According to current knowledge, the most critical pathogenic event in the development of implant-related infection is probably biofilm formation, which starts immediately after bacterial adhesion on implanted devices, leading to their irreversible colonization. A rationale prevention of biomaterial-associated infections should then specifically focus on inhibition of both bacterial adhesion and biofilm formation. Nonetheless, currently available prophylactic measures, although partially effective in reducing surgical site infections, are not based on the pathogenesis of biofilm-related infections and unacceptable high rates of septic complications, especially in high risk patients and procedures are reported. Traditionally, once demonstrated their biocompatibility, orthopedic implants have been designed as inert mechanical devices, their biological aspects being considered as a byproduct of a stable fixation to the surrounding bone or soft tissues. However, in the last decade, several studies have investigated the ability of implant surface modifications to mitigate possible adverse events, including implant-related infections. Several surface treatment modalities are under development in order to minimize bacterial adhesion, inhibit biofilm formation and provide effective bacterial killing to protect implanted biomaterials, even if there still is a great discrepancy between proposed and clinically implemented strategies. Here we provide a brief overview and an original classification of the various technologies under study or already in the market, with particular reference to a novel approach, based on a fast-resorbable hydrogel coating, that may change the paradigm of long-lasting antibacterial implant protection towards a more feasible short-term one, that may minimize the risk of long-term interference with the function of implanted biomaterials and of bacterial resistance induction, while effective protection at an acceptable cost/benefit ratio.
|Title of host publication||Periprosthetic Joint Infections|
|Subtitle of host publication||Changing Paradigms|
|Publisher||Springer International Publishing AG|
|Number of pages||17|
|Publication status||Published - May 31 2016|
ASJC Scopus subject areas
- Health Professions(all)