ICP-Brochure - Spiegelberg

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10 Antimicrobial Intraventricular Probe with Bolt The air-pouch is 35% smaller than the one on standard ventricular probes. The probe has two sets of numbered depth marks. The first set is related to the tip of the probe. The drill bit has an adjustable stop. The Allen wrench is used to adjust the stop. The dura opener is used to perforate the dura mater. The Silverline ventricular probe with bolt is fixed in the bone by means of a bolt. After making a burr hole and opening the dura the probe is placed in the ventricle with the bolt in place in the upper region of the probe. Then the bolt is slid down to the burr hole and screwed into the bone. Finally the probe is fixed in the bolt with the clamping nut. The Luerconnector is placed in the drainage tube and connected to a drainage kit. The air tube is connected to the <strong>ICP</strong>-Monitor. With the clamping nut the probe is fixed in the bolt. The second set of depth marks is related to the upper edge of the bolt. Description REF Antimicrobial SND 13.1.14 S Intraventricular Probe with Bolt 8F Technical Information The stylet is used to introduce the probe into the ventricle. The Luer-Lock Connector adapts the probe to the EVD kit. Material Silverimpregnated Polyurethane Filling volume .05 - .1 ml Outer diameter 2.7 mm Inner diameter drainage 1.5 mm Length of dual-lumen 200 mm probe Length of single lumen 1300 mm air tube Length of single lumen 70 mm drainage tube depth marks 50 mm 60 mm 70 mm Duration of use short term, not more than 30 days Shelf life 3 years Double packed EO sterile For single use Latex-free
Scientific Information about Silverline ® Technology Silverline Ventricular Probes are used for drainage and <strong>ICP</strong>-monitoring at the same time. They are made of polyurethane. Particles of silver and particles of an an unsoluble silver salt are incorporated in the material. Silver ions have a strong antiseptic effect. Because of the small size of the particles the specific surface area is large, which results in the release of ions in antimicrobial concentration on the surface of the catheter. The combination of the fast acting silver salt and the slow acting metallic silver results in an optimal short term and long term effect. The silver salt starts to release silver ions immediately when it gets in contact with body fluid. The release of silver ions from the metallic silver particles doesn´t start until some hours later, when the effect of the silver salt slows down. Silverline ventricular probes are available in two styles and in two diameters. In an in-vitro study (7) the Silverline material could demonstrate an antimicrobial effect on: - Staph. aureus, - Staph. epidermidis, - multi resistant Staph., - E. coli, - Pseudomonas aeruginosa, - Clostridium difficile, - Acinetobacter baumannii, - Streptococcus intermedius, - Candida albicans, and - Candida glabrata. Clinical studies indicate a marked reduction of the infection rate (9,10,11). Bibliography 1. Anneke, A.: Infektiöse Komplikationen von Liquoraußendrainagen. Dissertation Universität Heidelberg, 1999 2. Lozier AP, Sciacca RR, Romagnoli MF, Connolly ES Ventriculostomyrelated infections: A critical review of literature. Neurosurgery 51, 2002, 170-182 3. Naegeli, C. v.:Über die oligodynamischen Erscheinungen an lebenden Zellen. Neue Denkschr. Allg. Schweiz. Ges. 0 h 16 h 32 h Cultures of catheters after subjecting them to a suspension of Staph. aureus Upper row: Silverline catheter Lower row: Control catheter Naturwiss. 33, 1893, 174 - 182 4. Pfisterer, W.;Mühlbauer, M.; Czech, T.; Reinprecht, A.: Early diagnosis of external ventricular drainage infection: results of a prospective study. J Neurol Neurosurg Psychiatry 74, 2003, 929–932 5. Thurmann, R.B.; Gerba, C.H.P.: The molecular mechanisms of copper and silver ion disinfection of bacteria and viruses. Crit. Rev. Environmental Control, 18, 1989, 295-315 6. Zabramski J.M.; Darouiche, R.O. et al.: Efficacy of antimicrobialimpregnated external ventricular catheters: a prospective, randomized, controlled trial. J Neurosurg, 98, 2003, 725-730 7. Zschaler, R.: Testing of the Antimicrobial Effect of Catheter Tubing with a Roll Culture Method. www.spiegelberg.de/ home/documents/Zschaler.pdf 8. Kojic, E.M.; Darouiche, R.O.: Candida infections of medical devices. Clin. Microbiol. Rev., 17, 2004, 255-267 9. Keong, N.C.;D. Bulters, H. Richards, M. Farrington, O. Sparrow, J.D. Pickard, P.J. Hutchinson, P.J. Kirkpatrick: The SILVER (Silver-Impregnated Line Vs EVD Randomized) Trial : A Double-blind, Prospective, Randomized Controlled Trial of an Intervention to Reduce the Rate of External Ventricular Drain Infection. Neurosurgery, 71(2):394-404, August 2012 11. Izci, Y.; Secer, H.; Akay, C.; Gonul, E.: Initial experience with silver-impregnated polyurethane ventricular catheter for shunting of cerebrospinal fluid in patients with infected hydrocephalus. Neurol. Res. 2008, online version. 12. Fichtner, J.; Güresir, E.; Seifert, V.; Raabe, A.: Efficacy of silverbearing external ventricular drainage catheters: a retrospective analysis. J Neurosurg, Sept. 18, 2009, DOI: 10.3171/ 2009.8.JNS091297 11
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