Development of quaternary ammonium based acrylic copolymer antimicrobial coatings for polyurethane tracheoesophageal voice prostheses.

Tracheoesophageal voice prostheses (TEPs) are soft polymeric devices used to restore the voices of patients who have undergone total laryngectomy (TL). TEPs are implanted on the tracheoesophageal wall and come in direct contact with food, fluid and air. The environment of an implant is a budding ground for growth of microbes, leading to biofilm formation on the TEP surfaces. Biofilm formation is the leading cause of TEP failure because the biofilm affects its functioning by clogging the air passage over several weeks to a few months. Short useful lifespan of TEPs is a concern for patients undergoing total laryngectomy. To increase the useful lifespan of TEPs, it is imperative to prevent biofilm formation. This problem is addressed in the present study by developing a cationic crosslinked antimicrobial coating that prevents biofilm formation through contact killing. An acrylate-based tetracopolymer poly(methyl methacrylate [MMA]- co-n butyl acrylate [BA]- co -dimethylaminoethyl methacrylate [DMAEMA]- co -2 hydroxyethyl methacrylate [HEMA]) was synthesized by free radical polymerization and was crosslinked by hexamethylene diisocyanate (THDI) trimer through urethane linkages. The crosslinked tetracopolymer coatings were subjected to quaternary ammonium formation through N -alkylation with iodooctane. Different variants of coatings were synthesized and the tetracopolymer with 22.5% MMA, 22.5% BA, 20% HEMA and 35% DMAEMA showed desirable results. The developed coatings were characterized and tested for safety as well as mechanical and antimicrobial efficacy. The final results showed that the developed coatings exhibited good cytocompatibility, haemocompatibility, mechanical properties and antimicrobial properties for 180 days against E. coli , S. aureus and C. albicans.