Front Cover -- Handbook of Polymer Applications in Medicine and Medical Devices -- Copyright Page -- Contents -- Preface -- Author Biographies -- 1 Introduction -- 1.1 History -- 1.2 A Historical Example -- 1.3 Anthology Architecture -- 1.4 Summary -- References -- 2 Application of Plastics in Medical Devices and Equipment -- 2.1 Device Industry Overview -- 2.2 Health-care Trends -- 2.2.1 Minimally Invasive Surgeries -- 2.2.2 Alternate Site Treatment -- 2.2.3 Prevention vs. Treatment -- 2.3 From Legacy Materials to Advanced Specialty Polymers for Devices -- 2.4 Driving Trends Leading to New Material Requirements -- 2.4.1 Functionality -- 2.4.2 Compatibility -- 2.4.3 Cost -- 2.4.3.1 Material Costs or Process Improvements -- 2.4.3.2 Light Weighting -- 2.4.3.3 Commoditizing Materials of Construction -- 2.4.3.4 Technology Innovations -- 2.4.4 Ecological and Environmental Concerns and Influence of the Consumer -- 2.5 Market Factors Affecting the Industry -- 2.5.1 Concerns Over DEHP and Sometimes Even PVC -- 2.5.2 Bisphenol A -- 2.5.3 The Need for "Green" -- 2.5.4 Globalization of Markets -- 2.5.5 Globalization of Manufacturing -- 2.5.5.1 Energy Costs -- 2.5.6 Global Influences -- 2.5.6.1 Infectious Diseases (MRSA, SARS, H1N1) -- 2.5.6.2 Economic Pressures -- 2.6 Conclusion -- 3 Plastics Used in Medical Devices -- 3.1 Plastic Compositions -- 3.1.1 Polymer Properties -- 3.1.1.1 Linear, Branched, and Cross-linked Polymers -- 3.1.1.2 Isomers -- Structural Isomers -- Geometric Isomers -- Stereoisomers-Syndiotactic, Isotactic, Atactic -- 3.1.1.3 Molecular Weight -- 3.1.2 Polymer Blends -- 3.1.3 Additives -- 3.1.3.1 Fillers, Reinforcement, Composites -- 3.1.3.2 Release Agents -- 3.1.3.3 Slip Additives/Internal Lubricants -- 3.1.3.4 Catalysts -- 3.1.3.5 Impact Modifiers and Tougheners -- 3.1.3.6 Radiation Stabilizers -- 3.1.3.7 Optical Brighteners.

3.1.3.8 Plasticizers -- 3.1.3.9 Pigments, Extenders, Dyes, Mica -- 3.1.3.10 Coupling Agents -- 3.1.3.11 Thermal Stabilizers -- 3.1.3.12 Antistats -- 3.2 Medical Devices-Material Selection Process -- 3.2.1 Physical and Mechanical Properties -- 3.2.2 Thermal Properties -- 3.2.3 Electrical Properties -- 3.2.4 Chemical Resistance -- 3.2.5 Sterilization Capability -- 3.2.6 Long-Term Durability -- 3.2.7 Leachables and Extractables -- 3.2.8 Supplemental Tests -- 3.2.9 Shelf Life and Aging -- 3.2.10 Joining and Welding -- 3.2.11 Medical Grade Plastics -- 3.3 Common Medical Device Polymers -- 3.3.1 Polyethylene -- 3.3.2 Polypropylene -- 3.3.3 Polystyrene -- 3.3.4 Polyester -- 3.3.5 Polyester (PLA and Other Biosorbable Plastics) -- 3.3.6 Polycarbonate -- 3.3.7 Polyvinyl Chloride -- 3.3.8 Polyethersulfone -- 3.3.9 Polyacrylate (Acrylic, PMMA) -- 3.3.10 Hydrogel (Acrylate) -- 3.3.11 Polysulfone -- 3.3.12 Polyetheretherketone -- 3.3.13 Thermoplastic Elastomers (TPE, TPU) -- 3.3.14 Thermoset Elastomers-Silicone -- 3.3.15 Poly-p-xylylene (Parylene) -- 3.3.16 Fluoropolymers -- 3.4 Summary -- References -- 4 Polymeric Biomaterials -- 4.1 Introduction -- 4.2 Polymeric Biomaterials in Ophthalmology -- 4.2.1 Polymeric Contact Lens -- 4.2.2 Polymeric Intraocular Lens -- 4.2.3 Polymeric Artificial Cornea -- 4.3 Polymeric Biomaterials in Orthopedics -- 4.3.1 Polyethylene -- 4.3.2 Polyacrylates -- 4.3.3 Natural Polymers -- 4.4 Polymeric Biomaterials in Cardiovascular Diseases -- 4.4.1 Polyurethanes -- 4.4.2 Polyethylene Terephthalate -- 4.4.3 Expanded PTFE -- 4.5 Polymeric Biomaterials for Wound Closure -- 4.6 Polymeric Biomaterials in Extracorporeal Artificial Organs -- 4.7 Polymeric Biomaterials for Nerve Regeneration -- 4.8 Conclusions and Future Outlook -- References -- 5 Biofilms, Biomaterials, and Device-Related Infections -- 5.1 Introduction -- 5.2 Bacterial Biofilms.

