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      Advances in Ureteral Stent Design and Materials

      review-article

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          Abstract

          Purpose of Review

          There are three technological parameters that play a key role on the performance of an ideal stent. These are its material, design and surface coating. This article highlights some fundamental developments that took place in these three areas of stent’s technology, in order to contribute to the identification of an ideal stent.

          Recent Findings

          In addition to technological developments concerning stent’s material, design and surface coating, the flow dynamic performance of stents has recently attracted increasing attention. Notably, it has been postulated that the local flow field in a stent is correlated with the deposition of crystals and microorganisms. These findings could potentially revolutionise future stent’s designs, and complement developments made on materials and coatings.

          Summary

          The most relevant changes in materials, designs and surface coatings of ureteric stents are reviewed in this article. These are described in the context of a specific cause of stent’s failure they aim to address, with a particular focus on encrustation and biofilm formation.

          Related collections

          Most cited references63

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          Penetration of antibiotics through Staphylococcus aureus and Staphylococcus epidermidis biofilms.

          This study was carried out to elucidate the role of reduced antibiotic penetration in the resistance of Staphylococcus aureus and Staphylococcus epidermidis biofilms to different antibiotics. The biofilms of S. aureus ATCC 29213 and S. epidermidis ATCC 35984 were grown on black, polycarbonate membranes (diameter, 13 mm; pore size, 0.4 microm) placed on tryptic soy agar plates at 37 degrees C for 48 h. The penetration of oxacillin, cefotaxime, amikacin, ciprofloxacin and vancomycin through the biofilms was determined by measuring the diameter of zones of growth inhibition (of S. aureus ATCC 25923, a quality control strain) on Mueller-Hinton agar plates following diffusion of each antibiotic from an overlying antibiotic disc through the biofilm to the agar medium versus the respective control assemblies. The penetration of oxacillin and cefotaxime (beta-lactams) and vancomycin (a glycopeptide) was significantly reduced through S. aureus and S. epidermidis biofilms whereas that of amikacin (an aminoglycoside) and ciprofloxacin (a fluoroquinolone) was unaffected. The results of this study indicate that the role of reduced antibiotic penetration in the drug resistance of S. aureus and S. epidermidis biofilms may vary with the antibiotic being used.
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            Diamond-like carbon coatings as biocompatible materials—an overview

            A Grill (2003)
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              Anti-biofilm properties of chitosan-coated surfaces.

              Surfaces coated with the naturally-occurring polysaccharide chitosan (partially deacetylated poly N-acetyl glucosamine) resisted biofilm formation by bacteria and yeast. Reductions in biofilm viable cell numbers ranging from 95% to 99.9997% were demonstrated for Staphylococcus epidermidis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa and Candida albicans on chitosan-coated surfaces over a 54-h experiment in comparison to controls. For instance, chitosan-coated surfaces reduced S. epidermidis surface-associated growth more than 5.5 (10)log units (99.9997%) compared to a control surface. As a comparison, coatings containing a combination of the antibiotics minocycline and rifampin reduced S. epidermidis growth by 3.9 (10)log units (99.99%) and coatings containing the antiseptic chlorhexidine did not significantly reduce S. epidermidis surface associated growth as compared to controls. The chitosan effects were confirmed with microscopy. Using time-lapse fluorescence microscopy and fluorescent-dye-loaded S. epidermidis, the permeabilization of these cells was observed as they alighted on chitosan-coated surfaces. This suggests chitosan disrupts cell membranes as microbes settle on the surface. Chitosan offers a flexible, biocompatible platform for designing coatings to protect surfaces from infection.
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                Author and article information

                Contributors
                a.mosayyebi@soton.ac.uk
                costantino.manes@polito.it
                d.carugo@soton.ac.uk
                bhaskarsomani@yahoo.com
                Journal
                Curr Urol Rep
                Curr Urol Rep
                Current Urology Reports
                Springer US (New York )
                1527-2737
                1534-6285
                10 April 2018
                10 April 2018
                2018
                : 19
                : 5
                : 35
                Affiliations
                [1 ]ISNI 0000 0004 1936 9297, GRID grid.5491.9, Bioengineering Science Research Group, Faculty of Engineering and the Environment, , University of Southampton, ; Southampton, UK
                [2 ]ISNI 0000 0004 1936 9297, GRID grid.5491.9, Institute for Life Sciences (IfLS), University of Southampton, ; Southampton, UK
                [3 ]ISNI 0000 0004 1937 0343, GRID grid.4800.c, Department of Environment, Land and Infrastructure Engineering, , Politecnico di Torino, ; Turin, Italy
                [4 ]GRID grid.430506.4, Department of Urology, , University Hospital Southampton NHS Trust, ; Southampton, UK
                Article
                779
                10.1007/s11934-018-0779-y
                5893657
                29637309
                10162236-cb58-4806-8cd8-377a94d65bfa
                © The Author(s) 2018

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: University of Southampton
                Categories
                Endourology (P Mucksavage, Section Editor)
                Custom metadata
                © Springer Science+Business Media, LLC, part of Springer Nature 2018

                Urology
                ureteral stent,stent encrustation,biofilm,material,design,uti
                Urology
                ureteral stent, stent encrustation, biofilm, material, design, uti

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