Subcutaneous, catheter-related inflammation in a rabbit model correlates with peripheral vein phlebitis in human volunteers

• Published in: Journal of biomedical materials research Vol. 28; no. 2; p. 259
• Main Authors: Carruth, W A, Byron, M P, Solomon, D D, White, W L, Stoddard, G J, Marosok, R D, Sherertz, R J
• Format: Journal Article
• Language: English
• Published: United States 01.02.1994
• Subjects: Adult; Animals; Catheters, Indwelling - adverse effects; Chlorhexidine - adverse effects; Chlorhexidine - therapeutic use; Disease Models, Animal; Double-Blind Method; Humans; Phlebitis - epidemiology; Phlebitis - etiology; Prosthesis-Related Infections - etiology; Prosthesis-Related Infections - prevention & control; Rabbits; Risk Factors
• ISSN: 0021-9304; 1097-4636
• DOI: 10.1002/jbm.820280217

In the development of a polyurethane vascular catheter with anti-infective properties, it became desirable to develop a measure of tissue inflammation. This was investigated in a rabbit model by implanting uncoated catheters and catheters coated with heparin (HEP), chlorhexidine (CH), or CH/HEP in the subcutaneous space with or without 10(4) Staphylococcus aureus. At intervals of 2, 4, and 7 days after implantation, animals were sacrificed; tissue blocks containing catheters were removed and preserved with formaldehyde; and sections were stained with hematoxylin and eosin. Using a histologic index, 240 sections (10 for each experimental condition) were evaluated by two investigators blinded to experimental conditions. Uncoated catheters or catheters coated with CH alone had a lower histologic index (less inflammation) than catheters coated with HEP alone or CH/HEP (P < .05). When catheters were inoculated with S. aureus, those coated with CH, with or without HEP, had a lower histologic index than uncoated catheters (P < .05). Next, 30 volunteers had a control catheter inserted in a vein in one forearm and a catheter coated with either CH alone or CH/HEP in a vein in the other forearm. After 96 h of observation there was a greater risk of phlebitis associated with CH/HEP catheters than control catheters (P < .05), and no difference in the risk of phlebitis between CH catheters and control catheters (P = 0.43). Thus, the amount of inflammation around the catheter in the subcutaneous space of rabbit correlated with the risk of peripheral vein phlebitis.