Development of plasma-based coating processes for medical devices with tailored-range bactericidal properties

中心静脉导管(CVC)在医学上的许多应用都是至关重要的，特别是对重症监护和癌症患者。CVC的使用与中心静脉导管相关血流感染(CVC-BSI)形式的微生物污染的风险有关，CVC-BSI可能发生在其植入或操作过程中。CVC-BSI代表着一项重大的全球卫生保健挑战。预防CVC-BSI的基础是防止生物被膜和释放抗菌剂以克服细菌增殖。最常见和最成功的方法包括本体改性技术或表面方法，如物理(等离子体)或化学(等离子体、伽马辐射、电晕或激光接枝)。鉴于此，本项目建议开发一种基于等离子体增强化学气相沉积(PECVD)的抗粘附性、抗菌和血液相容性涂层的制备工艺。计划中的植入性血管表面修饰将提供相关的进步，以解决昂贵的医院感染问题，这是导致住院费用和临床并发症相应增加的原因，受CVC-BSI影响的患者的死亡率高达17%，在巴西估计为40%。计划中的表面改性策略预见了金属离子的受控释放，嵌入到不同建议的多功能薄膜结构中；它们将沉积在硅胶表面，并将针对管状几何形状进行优化。这里提出的方法是基于一项合作研发战略，合作研发战略涉及拉瓦尔大学生物材料和工程实验室，其在生物医学材料和等离子体表面处理方面的世界知名专业知识，致力于工业和研究目的等离子体工艺的加拿大老牌公司Plamionique Inc.，以及巴西领先的导管制造商IBEG。目前的工作计划预计将有临床医生、业界和学术合作者组成的网络参与，以最大限度地发挥CVC-BSI在加拿大和全球市场上引入的创新要素的最终影响。

Central venous catheters (CVCs) are vital for many applications in medicine, especially for critical care and cancer patients. The use of CVC is associated with risk of microbial contamination in the form of a central venous catheter-related blood stream infection (CVC-BSI), which can occur during their implantation or manipulation. CVC-BSI represent a major global health care challenge. Prevention of CVC-BSI are based on biofilm prevention and on the release of antibacterial agents to overcome bacterial proliferation. The most common and successful approaches include bulk modification techniques or surface approaches, such as physical (plasma) or chemical (grafting by plasma, gamma radiation, corona or laser). In this light, the hereby presented project proposes the development of a procedure for the fabrication of an antiadhesive, antibacterial and hemocompatible coatings, based on plasma enhanced chemical vapour deposition (PECVD). The planned surface modification of implantable CVCs will provide a relevant advancement to tackle the expensive nosocomial infection problems, which are responsible for a relevant increase of the hospitalization costs and clinical complications, up to mortality rate of 17% in patients affected by a CVC-BSI, estimated at 40% in Brazil. The planned surface modification strategies foresee the controlled release of metallic ions, embedded in different proposed architectures of multifunctional thin films; they will be deposited on silicone surfaces, and they will be optimized for tubular geometries. The here proposed approach is based on a collaborative research and development strategy involving the Laboratory for Biomaterials and Engineering of Laval University, with its world-renowned expertise in biomedical material and plasma surface treatments, Plasmionique Inc., an established Canadian company, devoted to plasma processes for industrial and research purposes, and IBEG, the leader catheters manufacturer in Brazil. The presented workplan foresees the participation of a network of clinicians, industrials and academic collaborators, to maximize the final impact on the introduced innovation element of CVC-BSI on the Canadian and global market.