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Antibacterial coating of implants: what surgeons should know

Published in N°18 - July / August 2022
Article viewed 48 times

Antibacterial coating of implants: what surgeons should know

By Carlo Luca Romanò(1), Hemant Sharma(2), Svetlana Bozhkova(3), Hiroyuki Tsuchiya(4) in category FOCUS
(1) Studio Medico Cecca-Romano – Corso Venezia, 2 20121 Milano, Italy - (2) Hull University Teaching Hospitals, Anlaby Road, Hull, HU3 2JZ – Hull, United Kingdom - (3) Vreden National Medical Research Center of Traumatology and Orthopedics – Akad.Baykova, 8, 154427, St. Petersburg, Russia - (4) Department of Orthopaedic Surgery - Graduate School of Medical Sciences, Kanazawa University - 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan / [email protected]

Up to 80% of human bacterial infections are biofilm-related, according to the U.S. National Institutes of Health. Among these, implant-related infections in orthopaedics and trauma still have a tremendous impact.

The impact of biofilm- and implant-related infections in ortho-trauma

Up to 80% of human bacterial infections are biofilm-related, according to the U.S. National Institutes of Health [1]. Among these, implant-related infections in orthopaedics and trauma still have a tremendous impact [2]. In fact, peri-prosthetic joint infection (PJI) is among the first reasons for joint replacement failure [3], posing challenging diagnostic and therapeutic dilemmas [4], with extremely high economic and social associated costs (Table 1). [5]

Table 1. Impact of implant-related infections in orthopedics and trauma: facts and figures.

 

Pathogenesis of implant-related infections and antibacterial coating rationale

Whenever a biomaterial is implanted, a competition starts between the host’s and the bacterial cells for surface colonization. In the event of bacterial adhesion to an implant, immediate biofilm formation starts, making the bacteria extremely resistant to host’s defense mechanisms and to antimicrobials[13]. In fact, in a wet environment, like the human body is, bacteria are capable to immediately adhere on a surface and to produce a protective intercellular matrix (the “biofilm”), which is completely formed in few hours. Once established, the biofilms efficiently protect the...

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