation of the composite material sleeve,60 can also be configured as ~ catheter introducer sheath 66, shown ~,n Fig. 8, for inserting pulmonary artery (Swan-Ganz or:
thermodilution) catheters, temporary pacing leads, etc., which may remain in place for several weeks. Under normal circumstances, an introduder sheath is lift- in place with the catheter which it surrounds for a portion of its' length, includi.ng,the region-where the device penetrates the skin.
Tontophoretic introducer sheaths 66 are easily manufactured with the composite material .approach because they are ' predominantly made of poly~etrafluorethylene (Teflon~} , vinyl (PVC}, or polyethylene (PE), materials, which can be loaded with carbon .or other conductive fillers or made conductive by other means known in the art and then loaded as'well as the first and second metal powders 32, 34.
Fig. 8 shows the introduces sheath 66 used in Conjunction with a.thermodilution catheter 68: Balloon and __-. _ _.__.._ . .. _.~~..~ ...., . .. . Y.. ,~ . . . . .. .
:., :7y.
~j.l~~' g TONTOP~iQRETIC STRUCTURE FOR MEDICAL DEVICES
FIELD OF THE INVENTION ,w The invention relates to oligoclynamic iontophoresis, and ,.
more particularly to an electrically conductive structure for medical devices that reduces or eliminates bacterial infection by killing bacteria with controlled oligodynamic iontophoresis.
BACKGROUND OF THE INVENTTON
Oligodynami~ metals, such as silver, are effective in minute quantities as bacteriostats and bactericides. The , most active form of these oligodynamic metals is as ions in solution. While the precise nature of 'the bactericidal effect is unknown, it is believed to involve altering the function of the cell membrane orlinking to the cell's DNA
to disrupt cell function. The bactericidal action is effective agaihst a broad spectrum of bacteria, including all of the common strains which cause infection. When these metals are used in the minuteaconcentratzons required t~ kill i or stem the growth of bacteria, they do not~:have any !, detrimental effect an normal mammalian cells.
Silver is used routinely in antibacterial salves, suci~
i ' as si3ver sulfadi;azine, and has also been used in clinical trials '~o coat gauze for burn dressings. Medical de~rices, such as catheters, with silver impregnated in a soluble collagen or polymer coating'are also known. After these catheters are placed, the~coating'slo~aly dissolves and the silver ~is released over time~into the environment. The infect~.on rates: with these products are reported to ~e twc~
to four times lower than sta~adard catheters, One catheter that uses silver as ~.n antibacterial. agent has had only limited success because the device, c~nsisting ' cuff whieh is inserted just of a silver impregnated collagen below the skin, is difficult to place correctly. The cuff ; v _ ._...___............. ..
;~ ~~..,~~t ~..~yvo ~~n~~s$ ~ . ~ 1 ~ ~ ~ ~ ~ PG'f/US93/10911 is also expensive, increasing he cost of a central venous catheter almost three-fold. Other catheters for reducing infection rates use well known approaches, most of them varying only in tho type and soluibility of the silver or ~ silver-alloy coating.
Many of tha prior art catheters that use oligodynamic metals as bacteriostats fail to adequately prevent infection for one or more o~ the following r~ason~: l) Silver released from soluble coatings is not always in the same charge state 1.0 and often is not charged at aZl, therefore its bactericidal potential ~.s not optimized; 2) With soluble-coated catheters, once the coating dissolves,. usually over about two weeks there .is no further antibacterial protection; 3) A non-soluble silver, silver alloy.'or silver-oxide coating can prevent colonization of the cathetex to a limited extent; but the ol~,godynamic metal is not reloased into the surrounding;
fluid or tissue; 4) Due o the substantaal change ire the catheter placement, procedure; the uee of these catheters requires additional personnel training; and 5) Altixough 20 infection can enter the body through-either the interior or the exterior of the cathe~~r;~ not all catheters provide both interior and exterior protection. Furthormr~re, despite the capability of silvex-alloy coated devicos to produce ~ two to four fold reduction in bacterial colonization, their ha;gh 2a cost greatly detracts from their modest capabilities.
Research from the 19'70's onward has been d~.rected 'toward improving the antibacterial effects c~f o3.igodynam.ic metals by electrically injecting the metal ions into solution. 'This process,,known as oligodynamic iontophoresis-; is capable of 30 reducing bacterial colonization fifteen ~o one-hundred fold.
Iontophoresis describes the movement of ions in a conductive fluid under 'the inf luence of law-strength electric fields, and in ;his context xefers to the (arcing of ions .into a conductive.~auid environment using'minute electric currents-:
35 For example,: if two electrodes made of a metal; such' as s2l~rer, 'are introduced into a conductive medium, such as W~,94/1145 , 2 ~ ~ ~ ~ ~ 6 PC.°T/US93/10911 ..' ;
_ 3 _ saline, blood or urane, and an electrical potential is . applied across the electrodes, silver dons are driven into solution creating an enhanced bactericidal effect., The current required to safely drive a sufficient amount of silver ions into solution to control infection is in the s .
range of 1 to 400 microAmperes. This current range does not cause localized cell necrosis arid it is below the sensory or pain thresh~o~d.
Despite its great potential, the oligodynamic iontophoresis phenomenon has found limited use in conjunction with medical devices, although urological. or Foley catheters have progressed to animah experiments. With respect to Foley catheters, researchers have identified several deficiencies ' i in prior art devices. Foremost is that the electrodes used to force ions into solution wear out, or corrode, at the 1 interface between air and the conductive medium. This problem probably also arises in blood-or saline environments as well as urine: Other s~;gnificant draw~aacks wiah prior art iontophoretic devices inoludc bulky, current-contro~.led power sources required for driving the electrodes; electrode configurations that do not protect both the outside axad the inside of the catheter; and manufacturing processes that are labor intensive.
