Novel Button Battery Coating Materials for Prevention of Esophageal Injury: An Ex Vivo Porcine Study

Sunday, September 29, 2024

9:30 AM – 9:36 AM EDT

Location: MBCC, 225

Disclosure(s):

Jake GJ Wihlidal, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Elysia M. Grose, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Evan J. Propst, MD, MSc:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Esophageal button battery (BB) impactions can result in life-threatening complications. Strategies to prolong timeline to injury for esophageal BB impactions are required to expand the treatment window and minimize harm. This study compared the efficacy of four BB coating materials in decreasing caustic tissue injury via replication of impaction in an ex vivo porcine model.

Methods: Four materials (methacrylate monomer, nitrocellulose, acrylic with fluorocarbon-coated silica, and thermoplastic rubber) were tested on CR2032 BBs in 3 coating conditions: “full” BB, anode-cathode junction (“rim”), and “custom” condition which maintained BB functionality. BBs from each condition were placed in a porcine tissue model and examined at 15, 30, 45, 60, 90, and 120 minutes. Outcomes of tissue injury were measured and compared to a control condition (no coating): tissue burn depth, surface area, discharged voltage, and heat signature. All experiments were performed in triplicate and analyzed via Kruskal-Wallis statistical analysis with Bonferroni post-hoc correction.

Results: In total, 78 conditions were compared across coating type, material, and timepoint. At 15 and 30 minutes, custom and rim coatings of all materials significantly reduced anode surface burn area compared to control (p < 0.05). Custom coated nitrocellulose, acrylic, and thermoplastic rubber coatings were found to significantly reduce both anode surface burn area and depth of burn at 120 minutes (p < 0.05). While all coating conditions significantly slowed thermal conductivity of BBs from 30 to 120 minutes as compared to control (p < 0.05), no significant differences in thermal conductivity were observed between coating patterns or materials. Rim coatings of all materials significantly reduced the discharged voltage of each battery at 90 minutes, when compared to control (p < 0.05).

Conclusions: Protective BB coating decreases tissue injury depth and surface area, and may delay serious injury after impaction by reducing voltage discharge across tissue.

Presenting Author(s)

Jake GJ Wihlidal, MD

Resident - PGY2
University of Toronto
Toronto, ON, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

EG

Elysia M. Grose, MD

Resident Physician
University of Toronto
Toronto, ON, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Jennifer M. Siu, MD, MPH

Otolaryngologist
University of Toronto
Toronto, Ontario, Canada

Disclosure information not submitted.
AJ

Adrian L. James, MD

Associate Professor
University of Toronto, Ontario, Canada

Disclosure information not submitted.
Evan J. Propst, MD, MSc

Professor
Hospital for Sick Children
Toronto, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Nikolaus E. Wolter, MD, MSc

Otolaryngologist
Hospital for Sick Children
Toronto, Ontario, Canada

Disclosure information not submitted.