Feasibility evaluation of chitosan coatings on polyethylene tubing for biliary stent applications

Endoscopic palliation for the obstructive jaundice caused by biliary or pancreatic malignant tumors is a commonly used medical treatment. However, plastic biliary stents are occluded by sludge deposition caused by bacterial adhesion in 3-5 months. Chitosan, which has both good biocompatibility and antimicrobial capability, was used to modify the inner surface of polyethylene (PE) tubing in this study. Chitosan was deposited onto the inner surface of oxidized PE tubing with the methanol precipitation technique. Attenuated total reflection/Fourier transform infrared and electron spectroscopy for chemical analysis indicated that the chitosan coating was feasible. Contact-angle measurements revealed that the surface hydrophilicity of the PE tubing increased with the chitosan coating. Morphological analysis with scanning electron microscopy showed that the PE surface became rougher and exhibited micropores after the chitosan coating. The adhesion of living Escherichia coli to chitosan-coated PE stents, characterized by the spreading plate method and scanning electron microscopy analysis, was more significant than that to unmodified stents after a 24-h phosphate-buffered saline or bile perfusion test. This finding may be attributed to the rougher and slightly positively charged surface of chitosan-coated PE tubing and to the - CH₃ hydrophobic functional groups in the chitosan structure. Because of its good biocompatibility, chitosan coated on the surface of PE can still be used for biliary stent applications with further chemical modification, such as sulfonation and quaternization, to increase its antimicrobial ability.