An example of an infection control catheter hat. uses separate electrodes on the catheter and an ext~rr~al 'power supply to drive ions into solution is U:S. Patent N~:
4,412,648 to l7avis. Other prior art oligodynamic iontophoresis devices do not use ex~erna~ power supplies.
't ~ For example, ~3.S. Patent No. 4r886,505 to Haynes, teaches 3Q placing two meals in direct physical contact to produce electrical currents. The currents produced, however, are ~;ikely to be too large t~ be safely used and possibly will alter the pH of the environment. In German Patent Docuanent D~ 3,g3a,359, two dissimilar metal powders not in electrical c~ntact with each other are embedded in a nonconductive catheter material,'such as electrically in~u3ating polymers.
s, , , ~ ' i :y Ck~ ~ . .. _ . ~. . .~__. ,...., . _..
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v .~-,..lr' WV~ 9~/1105~ . ~ ~ ~ ~ ~ ~ ~ P4.'f/US93/10911 ~,~:,;:,.a ~ !.l' w~ (~ a Hecause of the separation of dissimilar metals by an insulator, it is not likely that there is any iontoghoresis effect in this device as a result of a potential being created by the dissimilar metals, except for the possibility of when a biofilm forms on the catheter surface to complete the circuit. Were an electr~.cal circuit to be foxmed in this manner, the current density would not be regulated or predictable, arid the current produced therefore could be either too high to be safe or too ldw ~o be effective.
l0 An oligodynamic iontophoresis catheter which uses the properties of metals to generate a'current and to form an ion barrier for killing bacteria at a' localized body ' entry is disclosed in U.S. patent No.-4,569,6?3 to Tesia Tesi teaches placing a strip of an oligodynamia metal on a nonconductive substrate. The oligodynamiG metal acts es a sacrificial galvanic anode and gives off ions whan placed in conductive contact with a dissimilar metal by placing the catheter in r an electrolytic solution. because the conductivity and pH
of urine, far example, varies over time within the same person, as well as from indi~r.~dual to individual, it would be extremely difficult tea achn.eve a specific au~rrent density at a given time with 'any p=ecision or predictability. i Additionally, the Tesi device only provides localized infection control.
Thus, none of these devices fulfill the promise held out j by oligodynamic iontophoresis for reducing infection in ~.ong-term indwelling medical devices.
'i SUMMARY OF THE INVENTION
The present inventionprovides an iontophoretic ~30 structure'for a medical device that reduces the risk of ~,nfectzon associated with pxolonr~ed medical device implantation in the bodyo Specifically, the invention is v dixacted toward meting performance goals of general antibacterial effectiveness; ma.nimal electgode corrosion;
precise control of electrical current; portability -of the K
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current source; and ease of manufacture. These performance requirements can be readily addressed by a number of embodiments in which a controlled electrical current drives oligodynamic metal zone into solution to kill bacteria on and near the iontophoretic structure.
In one embodiment, an ~on~ophoretic structure for a medical device includes a first and second' galvanic material separated by a- resistive material, which when placed in contact with an electrolytic solution creates a current flow which injects anti-bacterial oligodyriamic metal ions into the solution:
_ In another embodiment; an elastomer incorporates a first and a second galvanic material separated by resistive material which controls a current flow between the galvanic materials when the elastomer is immersed in an electrolytic fluid. The first and second galvanic materials can be, metal powders in a conductive polymer that forms a composite material which may be dip-~craated over an existing catheter or extruded to form the catheter i~s~lf. Alternativel~r, the galvanic materials can be configured in layered structures, wherein each metal layer is separated from the other by a resistive layer. The layered structuxes can be placed on surfaces of the catheter where antibacterial action is desired.
~25 In another embodianent, two dissimilar metal paw~ders embedded in a conductive polymer substrate create an infection control sleeve that covers ~n ordinary catheter.
Whcn the sleeve is placed in anelectrolytic fluid to complete a circuit between the metal,powders, metal ions are driven .into solution where they have an antibactera.al effect catheter introducer This embodiment is else useful as a ' sheath.
In yet another embodiment, a method is provided for giving an, implantable medical device antibacterial properties by placing an ioritophore~ic structure on its surface prior to implantation. The iontophoretic structure can be either W~,94/110~5 ' ~ ~ /~ ~ ~ 1 6 ~G°T/U593/1~911 a coating including two dissimilar metal powders in a conductive polymer substrata, or a layered structure having two dissimilar metal layers separated by a conductive layer.
Tn still another embodiment, a method is grovided for protecting a naf:ural body structure with an iontophoretic structure comprising,two d~.ssimilar metal powders in a , conductive base material. The iontophoretic structure is painted c~nta the body structure when tie base material is in a softened or uncured state. The base material is then allowed to harden ar cure.
DFSCRIPTTUN QF THE DRAWINGS
The invention will be more fully understood from the following detailed desaription'taken in conjunction with the accompanying drawings in which: .
Fief. 1 is a perspective view of an iontophoresis ' catheter incorporating a composite material comprising metal powders in a conductive elastbmeric matrix;
Fig. 2 is a partial secti~nal view of the ~.on~.c~phoresis catheter o~ Fig. 1;
Fig. 3 is a depictiox? of the iontophoresis effect created by the composite material in the catheter of Fig. 1, Fig. 4 is a perspective view, of a pacing lead coated with the camp~site material of Fig. 1, Figl: 5 is a perspect~;ve view of an art~.ficial hip joint partially coated with the composite material of Fig. 1;
Fig. 6A is a perspective view of an infusian pump coated with the composite material of Fig. ~L;
Fig. 68 is a perspectiveview of a tooth coatod with the composite material of Fig. 1;
Fig. 7 is a perspective view ~f a catheter with an iorrtophoresis infection 'cont~oI sheath;
Fig. 8 is a perspective view of a catheter ~tith an ir~ntophoresis infection control intr~ducer sheath;
Fig. 9 is a perspective view of an iontophoresis catheter having a plurality of layered elect~odest - _ .. _..
