Ultrasound-activated cilia for biofilm control in indwelling medical devices.

Abstract

Biofilm formation and encrustation are major issues in indwelling medical devices, such as urinary stents and catheters, as they lead to blockages and infections. Currently, to limit these effects, frequent replacements of these devices are necessary, resulting in a significant reduction in patients' quality of life and an increase in healthcare costs. To address these challenges, by leveraging recent advancements in robotics and microfluidic technologies, we envision a self-cleaning system for indwelling medical devices equipped with bioinspired ultrasound-activated cilia. These cilia could be regularly activated transcutaneously by ultrasound, generating steady streaming, which can be used to remove encrusted deposits. In this study, we tested the hypothesis that the generated streaming can efficiently remove encrustations and biofilm from surfaces. To this end, we developed a microfluidic model featuring ultrasound-activated cilia on its wall. We showed that upon ultrasound activation, the cilia generated intense, steady streaming, reaching fluid velocity up to 10 mm/s. In all our experiments, this mechanism was able to efficiently clean typical encrustation (calcium carbonate and oxalate) and biofilm found in urological devices. The generated shear forces released, broke apart, and flushed away encrusted deposits. These findings suggest a broad potential for ultrasound-activated cilia in the maintenance of various medical devices. Compared to existing methods, our approach could reduce the need for invasive procedures, potentially lowering infection risks and enhancing patient comfort.