A review of the clinical implications of anti-infective biomaterials and infection-resistant surfaces

Campoccia, Davide; Montanaro, Lucio; Arciola, Carla Renata

doi:10.1016/j.biomaterials.2013.07.048

Cited by 293 publications

(199 citation statements)

References 100 publications

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“…The over use of antibiotics and increased antibiotic resistance from pathogens is considered one of the most concerning health threats of the 21st century, and new technologies addressing the issue are desperately needed [9][10][11][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Reactive combinatorial synthesis and characterization of a gradient Ag–Ti oxide thin film with antibacterial properties

et al. 2015

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Growing demand for orthopedic and dental implants has spurred researchers to develop multifunctional coatings, combining tissue integration with antibacterial features. A possible strategy to endow titanium (Ti) with antibacterial properties is by incorporating silver (Ag), but designing a structure with adequate Ag + release while maintaining biocompatibility has been shown difficult. To further explore the composition-structure-property relationships between Ag and Ti, and its effects against bacteria, this study utilized a combinatorial approach to manufacture and test a single sample containing a binary Ag-Ti oxide gradient. The sample, sputter deposited in a reactive (O 2 ) environment using a custom built combinatorial physical vapor deposition (PVD) system, was shown to be effective against Staphylococcus aureus with viability reductions ranging from 17 to above 99 %, depending on amount of Ag + released from its different parts. The Ag content along the gradient ranged from 35 to 62 wt%, but it was found that structural properties such as varied porosity and degree of crystallinity, rather than amount of incorporated Ag governed the Ag + release and resulting antibacterial activity. The coating also demonstrated in vitro apatite forming abilities, where structural variety along the sample was shown to alter the hydrophilic behavior, with degree of hydroxyapatite (HA) deposition varying accordingly. By means of combinatorial synthesis, a single gradient sample was able to display intricate compositional and structural features affecting its biological response, which would otherwise require a series of coatings. The current findings suggest that future implant coatings incorporating Ag as an antibacterial agent could be structurally enhanced to better suit clinical requirements.

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Section: Discussionmentioning

confidence: 99%

Reactive combinatorial synthesis and characterization of a gradient Ag–Ti oxide thin film with antibacterial properties

et al. 2015

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“…Infection is caused by either bacterial colonization at the wound site or foreign body response resulting from the implant material [5].Antibacterial biomaterials are one of the greatest interests in the war against implant-related infections, representing the broadest group of anti-infective biomaterials [6]. Focal antibacterial drug-loaded biomaterials can deliver a desired drug dose directly to the infected site for an extended time period while minimizing systemic distribution of toxic drugs [7,8].…”

Section: Introductionmentioning

confidence: 99%

Drug loaded homogeneous electrospun PCL/gelatin hybrid nanofiber structures for anti-infective tissue regeneration membranes

Xue

Liu³

et al. 2014

Biomaterials

324

219

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Email address: sharell@126.com (R. Shi). AbstractInfection is the major reason for guided tissue regeneration/guided bone regeneration (GTR/GBR) membrane failure in clinical application. In this work, we developed GTR/GBR membranes with localized drug delivery function to prevent infection by electrospinning of poly(ε-caprolactone) (PCL) and gelatin blended with metronidazole (MNA). Acetic acid (HAc) was introduced to improve the miscibility of PCL and gelatin to fabricate homogeneous hybrid nanofiber membranes. The effects of the addition of HAc and the MNA content (0,1,5,10,20,30, and 40 wt.% of polymer) on the properties of the membranes were investigated. The membranes showed good mechanical properties, appropriate biodegradation rate and barrier function. The controlled and sustained release of MNA from the membranes significantly prevented the colonization of anaerobic bacteria. Cells could adhere to and proliferate on the membranes without cytotoxicity until the MNA content reached 30%.Subcutaneous implantation in rabbits for 8 months demonstrated that MNA-loaded membranes evoked a less severe inflammatory response depending on the dose of MNA than bare membranes. The biodegradation time of the membranes was appropriate for tissue regeneration. These results indicated the potential for using MNA-loaded PCL/gelatin electrospun membranes as anti-infective GTR/GBR membranes to optimize clinical application of GTR/GBR strategies.

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“…In addition, one cannot fail to point out that there is still need for more studies involving surgery with implants, especially with regards to the safety of antibiofilm strategies to treat infections involving bone tissue and biomaterials (11) . This would also be a point to consider in studies on readmission following orthopedic surgery, considering that infections associated with the use of biomaterials differ in epidemiology, etiology and severity in relation to procedures which are not used (14) . It is noteworthy here that there was no mention in any of the studies about extrinsic factors for surgical site infections, namely: hospital stay prior to the procedure, processing of items and materials for care, surgical techniques, or operating room environment.…”

Section: Discussionmentioning

confidence: 99%

“…These are numbers that could support political decisions related to training of specialized personnel, targeting resources and quality of care (13) . Post-operative infections in orthopedics are considered serious and devastating complications which generate economic, clinical and social impacts (14) , leading to subsequent hospitalizations and new surgical interventions. The whole multidisciplinary team should be involved in order to recognize conditions and risk factors already identified in the literature in advance.…”

Section: Introductionmentioning

confidence: 99%

Readmission from orthopedic surgical site infections: an integrative review

Torres

Turrini

Merighi

et al. 2015

Rev. esc. enferm. USP

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Objective: Characterizing readmissions from orthopedic surgical site infections. Method: An integrative review of literature in the LILACS, IBECS, MEDLINE, Cochrane, SciELO and PUBMED databases, using the descriptors Patient readmission, Wound infection, Cross infection, Orthopedic procedures, Orthopedics. Results: 78 studies were identified and 10 publications were selected. Surgical site infections are the most common cause of unplanned orthopedic readmissions, representing long periods of hospitalization, new surgical procedures and high costs, and greater possibility of subsequent hospitalizations. Most significant predictors have indicated average length of hospitalization, need for intensive care, emergency status at admission, risk of death, age > 65 years, males and higher body mass index. Conclusion: Readmission rates have increasingly become measures of quality and concerns about costs. New studies could involve issues related to indirect costs, specifically social and psychological costs.

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A review of the clinical implications of anti-infective biomaterials and infection-resistant surfaces

Cited by 293 publications

References 100 publications

Reactive combinatorial synthesis and characterization of a gradient Ag–Ti oxide thin film with antibacterial properties

Reactive combinatorial synthesis and characterization of a gradient Ag–Ti oxide thin film with antibacterial properties

Drug loaded homogeneous electrospun PCL/gelatin hybrid nanofiber structures for anti-infective tissue regeneration membranes

Readmission from orthopedic surgical site infections: an integrative review

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