5.2.1 What Are Biofilms, Where Are They Found, and Why Are They Problematic? -- 5.2.2 Adaptation of Biofilm Structure for Survival in Changing Environments -- 5.2.3 Resistance of Bacteria in Biofilms -- 5.3 Biofilm Microbiology and Infectious Disease -- 5.3.1 Bacterial Adhesion to Surfaces -- 5.3.2 Processes of Biofilm Formation -- 5.4 Device-Related Infection -- 5.4.1 Biofilm Formation by Staphylococci -- 5.4.2 Detecting Device-Related Infections -- 5.4.3 Nucleic Acid-Based Detection Methods -- 5.5 Clinical Examples of Biofilm Infections -- 5.5.1 Infection Related to Surgical Repair Materials -- 5.5.2 Bacterial Biofilms on Sutures -- 5.5.3 Bacterial Biofilms on Surgical Mesh -- 5.5.4 Bacterial Biofilms in Orthopedic Prosthetic Joint Infection -- 5.6 Prevention and Treatment -- 5.6.1 Biofilm-Resistant Biomaterials -- 5.6.2 Testing for Antibacterial and Antibiofilm Properties of Biomaterials -- 5.6.3 Potential Agents for the Control of Microbial Colonization of Biomaterials -- 5.6.4 Delivery of Biofilm Control Agents at Biomaterial Surfaces -- 5.6.5 The Bioelectric Effect as an Adjunct to Antibiotics -- 5.6.5.1 Biomaterials that Resist Bacterial Attachment and Biofilm Formation -- 5.7 Conclusions -- References -- 6 Adhesives for Medical and Dental Applications -- 6.1 Introduction -- 6.2 Natural Adhesives -- 6.3 Synthetic and Semisynthetic Adhesives -- 6.4 Cyanoacrylic Adhesives -- 6.4.1 Medical Grade Cyanoacrylate Adhesives -- 6.4.2 Commercial Grades of Cyanoacrylate Tissue Adhesives -- 6.5 Test Methods to Characterize Strength of Tissue Adhesives -- 6.6 Medical and Dental Applications of Adhesives -- 6.6.1 Adhesives for Skin Closure -- 6.6.2 Case Studies of Tissue Adhesives -- 6.6.2.1 Comparison of Effects of Suture and Tissue Adhesive on Bacterial Counts -- 6.6.2.2 Sutureless Anastomoses of Small and Medium Vessels.

