Surface morphology of unused and used Hydromer-coated intravenous catheters

Hydromer-coated polyurethane (Erythroflex) catheters, unused, or intravenously inserted for 2-20 days, were studied by scanning electron microscopy (SEM). Both unfixed and fixed (2% glutaraldehyde in phosphate buffer), and air-or critical-point dried (CPD) specimens were investigated. The catheter segments were sputter-coated with approx. 20 nm gold and studied at an accelerating voltage of 20 kV. The specimens were examined for surface depositions, thickness and structure of the Hydromer layers, and occurrence of adhering and embedded bacteria. The outer Hydromer layer showed, in the unused specimens, scratches and fissures, as well as adhering foreign bodies. In used specimens, the layer was swollen, with cracks (like "dried earth"), and, occasionally, amorphous substances and coccoid bacteria were seen adhering. Damage to the layer, or even its total disappearance was also noted in some specimens. The inner (luminal) Hydromer layer was, in unused specimens, clean and slightly wavy. In used catheters, it was thicker, possibly swollen, with small, isolated or agglomerated protrusions, like a "lunar landscape". Adhering platelets and amorphous substances were also occasionally seen. The results suggest that the Hydromer is a fragile material in both its dry and wet forms. Thus, the Hydromer-coated catheters should neither be stored in flexible packs, nor inserted by the Seldinger technique. The findings do not support the belief that the Hydromer-coating can prevent either thrombus formation, or intraluminal occlusion of the in-situ catheters.