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Fig. 10 is a perspective view of an alternative embodiment of an iontophoresi~' catheter having a plurality of layered electrodes arranged in strips; and Fig. 11 is a partial sectional view of the iontophoresis catheter of Fig: 10.
DETAILED DESCRIPTION OF THE TNVENTION
Iontophoretic structures in accordance with the invention may be divided into two categories: a composite material used to coat a medical device, or a 'plurality of discrete layered electrodes placed on the medical device,, _ both of which categories are disclosed hereinbelow. The medical device can be a short-term, long-tsrm, ar permanent implant and includes such devices as:~ urinary catheters, vascular access catheters and introduces sheaths, fluid x5 introduction tubing and fittings such as intra-venoustubing, a:
urinary drainage bags and tubing; chest drainage tubes, infusion pumps, pacing~leads, tracheotomy tubes,: ventilation tubes, prosthetic joints, heart valves, wound dressings,-orthopedic pins or plates,, or any other medical device used ZO in an environment or apppication where anti--bacterial properties are a consideration. however, because urinary catheters are an especially attractive application for the iontophoretic structures, the ensuing datailed description is directed hereto.
25 With respect to the first category 'of i~ntapho=etic' structure for a medical device,; Fig. 1 illustrates an exemplary iontophnresis catheter 10 that uses the composite' material approach to kill bacteria: The iontophoresis catheter 10 is substantially identical to a normal: or non-3,0 infection controlling catheter in that it is a hollow flexible tube comprising an elastomeric wall 12 having an inner surface 14 and an outer surface l5, a proximal end 18;
' and a distal end 20. The generally cylindrical inner surface 14 defines a lumen 22 for the passage' of fluid. both the 35 j~roximal, end 18 and the distal end 20 are provided with one ,.X,. W~ 94!11058' . ~ ~ 4 ~ ~ ~ ~ PCT/US93/109I1 ax~.~
~ $ s or more openings 26 to allow the fluid to be introduced or evacuated from the lumen 22. The distal end 2o is shaped to facilitate insertion or placement o~ the iontophoresis' catheter 10 into thebody. The iontophoresis catheter 10 may also be fitted with a retention device 28, such as a balloon f fitting, - to prevent unintentional withdrawal of the iontophoresis catheter 10 from the body.
Fig: 2 is a partial sectional view of the iontephoresis ;' catheter 10 of Fig. 2, taken along the line A-A', that depicts details of a composite'material comprising galvanic materials, such as metal powders, ix~ a conductive elastomeric ' matrix 3O that distinguishes the iontoph;oresis catheter 10 from prior art Catheters. The wall ~:2 of the catheter comprises the Conductive base material 3'0, and a first and a second dissimilar metal powder, 32 and 34 respectively.
The base material 30 is a conductive polymer similar to'that used in ~tati'c-proof bags for packaging charge-sensitive electronics in ,which the conductivity ~resistivity) is controlled to a predetermined value 'by its composit~.on.
Exemplary conductive polymers can be madefrom polymers inclur~ing polyvinyl, polyestea~, polyethylene, or a naturally conductive polyvi.nylidene fluoride. When loaded with carbon ' or other conductive fillers-, for example, these po~;ymers can be made conductive and thereby used as the base'material 30 for an iontophoresis catheter 10. Exemplary first and second metal potader combinations having an eleC~rochemical half-cell potential difference .include silver and gold, silver and copper, or silver and platinum mixed' into the polymer at very low volume concentrations grior,to extrusion fabrication of 1 30 the comgbsite.catheter 10. Although these exemplary powders ~;xe ~ela~ively expensive, they are used in such minute quantities that their use does not adversely impact overa~.l cost of the iontophoresis catheter 10.
For catheter applications in which the elastomeric wall 12 is extruded, it is feasible to make the entire 'wall 12 from the composite material 30, 32, 34: Hr~wever, Foley ~~,.
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, . ... ..:,;.:... .. .... .... . ,,..... ".. ...., ~;T, WO 94t11458' ~ ~ ~ ~ ~ ~ ~ ~ PCTlU~93/14911 ~v~
- g -catheters which are typically made of latex and/or silicone rubber, are not extruded;
but are generally dip-cast, and (finish-coating in a ffinal dip is a natural processing step in their manufacture.
Therefflre, the iontophoresis catheter 10 can be made by finish-coating it with the composite material 30, 32, 34. Since rubber is generally inferior to plastic in terms of infection rates, overcoating with a castable plastic 'is advantageous in and of itself.
When the composite catheter to is placed in contact with or immersed in a fluid.
that is electrolytic, such as saline, blood, drug preparations, or urine, the first and second metal powders 32, 34 become an array of small batteries.
Specifically, each powdered metal . granule embedded in the base material 30 that makes contact with the electrolytic 3.5 fluid 24 becomes either an anode or a cathodes depending on the partioul.ar metals chosen as the first and second metal powders 3 2;, 3 4 Referring to Fig. '3, a depiction= of the iontophoresis effect created by the composite material 30, 32, 34 in the catheter of Fig. 2 is shown. The ffirst and second metal powders 32, 34 act as el ctrodes and create a voltage potential therebetween, whereby electrons 3&
migrate through the base material 3'0 and generate an electric current. Metal ions 38 are thus driven into the canductive fluid 24 by iontophoresis. The electric current is' regulated by the quantity and nature of metal powder 32, 34 embedded in the base material 30 and by the conductivity of the base material 30. These factors are adjusted so that the current and ultimate metal ion densities ale in an efficacious and safe range by use of the following: formula:
r 'AMP y In -, z/~
CM'2 4=p L 1 wh~.re~na "I" is the'total average current per unit surface area (amperes per cm2), ", ' "~",. '.. . ';.: . . ,.; ~.. .' ~~.. ~.~..,.~ ,. ... . . . , ;;~ fVO 9~411105~ 1'CT/1JS93/10911 - is -"p" is the volume resistivity of the conductive base .
