That antimicrobial tubing effectively reduces the event of hospital acquired infections (HAI) is well-known and appreciated by healthcare professionals. But when it comes to manufacturability, the silver ion lined tubing can be a challenge.

Antimicrobial tubing can effectively guard against HAIs when used in catheters, ventilation, IVs, and other invasive tubing. And, now, using a “new breed” of thermoplastic elastomers (TPEs), custom tubing formulas are effectively addressing manufacturability issues.

There are a lot of specialty antimicrobials and additives that might perform well in the lab, but that does not mean they are manufacturable in real-life production. There is also the issue of fast-acting antimicrobials and long-lasting antimicrobial dispersion. One select company that we test for is able to incorporate both, and this takes precise processing to accomplish.

New applications

Applications for this new breed of antimicrobial tubing cover a wide range of devices. Disposable devices in the urinary area: catheters, drainage tubes, drainage bags, and fluid collection systems are candidates for antimicrobial tubing. The same is true for stabilization of catheters, IV monitors, IV lines, and stool management tubing. Sometimes it's about reinventing an old product; other times a full paradigm shift is required. Eldon James is working with one catheter manufacturer on both through feature incorporation and the use of different materials.

One project calls for customized tubing materials and focuses on the needs of the end patient and the ever-increasing bio-hazard risk of developing strains of bacteria and viruses that are immune to today's antibiotics. Antimicrobials can address this before it becomes an issue. For instance, antimicrobials are not only in the tubing, but also in the luers to ward off infection that can occur from switching tubing connections by the medical staff.

On the urinary side, another application involves changing from PVC to TPE tubing materials. To prevent UTI (urinary track infection), PVC with an antimicrobial coating is required. The problem is it clouds the tube and clarity becomes an issue. Everything goes back to the clinician and they want a water-clear tube. PVCs are the cheapest materials. But they are not environmentally friendly. The new TPE materials solve both issues.

A case for antimicrobial tubing is not always found within the walls of medical facilities. Antimicrobial tubing is also moving into the consumer pharmaceutical delivery device area as illustrated in the following application. While pathogens can attack through various parts of the body, the most common places for allergens, viruses, and bacteria to enter are through the nose and mouth.

We worked with a company that developed a personal nasal hygiene product for nasal irrigation (navage). This is the first method for this application that uses gentle power suction as opposed to pressure of a squeeze bottle to irrigate the nasal cavity. The device uses a two-bottle system with a micro diaphragm pump and a check valve that regulates the relative vacuum in the lower bottle. The vacuum draws saline from the upper bottle through the nose and then into the lower bottle.

An important part of this system is the antimicrobial tubing - 5/16 ID tubes - used for the saline irrigation. The company opted for antimicrobial tubing with the silver ion coating on the interior because one of the tubes carries clean, pure saline, but when it comes out of the nose, it is not clean and it runs through the second tube to the bottle. Having antimicrobial protection is an added protection, since this is a reusable device.

In this case, the need for comfortable and flexible non-PVC tubing with a specific durometer, resulted in Eldon James developing a custom antimicrobial tubing that is one of a kind. Using a special TPE formulation it was developed only for this application. Three or four different materials were evaluated before a specific type of flexible polyethylene was selected.

As the medical industry moves away from PVC tubing due to concerns involving chloride (ROHS listed) phylates and DEHP, new tubing developments are providing answers. TPEs are clean and green, they can be incinerated without hazardous chlorine gasses and they provide very good tube clarity. Teaming these materials with new developments in clear antimicrobials, we can now offer water-clear antimicrobial tubing products that are safe for patients and our environment, while giving hospitals and care-giving facilities added protection from costly HAIs.

HOW THEY'RE MADE

Eldon James antimicrobial tubing and fitting products are manufactured in a cleanroom environment. Antimicrobial product packaging will soon be done in the clean room as well. As an added precaution, antimicrobial tubing is used on the extrusion line. As the tubing is made, it progresses through a water bath that cools the tubing before it gets to the cutter.

Medical tubing requires that the water be clean and that it does not contribute any bio-burden. Biofilm can easily form on the sides of the tubing that keep the water circulating through the bath. To ensure it is kept clean and doesn't contribute to the bio-burden, antimicrobial tubing is used to inhibit bacterial growth in all tubes.