Kauçuk yapıda Foley idrar sondalarının sitotoksisitesinde çinko bileşiklerinin olası rolü.

Objective: The cytotoxic effects of natural rubber gloves and urinary catheters on different cells have been earlier reported. In order to reduce these effects, various coating techniques such as silver or polymer (hydrogel, silicone, polytetrafluoroethylene (PTFE)) coatings have been developed. However, during manufacturing process of silicone-coated rubber catheters, similar to latex catheters, zinc compounds, which have cytotoxic effects are added to the natural rubber base. The aim of this study was to compare the in vitro cytotoxic effects of rubber catheters with the silicone-coated rubber and to investigate the causes of the toxic effect. Method: The cytotoxic effects of total 48 urinary catheters in three different structure (natural rubber, silicone, silicone-coated rubber) and 8 different brands were analysed in mouse connective tissue fibroblast cell culture (L-929) by qualitative (imaging and scoring) and quantitative (MTT) methods. The levels of the elements in catheter extracts were examined in an Atomic Absorption Spectrophotometer (AAS). Results: Compared with standard polyethylene used as a negative control, the extracts from 100% silicone did not change vitality of the fibroblast cells (95.43% ± 5.39), while the natural rubber (8.57% ± 0.54) and the silicone-coated rubber (21.0% ± 2.52) decreased this significantly (p <0.01). The analysis of the catheter extracts by the AAS method showed that the zinc levels of rubber and silicon-coated catheter extracts were 4.78 ± 0.66 mg/L and 2.78 ± 0.33 mg/L, respectively and correlated with the observed toxic effects. No significant differences were found in the levels of elements such as Cr, Ag, Cu, Bi, Pb, Fe, Co and Cd. The addition of the metal chelating agent ethylenediaminetetracetic acid (EDTA) in a non-toxic level (5 µM) for the cells, reversed the latex cytotoxicity (101.05% ± 5.86 and 100.24 ± 4.9, respectively). Conclusion: Our study demonstrated that both the rubber and the silicone-coated rubber catheters have cytotoxic effects. Zinc compounds, which are added to rubber in the production stage for a variety of purposes, have proven to be responsible for this toxicity. The significant difference between the cytotoxic effects of the silicone-coated rubber and latex catheters suggests that the production technology is an important factor for the quality. Different coating methods have to be investigated or the products proved to be non-toxic should be used instead of the rubber catheters, in order to reduce complications in urinary catheterization in clinical practice. [ABSTRACT FROM AUTHOR]