.material 30 (~hm-cm), ~
"r" is the average metal powder granule radius (cm);
"V" is the voltage produced by the two dissimilar metals powders 32, 34 in the electrolytic fluid; and "L'! is the metal powder volume loading of the base material as a fractian (ie 0-1).
With respect to the above formula, the ~n~tal powders are assumed to be of the same granule size 'and of the same volume 1.0 loading. In practice, they do not have to be the same size ;
,.
and volume loading. To achieve a current density between 10'R
to 10'6 amperes per mm2, which is the desired range to be bacteriostatic or bactericidal and yet not be so high as to cause' pH changes or other' deleteriaus mammalian cell 25 reactions, the following exemplary va~.ues can be used in the above equation to define he composite material specifications V - 0:12 valts (for silver and gold in an NaCl electrolyte);
2 0 r = 10'3cm P
p = 1. 5 X 106 t ~- 5 X X04 ohm-cm; and , ~eQ~.. . ' .
An iontophoreeis catheter 10 incorporating the above described composite material has numerous advantages over the ' 25 prior art with respect to effectiveness, controllability, and ease pf use. Foremost, bacterial potency is maximized because metal is guaranteed to go 'into solution as -icans; thus producing a minimum ten-fold reduction in laacterial I colonization rate. Also, tlae iontophoresis eatheter 10 does 30 not need an external current source or controller because the iontophoresis current is self-generating and self-regulating.
Furthermore, because the metal powders 32, 3~ (electrodes) are dispersed through the base material 3o, az~d because the current ;le~tel is very low, the electrodes are functional for 35 months of use. There is also no place in the circuit where corrosion of the electrodes at the air jelectralyte interface WO 94/11058 PC'fJUS93/10911 214~~~.G
_zz_ can cause the entire catheter to become non-functional with regard to its infection resistance. Finally, there is no change in procedure for placing or maintaining the iontophore~zs catheter l0 because it is in many ways virtually identical to existing non-infection control devices in size and shape:
As previously discussed, the composite material approach finds ready application~on numerous other medical devices where antibacterial properties are desirable. Fig. 4 is an 1.0 illustration of the composite material 30, 32, 34 used to protect a pacing dead 40: The pacing lead 40 cpnnects the heart tissue to the control and monitoring'apparatus of a ;
cardiac pacemaker (not Shown) via a wire 42 and an electrode 44 in' the tissue: The wire 42 is shown covered with the l5 composite matera.al 30, 32, 34. ~Eig. 5 is a depiction of the composite material 30, 32; 34 used with a pr~osthetic.devics, ;
such as an artificial hip jgint 46. The shaft 48 is shown coated with composite material 30, ~2, 34 and implanted into a femur 50. Fig: 6A shown an infusion pump 52 coated with 20 the composite material 30, 32, 34 and connected to tubing 54 which may also be coated. '~ , The composite material 30, 32; 34 can also be coated onto a natural body structure 55, such a~ a tooth, as ~.llustrated in Fig. 6B. This is accomplished by painting the 25 composite material 30, 32, 34 onto the surface to be protected while the base material 30 is in a liquified or softened state and then letting the base n~ater~:al 30 harden.
In an alternative embodiment the base material 30 is binary adhesive, such as a catalytic,,, two-part, conductive epoxy 30 mix.
W~ah further regard to catheters,; a vascular access add . ~on device that benefits from the composite material approach for an iontophcaretic structure is shown in Fig. 7; wherein i an ordinary catheter 56 is shown fated with an ~.nfection 35 g~ntrol kit 58 incor~oratxng the c~m~aosite material 30, 32, 34: The infection control kit 58 is an after-market device ;,, WEl'94/11055 ~ ~ 4 ~ ~ ~ ~ PG~f/US93/10911 _ ~2 which includes a replaceable iontophoretic infection control sleeve 60 and an iontophoretic Luex adaptor 62 for connecting the proximal end 18 of the catheter 5 6 o intravenous ( T : V . ) tubing 64. The sleeve 60, made of or coated with the composite material 30, 32, 34 slips over the outer: surface 16 'of the catheter 56 to be inserted the body. The sleeve 60 covers anly a short section of the catheter'S6 near its proximal end 18, but is' long enough to inter the body: wherein moisture will aeti~rate the iontopharesis process: The sleeve 60 thus protects the catheter surface 16 from infection. The ,.
Luer adaptor 62 may also be made of or coated on the inner surface with the composite material' 30, 32; 34 to protect he inner surface 14 of the catheter 56 fram bacterial colonization progressing down to the -catheter 56 from the 1,5 inside of the T.V: tube 64: The sleeve f,0 is fabricated -from .
3 0 ; and one Qf the above zef erenced conductive base anaterials the Luer adaptor 62 is made of a harder plastic, such as acrylic or po~ycarbonate. The sleeve 60 may be configured to accommodate a variety of catheter sizes:
An adaptation of the composite material sleeve,60 can also be configured as ~ catheter introducer sheath 66, shown ~,n Fig. 8, for inserting pulmonary artery (Swan-Ganz or:
thermodilution) catheters, temporary pacing leads, etc., which may remain in place for several weeks. Under normal circumstances, an introduder sheath is lift- in place with the catheter which it surrounds for a portion of its' length, includi.ng,the region-where the device penetrates the skin.
Tontophoretic introducer sheaths 66 are easily manufactured with the composite material .approach because they are ' predominantly made of poly~etrafluorethylene (Teflon~} , vinyl (PVC}, or polyethylene (PE), materials, which can be loaded with carbon .or other conductive fillers or made conductive by other means known in the art and then loaded as'well as the first and second metal powders 32, 34.
