Antibacterial Surfaces by Elena Ivanova & Russell Crawford

Author:Elena Ivanova & Russell Crawford
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Keywords

Implant surfacesAntibacterialBactericidalTitaniumBiocide-releasing surfacesNanoparticlesSurface topography

6.1 Introduction

Bacterial infection of biomaterials has long been a significant problem, both during implant surgery and after the implantation process (Lavernia et al. 2006; Bozic and Ries 2005; Montanaro et al. 2011; Arciola et al. 2012; Campoccia et al. 2013a, b; Busscher et al. 2012; Whitehouse et al. 2002). Infection that results from receiving a contaminated biomedical implant substantially affects the quality of life for the patient and represents a large burden to society by increasing the number of clinical procedures having to be undertaken in the healthcare system, thus increasing the costs of health care. For example, it has been estimated that antibiotic treatment and revisionary surgery for replacement of an infected total hip causes the primary procedure costs to triple to an average of $75,000 in the US (Lavernia et al. 2006; Bozic and Ries 2005). It has been found that infections that have arisen from orthopaedic surgery prolonged the hospital stay for patients by a median of 2 weeks each, approximately doubled the re-hospitalisation rates, and increased healthcare costs by more than 300 % (Whitehouse et al. 2002). Complications arise as a result of the the pathogenic bacteria developing resistance to the natural host defense mechanisms and antibiotics. This means that treatment of the infection whilst the implant is still resident in the patient is usually unsuccesful, leading to the necessity for surgical intervention (Olson et al. 2002; Davies 2003; Vasilev et al. 2009; Høiby et al. 2010). It appears that only a low dose of inoculum is required to result in the infection of an implant; in an animal model study, it was found that 100 colony-forming units (cfu) of S. aureus were sufficient to infect 95 % of the subcutaneous implants used in the study (Arciola et al. 2012; Campoccia et al. 2013b; Song et al. 2013). Most of the microorganisms that cause implant infections are present in the host flora, of which the most frequent are Staphylococci, Streptococci, Pseudomonas species and coliform bacteria (Campoccia et al. 2013a, b; Olson et al. 2002; Davies 2003).

In an effort to combat implant-associated bacterial infection, recent focus has been placed on the development of antibacterial surfaces (Campoccia et al. 2013a, b; McLean et al. 1993; Yoshinari et al. 2001; Wan et al. 2007a, b; Zhao et al. 2009; Vasilev et al. 2009; Rautray et al. 2010; Glinel et al. 2012; Hajipour et al. 2012; Hasan et al. 2013). With the current growth in the development of novel nanofabrication tools, modifying the chemical and physical characteristics of implant surfaces has been shown to co ntrol the molecular to micro-scale topological features of many substrate surfaces. This chapter will provide an insight into the current methods being used for the design of antibacterial surfaces on implant materials and a rationale for the applicability of the unique surfaces being produced.

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