Urinary indwelling catheters are widely used in the medical sphere, helping patient's process urine through the bladder, often in testing and painful circumstances. However, sustained use of these devices can lead to a range of problems; most commonly, blockages from debris, mucus and blood clots, causing painful encrustations.
After wounds, catheters are the secondbiggest cause of healthcare acquired infections, as frequent blockages lead to changeovers, making patients susceptible to a range of bacteria.
For Margaret Rew, a UK-based senior teaching nurse and advisor on catheter related difficulties, the use of these devices can create a vicious cycle, breaking down the body's natural defences and making it vulnerable to infection.
"Problems start because the catheter breaks down the natural barrier that we have against infection," Rew says. "Within a few days of having a catheter, every single patient will have bacteria in their bladder. It can lead to urinary tract infections, which cost the NHS millions. More importantly, it can be very dangerous; patients end up in A&E all the time with blocked catheters and UTIs."
Catheter maintenance solutions can overcome these difficulties, allowing the device to remain patent and drain quickly and clearly. These washing procedures have evolved gradually over time to become more sophisticated. Traditionally the focus was on removing and washing the device, rather than specifically targeting the root cause of infections and blockages.
"The thing is that in order to do a bladder washout you had to disconnect the catheter from the catheter bag, and by doing that, you are potentially introducing an infection risk because you've broken that closed system," Rew explains.
In light of these complications, Rew collaborated with B.Braun to create Uro-Tainer Twin, a citric acidbased solution that is administered through the catheter, by opening the connection from the urinary bag. This device has been widely used in clinical practice, renowned for its ability to remove blockages and encrustations.
Buildings on the success of this last product, Rew and B.Braun have now co-designed a Polihexanide cleansing solution that significantly reduces the bacterial load through mechanical rinsing, specifically created to combat microbial resistance.
"If a patient becomes symptomatic of a UTI and they're given antibiotics, the drugs will probably kill the bacteria that are free flowing in the urine," Rew says. "But a lot of the time they can't penetrate the biofilm, so as soon as they stop the antibiotics, the biofilm will reinfect the patient."
A widely used disinfectant and antiseptic, Polihexanide is well tolerated within the body, known for its ability to mimic natural antimicrobial rhythms, making it a near perfect solution for catheter cleansing. Uro-Tainer Polihexanide therefore provides an effective mechanical flush for mucus, while at the same time reducing and removing bacterial load.
As with the previous product, the device can be easily administered through a catheter by opening the connection from the urinary bag. The cleanser then flows into the device and is taken up by lowering the bag below the ladder, all in one simple step.
So far this latest device is making a huge difference to patients with longsuffering urinary problems, including those with severe and chronic blockages and infections. "We had one patient who was going to A&E every two weeks with recurrent infections, pain and blockages," Rew says. "The nurse moved him over to polihexanide and he hasn't had a problem since."
With its latest offering, B.Braun has created an innovative, forward-thinking product that is founded on old-fashioned medical principles. "It's simple. It's safe. And it does exactly what it says on the tin," Rew concludes.