Fig. 8 shows the introduces sheath 66 used in Conjunction with a.thermodilution catheter 68: Balloon and __-. _ _.__.._ . .. _.~~..~ ...., . .. . Y.. ,~ . . . . .. .
4 ~ ~ ~ s PGT~LJS93110911 ,; r", Wt~ 94/11058 ' ~:.,~,'~,;~
temperature sensing elements, 74 and 75 respectively, known to those skilled in the art, are shown on the distal end 20.
Because the inside of the introduces sheath 66 is in intimate contact with the outer surface 16 of the elastomeric wall 12, the composite material 30, 32, 34 of the introduces sheath 66 grotects both the sheath 66 and the outer wall 32 of the thermodilution catheter 68. Like the ion~tophoresis catheter 10, and the catheter 56 having an i~ntophoresis infection control kit 58, tlae introduces sheath 66 is virtually ~.0 identical in size, shape; and use asprior art devices.
As described wa.th respect' to Figs. 1-8; various embodiments of the composite material category of the iontophoretic structure for' a medical device have been a:
illustrated. Tn composite material embodiments, the integral l5 power source for driving oli~odynamic metal ions into solution is the electromotive force created by dissimilar metal powders 32, 34 embedded in and separated from each other by the conductive base material 30 of specifically created resistivity.
20 Referring now to Figs: 9-ll, a variety of embodiments of the other category of 3antophoretic structure for a medical device are shown which incorporate the p3urality of discrete layered stxuc~tures:.. Tn these embodiments a plurality of layered structures comprise dissimilar galvanic 25 materials separated by a resistive layer. These structures may be incorporated in the above-recited medical dev~.ces during manufacture, ar adhered to the surface of the devices as an aftermarket item.
Referring to Fig: 9 a perspective view of an embodiment 30 70 is shown, wherein, the of an iontophoresis catheter oligodynamio iontophoresis effect is achie~red using a ' p3ural~.ty of layered structures 72 on either the inner surface-1'4, the outer surface 16, or b~~h of a noncor~ductive wall 12. The layered structures 7~, while depicted in a 35 circuhar''configuration can be any shape, such as oval or square.
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~,;.:.. ., .., .:.'.::; ....... ..~.. , , 13'O 9.x/11058 ~ ~ ~ (~ ~ 2 ~ ~ PC'1C/US93/I0911 H nl..r Fig: 10 depicts an alternative configuration of the iontophoresis catheter 70, wherein the plurality of layered structures 72 are bands that surround the wall 12.
,:
Alternatively, the layered structures 72 can be a plurality of longifiudinal ,strips. The embodiments of Figs. 9 and 10 permit selective placement of a layered structure 72 on an a f isolated region of the wall 12, or distribution of the layered structures ?2 on the entire wall 12.
Referring t~o Fig. 11, a partial cross section of the iontophoresis catheter 70 of Fig. ltt along the Line B-B~ is shown, wherein the layered structures 72 are bands adhered to the inner surface 14 and outer surface 16 of the wall 12.
~aah layered electrode 72 comprises a first metal electrode ', 76, a resistive layer 78, and a second'metal electrode 80.
As with the font~phoresis catheter 10 of Fig: l, the metals are biocompatib~,e and form an electrical potential difference between them in an electrolytic fluid. Whereas, in the iontophoresis catheter 10 'of Fig: 1 the conductive (resistive) base materiel 3o regulates 'the current flow between the ffirst and second metals 32, 34, in this embodiment the (conductive) resistive layer 78 regulates the current flow between the dissimilar metals of the first and second elect~codes 76, 80.
For the xontophoresis cathetex 70 of Figs. 9 and l0;
wherein the f~:rst and second metal-electrodes 76, 80 of the layered structures 72 have a 1 volt gotentia~. between them;
a current density ~f 10'R Amperes per ~nan2 results fig the thickness of the resistive 3.ayer 78 is approximately 10 micrometers and has a,bulk conductivity of 10" ahm~cm and the 80 exposedlarea of each of the electrodes 7~, 80 in the layered structures 72 is the same. Typical combinations of metals used for the ,first and second metal electrodes 76; 8~
generate between Q.l,to 2 Volts. Therefore; the thickness of the above, described resistive layer 78 can be between 1 and.20 miaxomet~rs. Many'oth~r combinations of conductivity ,, . , .
and thickness for the resistive layer ?8 are possible to obtain the target current density.
Although the invention has been shown and described with respect to exemplary embodiments thereof, various other changes, omissions and additions in dorm and detail thereof may be made therein without departing from the spirit and scope of tae invention.
temperature sensing elements, 74 and 75 respectively, known to those skilled in the art, are shown on the distal end 20.
Because the inside of the introduces sheath 66 is in intimate contact with the outer surface 16 of the elastomeric wall 12, the composite material 30, 32, 34 of the introduces sheath 66 grotects both the sheath 66 and the outer wall 32 of the thermodilution catheter 68. Like the ion~tophoresis catheter 10, and the catheter 56 having an i~ntophoresis infection control kit 58, tlae introduces sheath 66 is virtually ~.0 identical in size, shape; and use asprior art devices.
As described wa.th respect' to Figs. 1-8; various embodiments of the composite material category of the iontophoretic structure for' a medical device have been a:
illustrated. Tn composite material embodiments, the integral l5 power source for driving oli~odynamic metal ions into solution is the electromotive force created by dissimilar metal powders 32, 34 embedded in and separated from each other by the conductive base material 30 of specifically created resistivity.
20 Referring now to Figs: 9-ll, a variety of embodiments of the other category of 3antophoretic structure for a medical device are shown which incorporate the p3urality of discrete layered stxuc~tures:.. Tn these embodiments a plurality of layered structures comprise dissimilar galvanic 25 materials separated by a resistive layer. These structures may be incorporated in the above-recited medical dev~.ces during manufacture, ar adhered to the surface of the devices as an aftermarket item.
