A review of the biostability and carcinogenicity of polyurethanes in medicine and the new generation of 'biostable' polyurethanes.

Polyurethanes are very versatile materials which have been used in the body for over 20 years. In fact, there are probably more scientific papers describing these materials and modifications of these materials for medical use than any other material to date. Unfortunately, some formulations of these polymers are subject to biodegradation and have limited their application in the body. Extensive investigation of the biodegradation mechanisms of these polymers by many researchers in the field has led to the development of a new generation of what are now called 'biostable' polyurethanes. This article reviews the history of polyurethane in medicine, polyurethane nomenclature, the biodegradation of these materials, the proposed mechanisms of its degradation as well as the carcinogenicity associated with these materials. Included in the discussion are the polyurethanes used as pacemaker lead insulators as well as those used to coat breast implants. The article concludes with a review of the new generation of 'biostable' polyurethanes and their proposed formulations.