Issue title: Selected Presentations held at the 33th Annual Conference of the German Society for Clinical Microcirculation and Hemorheology, Villingen-Schwenningen, Germany, 14-15 November, 2014
Article type: Research Article
Authors: Hiebl, B. | Hopperdietzel, C. | Hünigen, H. | Dietze, K. | Jung, F. | Niehues, S.M.
Affiliations: Center for Medical Basic Research, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany | Institute of Biomaterial Science and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Teltow, Germany | Faculty of Veterinary Medicine, Institute of Veterinary Anatomy, Freie Universität Berlin, Berlin, Germany | Department of Radiology, Charité-University Medicine Berlin, Berlin, Germany
Note: [] Corresponding author: B. Hiebl, Center for Medical Basic Research, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany. E-mail: [email protected]
Abstract: Implantable long-term central venous port systems (CVPS) are widely used as a permanent means of accessing the vascular system for intravenous delivery of drugs, parenteral nutrition, blood transfusion, and blood sampling. These systems allow easy and repetitive puncture without causing much damage to the vessels. However, the body foreign surface of CVPS induces an inflammatory response with varying intensity (depending on the implant materials) that leads to formation of a fibrous tissue capsule around the implant. This study was designed to investigate the influence of bacterial infection on the tissue reaction induced by implanted CVPS in adult patients. 20 patients (9 women, 11 men, 58 ± 14 yrs of age) were included in this study. These patients received explantation of a polysulfone based CVPS (ChemoSite™, Covidien, Mansfield, USA) due to port related infections (patients with bacterial infections at the implantation site: group A, 5 men, 1 women) or to other reasons such as termination of treatment, thrombosis, or CVPS dysfunction (patients without bacterial infections, group B, 6 men, 8 women) 299.9 ± 261.2 days after CVPS implantation. A sample of the encapsulating tissue covering the CVPS together with surrounding tissue (at least 1 × 1 cm2) was placed in a small container with fixing agent, a buffered neutral 4% formalin solution (pH 7). Histological sections of the samples were prepared for light microscopic analysis after paraffin embedding. Sections of 3 μm were cut and stained with haematoxylin and eosin, Weigert's elastic stain, and Heidenhain's azan stain. There was no difference in thickness, collagen and elastin content, or cell and capillary density of the fibrous capsule between both groups. Due to the wound healing reaction involving angiogenesis and fibroblast activation cell density and number of capillaries in the capsule tissue of all patients showed a positive correlation (r = 0.45, p < 0.05). However, the study demonstrated that at the end of the foreign body reaction the artificial tissue layer which covers the CVPS after implantation due to foreign body reaction shows only low reactivity towards infections.
Keywords: Encapsulation, infection, central venous access system, biomaterial
DOI: 10.3233/CH-141881
Journal: Clinical Hemorheology and Microcirculation, vol. 58, no. 1, pp. 107-113, 2014