Referring to Fig: 9 a perspective view of an embodiment 30 70 is shown, wherein, the of an iontophoresis catheter oligodynamio iontophoresis effect is achie~red using a ' p3ural~.ty of layered structures 72 on either the inner surface-1'4, the outer surface 16, or b~~h of a noncor~ductive wall 12. The layered structures 7~, while depicted in a 35 circuhar''configuration can be any shape, such as oval or square.
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~,;.:.. ., .., .:.'.::; ....... ..~.. , , 13'O 9.x/11058 ~ ~ ~ (~ ~ 2 ~ ~ PC'1C/US93/I0911 H nl..r Fig: 10 depicts an alternative configuration of the iontophoresis catheter 70, wherein the plurality of layered structures 72 are bands that surround the wall 12.
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Alternatively, the layered structures 72 can be a plurality of longifiudinal ,strips. The embodiments of Figs. 9 and 10 permit selective placement of a layered structure 72 on an a f isolated region of the wall 12, or distribution of the layered structures ?2 on the entire wall 12.
Referring t~o Fig. 11, a partial cross section of the iontophoresis catheter 70 of Fig. ltt along the Line B-B~ is shown, wherein the layered structures 72 are bands adhered to the inner surface 14 and outer surface 16 of the wall 12.
~aah layered electrode 72 comprises a first metal electrode ', 76, a resistive layer 78, and a second'metal electrode 80.
As with the font~phoresis catheter 10 of Fig: l, the metals are biocompatib~,e and form an electrical potential difference between them in an electrolytic fluid. Whereas, in the iontophoresis catheter 10 'of Fig: 1 the conductive (resistive) base materiel 3o regulates 'the current flow between the ffirst and second metals 32, 34, in this embodiment the (conductive) resistive layer 78 regulates the current flow between the dissimilar metals of the first and second elect~codes 76, 80.
For the xontophoresis cathetex 70 of Figs. 9 and l0;
wherein the f~:rst and second metal-electrodes 76, 80 of the layered structures 72 have a 1 volt gotentia~. between them;
a current density ~f 10'R Amperes per ~nan2 results fig the thickness of the resistive 3.ayer 78 is approximately 10 micrometers and has a,bulk conductivity of 10" ahm~cm and the 80 exposedlarea of each of the electrodes 7~, 80 in the layered structures 72 is the same. Typical combinations of metals used for the ,first and second metal electrodes 76; 8~
generate between Q.l,to 2 Volts. Therefore; the thickness of the above, described resistive layer 78 can be between 1 and.20 miaxomet~rs. Many'oth~r combinations of conductivity ,, . , .
and thickness for the resistive layer ?8 are possible to obtain the target current density.
Although the invention has been shown and described with respect to exemplary embodiments thereof, various other changes, omissions and additions in dorm and detail thereof may be made therein without departing from the spirit and scope of tae invention.
Claims (33)
1. An iontophoretic structure, comprising:
a first material having a first galvanic electrical potential;
a second material having a second galvanic electrical potential; and a conductive material, said first material and said second material being distributed in said conductive material, and said conductive material having a predetermined resistivity for controlling a current flow produced between said first material and said second material when said iontophoretic structure is in contact with an electrolytic fluid.
a first material having a first galvanic electrical potential;
a second material having a second galvanic electrical potential; and a conductive material, said first material and said second material being distributed in said conductive material, and said conductive material having a predetermined resistivity for controlling a current flow produced between said first material and said second material when said iontophoretic structure is in contact with an electrolytic fluid.
2. The iontophoretic structure of claim 1, wherein said first material comprises silver and said second material comprises gold.
3. The iontophoretic structure of claim 1, wherein said first material comprises silver and said second material comprises platinum.
4. The iontophoretic structure of claim 1, wherein said first material comprises silver and said second material comprises copper.
5. The iontophoretic structure of claim 1, wherein said conductive material is a conductive polymer.
6. The iontophoretic structure of claim 5, wherein said conductive polymer is chosen from the group consisting of polyvinyl, polyester, polyethylene, polyurethane and polyvinylidene.
7. The iontophoretic structure of claim 1, wherein said first material includes a first plurality of metal particles, said second material includes a second plurality of metal particles, and said conductive material includes a conductive polymer, said first and said second metal powders embedded in said conductive polymer.
8. The iontophoretic structure of claim 1, wherein said first material includes a first metal layer having a first galvanic electrical potential and said second material includes a second metal layer having a second galvanic electrical potential.
9. An iontophoresis catheter comprising:
an elastomeric cylindrical wall having an outer wall surface and an inner wall surface, and inner will surface defining a lumen for containing a fluid, and a distal end and a proximal end, each said end having at least one opening to permit introduction or evacuation of said fluid from said lumen, said wall comprising a first material having a first galvanic electrical potential and a second material having a second galvanic electrical potential, said first and second materials distributed in a conductive material having a predetermined resistivity for controlling a current flow produced between said first material and said second material when said iontophoresis catheter is in contact with an electrolytic fluid.
an elastomeric cylindrical wall having an outer wall surface and an inner wall surface, and inner will surface defining a lumen for containing a fluid, and a distal end and a proximal end, each said end having at least one opening to permit introduction or evacuation of said fluid from said lumen, said wall comprising a first material having a first galvanic electrical potential and a second material having a second galvanic electrical potential, said first and second materials distributed in a conductive material having a predetermined resistivity for controlling a current flow produced between said first material and said second material when said iontophoresis catheter is in contact with an electrolytic fluid.
10. The iontophoresis catheter of claim 9, wherein said first material comprises silver and said second material comprises gold.
11. The iontophoresis catheter of claim 9, wherein said first material comprises silver and said second material comprises platinum.
12. The iontophoresis catheter of claim 9, wherein said first material comprises silver and said second material comprises copper.
