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Related Experiment Videos

Sterile shunt malfunction. A scanning electron microscopic perspective.

D J Gower, J C Lewis, D L Kelly

    Journal of Neurosurgery
    |December 1, 1984
    PubMed
    Summary

    A study on silicone shunts found neutrophils and giant cells on malfunctioning tubing, suggesting a delayed hypersensitivity reaction to silicone. This cellular response differs from shunts removed for elective revision.

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    Area of Science:

    • Biomaterials Science
    • Immunology
    • Neurosurgery

    Background:

    • Delayed hypersensitivity reactions to silicone implants are increasingly recognized.
    • Silicone plastics are widely used in medical devices, including shunting systems.

    Purpose of the Study:

    • To investigate the cellular response on the internal surface of silicone tubing in ventriculoperitoneal shunts.
    • To evaluate potential delayed hypersensitivity reactions to silicone in shunting systems.

    Main Methods:

    • Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to examine distal peritoneal tubing from 20 patients.
    • Tubing was analyzed from shunts removed due to malfunction (n=12) and elective revision (n=8).

    Main Results:

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    • Malfunctioning shunt tubing showed significant cellular adherence, including neutrophils and giant cells, often associated with platelets.
    • Elective revision tubing had minimal cellular presence and no platelet association.
    • Cultures were negative, ruling out infection as the cause of cellular response.

    Conclusions:

    • The observed cellular response in malfunctioning shunts suggests a delayed hypersensitivity reaction to silicone.
    • These findings are consistent with reactions seen in other silicone-based medical implants.
    • Further research is warranted to understand the specific mechanisms of silicone hypersensitivity in shunts.