6.6.2.3 Tissue Adhesive as Dressing after Open Pediatric Urological Procedures -- 6.6.2.4 Tissue Adhesive Applications in Gastrointestinal Endoscopic Procedures -- Gastric Variceal Bleeding -- Esophageal Variceal Bleeding -- Peptic Ulcer Bleeding -- Bleeding from Other Sources -- Closure of Fistula -- 6.6.2.5 Tissue Adhesives in Topical Skin Wounds -- 6.6.2.6 Tissue Adhesive for Closure of Hernia Incisions -- 6.6.2.7 Use of Tissue Adhesive for Skin Closure in Plastic Surgery -- 6.7 Bone Adhesives -- 6.8 Dental Applications of Adhesives -- 6.8.1 Methacrylic Acid -- 6.8.2 Methyl Methacrylate -- 6.8.3 Hydroxy Ethyl Methacrylate -- 6.8.4 4-Methacryloyloxyethyl Trimellitic Acid -- 6.8.5 4-Acryloyloxyethyl Trimellitate Anhydride -- 6.8.6 10-Methacryloyloxydecyl Dihydrogen Phosphate -- 6.8.7 Other Monomers -- References -- 7 Silicones -- 7.1 Chemical Structure and Nomenclature -- 7.1.1 Historical Milestones in Silicone Chemistry -- 7.1.2 Nomenclature -- 7.1.3 Preparation -- 7.1.3.1 Silicone Polymers -- 7.1.3.2 Polymerization and Polycondensation -- 7.1.3.3 Silicone Elastomers -- Cross-linking with radicals -- Cross-linking by condensation -- Cross-linking by addition -- Elastomer filler -- Processing of silicone elastomers -- 7.1.3.4 Silicone Gels -- 7.1.3.5 Silicone Adhesives -- 7.1.3.6 Silicone Film-in-Place, Fast-Cure Elastomers -- 7.1.4 Physico-Chemical Properties -- 7.2 Conclusion -- Acknowledgments -- Bibliography -- 8 Review of Research in Cardiovascular Devices -- 8.1 Introduction -- 8.2 The Heart Diseases -- 8.3 The Cardiovascular Devices in Open-Heart Surgery -- 8.3.1 Blood Pumps -- 8.3.2 Valve Prostheses -- 8.3.3 Heart Pacemaker -- 8.4 The Minimally Invasive Cardiology Tools -- 8.5 The Technology for Atrial Fibrillation -- 8.6 Minimally Invasive Surgery -- 8.6.1 The Classical Thoracoscopic Tools -- 8.6.2 The Surgical Robots.

8.6.3 Blood Pumps-MIS Application Study -- 8.6.3.1 Minimally Invasive VAD Implantation -- 8.6.3.2 The AORobAS Idea -- 8.6.3.3 The Blood Pump Support in the Palliative (Pediatric) Surgery Study -- 8.7 The Minimally Invasive Valve Implantation -- 8.8 Support Technology for Surgery Planning -- 8.9 Conclusions -- 8.10 Acknowledgments -- References -- 9 Endotracheal Tube and Respiratory Care -- 9.1 Introduction -- 9.2 Properties of the Endotracheal Tube -- 9.2.1 Anatomy of the Endotracheal Tube -- 9.2.2 Development and Properties of the Endotracheal Tube -- 9.2.3 Physiologic Effects of Endotracheal Tube Placement -- 9.2.4 Complications of Endotracheal Tube Placement -- 9.3 Endotracheal Tubes and Other Airway Adjuncts -- 9.3.1 Choice of Endotracheal Tube Size -- 9.3.1.1 Small Tubes and Airway Resistance -- 9.3.1.2 Large Tubes and Trauma -- 9.3.2 Potentially Beneficial Alternatives to the Standard Endotracheal Tube -- 9.3.2.1 Preformed and Reinforced Tubes -- 9.3.2.2 Laser Tubes -- 9.3.2.3 Subglottic Suctioning Evac Endotracheal Tubes -- 9.3.2.4 Double-Lumen Endotracheal Tubes -- 9.3.2.5 Supraglottic Airways -- 9.4 Proper Safeguarding of the Airway -- 9.4.1 Airway Evaluation: Predicting the Difficult Airway -- 9.4.2 Identifying Proper Position of the Endotracheal Tube -- 9.4.2.1 Detection of Esophageal Intubation -- 9.4.2.2 Confirmation of Appropriate Depth of Insertion -- 9.4.2.3 Cuff Pressure Monitoring -- 9.4.2.4 Evaluation of an Audible Cuff Leak -- 9.4.2.5 Documentation of Placement -- 9.4.3 Stabilization of the Endotracheal Tube -- 9.4.3.1 Taping -- 9.4.3.2 Commercially Available Devices -- 9.4.3.3 Stapling for Facial Burns -- 9.4.4 Rapid Response Cart for Airway Emergencies -- 9.5 Maintenance of the Endotracheal Tube -- 9.5.1 Heat and Humidity of Inspired Gas -- 9.5.2 Suctioning -- 9.5.3 Subglottic Care -- 9.5.4 Bronchoscopy.

9.5.5 Biofilm Management.