13. The iontophoresis catheter of claim 9, wherein said conductive material is a conductive polymer.
14. The iontophoresis catheter of claim 13, wherein said conductive polymer is chosen from the group consisting of polyvinyl, polyurethane, polyester, polyethylene, and polyvinylidene.
15. The iontophoresis catheter of claim 9, wherein said first material comprises a first plurality of metal particles, said second material comprises a second plurality of metal particles, and said wall comprises a conductive polymer, said first and said second plurality of metal particles embedded in said conductive polymer.
16. The iontophoresis catheter of claim 15, wherein said first and second plurality of metal particles, and said conductive polymer comprise a composite material extruded to form at least part of said cylindrical elastomeric wall.
17. The iontophoresis catheter of claim 15, wherein said first and second plurality of metal particles, and said conductive polymer comprise a liquefied composite material into which said cylindrical elastomeric wall is dipped to form a composite coating.
18. The iontophoresis catheter of claim 9, wherein said first material comprises a first metal layer, said second material comprises a second metal layer, and said first and said second metal layers have a resistive layer therebetween, said resistive layer controlling a current flow produced between said first metal layer and said second metal layer when said iontophoresis catheter is in contact with an electrolytic fluid, and defining an antibacterial structure.
19. The iontophoresis catheter of claim 18, wherein said lumen comprises a plurality of said antibacterial structures on said outer wall surface.
20. The iontophoresis catheter of claim 19, wherein said lumen comprises a plurality of said antibacterial structures on said inner wall surface.
21. The iontophoresis catheter of claim 18, wherein said lumen comprises a plurality of said antibacterial structures on said inner wall surface and said outer wall surface.
22. An iontophoresis catheter comprising:
an elastomeric cylindrical wall having an outer wall surface and an inner wall surface, said inner wall surface defining a lumen for containing a fluid, and a distal end and a proximal end, each said end having at least one opening to permit introduction or evacuation of said fluid from said lumen, said elastomeric cylindrical wall comprising a first plurality of metal particles and a second plurality of metal particles embedded in a conductive material having a predetermined resistivity for controlling a current flow produced between said first and second plurality of metal particles when said iontophoresis catheter is contact with an electrolytic fluid.
an elastomeric cylindrical wall having an outer wall surface and an inner wall surface, said inner wall surface defining a lumen for containing a fluid, and a distal end and a proximal end, each said end having at least one opening to permit introduction or evacuation of said fluid from said lumen, said elastomeric cylindrical wall comprising a first plurality of metal particles and a second plurality of metal particles embedded in a conductive material having a predetermined resistivity for controlling a current flow produced between said first and second plurality of metal particles when said iontophoresis catheter is contact with an electrolytic fluid.
23. An iontophoresis catheter comprising:
an elastomeric cylindrical wall having an outer wall surface and an inner wall surface, said inner wall surface defining a lumen for containing a fluid, and a distal end and a proximal end, each said end having at least one opening to permit introduction or evacuation of said fluid from said lumen, said elastomeric cylindrical wall comprising a plurality of layered electrodes comprising a first metal layer, a second metal layer, an a resistive layer therebetween, said resistive layer having a predetermined resistance for controlling an electric current produced between said first metal layer and said second metal layer when said iontophoresis catheter is immersed in an electrolytic fluid.
an elastomeric cylindrical wall having an outer wall surface and an inner wall surface, said inner wall surface defining a lumen for containing a fluid, and a distal end and a proximal end, each said end having at least one opening to permit introduction or evacuation of said fluid from said lumen, said elastomeric cylindrical wall comprising a plurality of layered electrodes comprising a first metal layer, a second metal layer, an a resistive layer therebetween, said resistive layer having a predetermined resistance for controlling an electric current produced between said first metal layer and said second metal layer when said iontophoresis catheter is immersed in an electrolytic fluid.
24. An iontophoresis infection control kit for a catheter having a distal end, a proximal end, an inner lumen, and an outer surface, comprising:
an infection control sleeve comprising a first plurality of metal particles and a second plurality of metal particles embedded in a conductive elastomeric material having a predetermined resistivity for controlling a current flow produced between said first and second plurality of metal particles when said infection control sleeve is in contact with an electrolytic solution, said sleeve placed over said outer surface of said catheter near said proximal end.
an infection control sleeve comprising a first plurality of metal particles and a second plurality of metal particles embedded in a conductive elastomeric material having a predetermined resistivity for controlling a current flow produced between said first and second plurality of metal particles when said infection control sleeve is in contact with an electrolytic solution, said sleeve placed over said outer surface of said catheter near said proximal end.
25. The iontophoresis infection control kit of claim 24, wherein said infection control sleeve is an introducer sheath.
26. The iontophoresis infection control kit of claim 25, further comprising an adaptor for connecting said proximal end of said catheter to intravenous tubing.
27. A method of providing antibacterial protection for an implantable medical device comprising:
selecting a medical device having a surface that is exposed to bodily fluids when said medical device is implanted within a body; and placing an iontophoretic structure on at least a portion of said surface, said iontophoretic structure including, a first plurality of metal particles having a first galvanic electrical potential, a second pluralilty of metal particles having a second galvanic electrical potential, and a non-conductive polymer loaded with a conductive material separating said first plurality of metal particles from said second plurality of metal particles, said conductive material providing said non-conductive polymer with a predetermined resistivity for controlling a current flow produced between said first plurality of metal particles and said second plurality of metal particles when said iontophoretic structure is in contact with an electrolytic fluid.
selecting a medical device having a surface that is exposed to bodily fluids when said medical device is implanted within a body; and placing an iontophoretic structure on at least a portion of said surface, said iontophoretic structure including, a first plurality of metal particles having a first galvanic electrical potential, a second pluralilty of metal particles having a second galvanic electrical potential, and a non-conductive polymer loaded with a conductive material separating said first plurality of metal particles from said second plurality of metal particles, said conductive material providing said non-conductive polymer with a predetermined resistivity for controlling a current flow produced between said first plurality of metal particles and said second plurality of metal particles when said iontophoretic structure is in contact with an electrolytic fluid.
