Development of a novel infection-resistant skin-button and cover materials for long-term VAD support

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In this study, we developed a novel infection-resistant skin-button for preventing the driveline infection. Our skin-button that resembled a hemispheric button was consisted of bi-layered parts. These parts were made of the segmented polyurethane having skin-like flexibility and sufficient mechanical strength. The lower part featured tissue-compatible porous flange for implanting into the subcutaneous tissue around the driveline. Its pore size was optimized to promote tissue-ingrowth into the material, and the topmost nonporous part was used for fixing the driveline in the state of exposing from the skin. In in vivo study, three animals with newly developed skin-button demonstrated no sign of the epidermal downgrowth at all, and local bacterial infection at the exit site of the driveline was completely prevented.We conclude that the newly developed skin-button may become a useful tool for preventing device-rerated infection in prolonged VAD support.