Percutaneous devices: a review of applications, problems and possible solutions

Abstract

Percutaneous devices enable the transfer of mass, energy and forces through the skin. There is a wide clinical need for this, which is not likely to decrease or disappear. The emerging new artificial organs, such as wearable kidneys or lungs, will be in increased demand in the future. Any application lasting longer than days or weeks is endangered by infections entering the body via the exit site. The only carefree solution that has been found is for an exit site placed on the skull, where it can be securely immobilized. For the majority of the locations on the abdomen or chest, no solution for an infection-free device has been found. A solution may be possible with a better understanding of the physiology of keratinocytes as a barrier for microbes.

Keywords::

• catheter
• energy transfer
• exit site
• force transfer
• infection
• mass transfer
• percutaneous device
• skin-penetrating device
• three-phase junction
• VAD driveline

Financial & competing interests disclosure

The authors have received a grant from the German Federal Ministry of Education and Research (01EZ0855) and hold a patent for the new approach described in this article (EP 1466566 [A1]). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.