28. A method of providing antibacterial protection for an implantable medical device comprising:
selecting a medical device having a surface that is exposed to bodily fluids when said medical device is implanted within a body; and placing an iontophoretic structure on at least a portion of said surface, said iontophoretic structure including, a first metal layer having a first galvanic electrical potential, a second metal layer having a second galvanic electrical potential, and a non-conductive polymer loaded with a conductive material separating said first metal layer from said second metal layer, said conductive material providing said non-conductive polymer with a predetermined resistivity for controlling a current flow produced between said first metal layer and said second metal layer when said iontophoretic structure is in contact with an electrolytic fluid.
selecting a medical device having a surface that is exposed to bodily fluids when said medical device is implanted within a body; and placing an iontophoretic structure on at least a portion of said surface, said iontophoretic structure including, a first metal layer having a first galvanic electrical potential, a second metal layer having a second galvanic electrical potential, and a non-conductive polymer loaded with a conductive material separating said first metal layer from said second metal layer, said conductive material providing said non-conductive polymer with a predetermined resistivity for controlling a current flow produced between said first metal layer and said second metal layer when said iontophoretic structure is in contact with an electrolytic fluid.
29. Use of an iontophoretic structure for protecting a natural body structure, said iontophoretic structure including a first galvanic material having a first electrical potential, a second galvanic material having a second electrical potential, and a non-conductive polymer loaded with a conductive material separating said first galvanic material from said second galvanic material, said conductive material providing said non-conductive polymer with a predetermined resistivity for controlling a current flow produced between said first galvanic material and said second galvanic material when said iontophoretic structure is in contact with an electrolytic fluid, said first galvanic material including a first plurality of metal particles, said second galvanic material including a second plurality of metal particles, said first and said second plurality of metal particles embedded in said non-conductive polymer loaded with said conductive material.
30. The use of claim 29, wherein said non-conductive polymer loaded with a conductive material includes a binary adhesive.
31. The use of claim 29, wherein said body structure is a tooth.
32. A method of providing antibacterial protection for an implantable medical device comprising:
selecting a medical device having a surface that is exposed to bodily fluids when said medical device is implanted within a body; and placing an iontophoretic structure on at least a portion of said surface, said iontophoretic structure including, a first plurality of metal particles having a first galvanic electrical potential, a second plurality of metal particles having a second galvanic electrical potential, and an inherently conductive polymer separating said first plurality of metal particles from said second plurality of metal particles, said inherently conductive polymer having a predetermined resistivity for controlling a current flow produced between said first plurality of metal particles and said second plurality of metal particles when said iontophoretic structure is in contact with an electrolytic fluid.
selecting a medical device having a surface that is exposed to bodily fluids when said medical device is implanted within a body; and placing an iontophoretic structure on at least a portion of said surface, said iontophoretic structure including, a first plurality of metal particles having a first galvanic electrical potential, a second plurality of metal particles having a second galvanic electrical potential, and an inherently conductive polymer separating said first plurality of metal particles from said second plurality of metal particles, said inherently conductive polymer having a predetermined resistivity for controlling a current flow produced between said first plurality of metal particles and said second plurality of metal particles when said iontophoretic structure is in contact with an electrolytic fluid.
33. Use of an iontophoretic structure for protecting a natural body structure, said iontophoretic structure including a first galvanic material having a first electrical potential, a second galvanic material having a second electrical potential, and an inherently conductive polymer separating said first galvanic material from said second galvanic material, said inherently conductive polymer having a predetermined resistivity for controlling a current flow produced between said first galvanic material and said second galvanic material when said iontophoretic structure is in contact with an electrolytic fluid, said first galvanic material including a first plurality of metal particles, said second galvanic material including a second plurality of metal particles, said first and second plurality of metal particles embedded in said inherently conductive polymer.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA002313440A CA2313440C (en) | 1992-11-12 | 1993-11-10 | Methods of making an antibacterial device |
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/975,597 US5322520A (en) | 1992-11-12 | 1992-11-12 | Iontophoretic structure for medical devices |
| US975,597 | 1992-11-12 | ||
| PCT/US1993/010911 WO1994011058A1 (en) | 1992-11-12 | 1993-11-10 | Iontophoretic structure for medical devices |
Related Child Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002313440A Division CA2313440C (en) | 1992-11-12 | 1993-11-10 | Methods of making an antibacterial device |
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| CA2149216A1 CA2149216A1 (en) | 1994-05-26 |
| CA2149216C true CA2149216C (en) | 2000-10-17 |
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| CA002149216A Expired - Lifetime CA2149216C (en) | 1992-11-12 | 1993-11-10 | Iontophoretic structure for medical devices |
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| US (3) | US5322520A (en) |
| EP (1) | EP0678047A4 (en) |
| JP (1) | JP3555684B2 (en) |
| CA (1) | CA2149216C (en) |
| WO (1) | WO1994011058A1 (en) |
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| WO2019204491A1 (en) * | 2018-04-17 | 2019-10-24 | The Regents Of The University Of California | Galvanic redox material and implantable device and methods thereof |
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| WO2019204491A1 (en) * | 2018-04-17 | 2019-10-24 | The Regents Of The University Of California | Galvanic redox material and implantable device and methods thereof |
Also Published As
| Publication number | Publication date |
|---|---|
| US5322520A (en) | 1994-06-21 |
| JPH08506027A (en) | 1996-07-02 |
| EP0678047A1 (en) | 1995-10-25 |
| WO1994011058A1 (en) | 1994-05-26 |
| CA2149216A1 (en) | 1994-05-26 |
| EP0678047A4 (en) | 1996-03-27 |
| US5725817A (en) | 1998-03-10 |
| US5498248A (en) | 1996-03-12 |
| JP3555684B2 (en) | 2004-08-18 |
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