Evaluation of Antibacterial and Cytotoxic Properties of a Fluorinated Diamond-Like Carbon Coating for the Development of Antibacterial Medical Implants

Enhanced antibacterial and corrosion resistance performance of fluorine-doped diamond-like carbon coatings on 316 L stainless steel

Biomedical materials must meet increasingly stringent standards for antibacterial efficacy and corrosion resistance. This study investigates the enhancement of these properties in 316 L stainless steel through the application of fluorine-doped diamond-like carbon (F-DLC) coatings. A series of F-DLC coatings with varying fluorine (F) concentrations were fabricated using plasma-enhanced chemical vapour deposition (PECVD). Fluorine doping increased the sp2/sp3 ratio (0.65-0.93) and enhanced surface hydrophobicity, as indicated by an increase in the contact angle from 63.1° to 79.7°. The impact of F concentration on bacterial adhesion was investigated using Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). DLC coatings with higher F concentrations and sp2/sp3 ratios exhibited a notable reduction in bacterial adhesion - up to 74 % for E. coli and 77 % for S. aureus - compared to uncoated stainless steel. The extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) theory was employed to model bacteria-surface interactions, revealing the role of F in bacterial adhesion behaviour. Furthermore, the F-DLC coatings achieved a significant corrosion inhibition rate of 98.3 % in Hanks' balanced salt solution at 37 °C. Overall, higher F concentrations in the DLC coatings promote antibacterial and anti-corrosion performance by shifting the carbon structure from a three-dimensional sp3-dominated configuration to a two-dimensional sp2-rich structure.

In Vitro and In Vivo Evaluation of Toxicity of Structurally Different Diamond-Like Carbon Wear Debris in Joint Replacements

Diamond-like carbon (DLC) wear debris, which is often composed of different types of structures, is generated from DLC-modified artificial joints in the human body, and its biocompatibility evaluation is especially important to prevent wear-debris-induced implant failure. Here, RAW 264.7 macrophages (inflammatory-reaction assay) and primary mouse osteoblasts (osteoblastogenesis assay) were employed to investigate the toxicity of DLC wear particles (DWPs) by evaluation of cell viability and morphology, enzyme-linked immunosorbent assays, and quantitative reverse-transcription polymerase chain reaction (PCR). Relevant histopathological analysis of rat joints was also performed in vivo. We found that DWPs with a relatively high sp2/sp3 ratio (graphite-phase tendency) manifested a higher cytotoxicity and significant inhibition of osteoblastogenesis. DWPs with a relatively low sp2/sp3 ratio (diamond-phase tendency) showed good biocompatibility in vivo. The DWPs exhibiting a low sp2/sp3 ratio demonstrated reduced secretion of TNF-α and IL-6, along with increased secretion of TIMP-1, resulting in the downregulation of MMP-2 and MMP-9 and upregulation of interleukin-10 (IL-10), thereby attenuating the inflammatory response. Moreover, coculturing osteoblasts with DWPs exhibiting a low sp2/sp3 ratio resulted in an elevated OPG/RANKL ratio and increased expression of OPG mRNA. Because of the absence of electrostatic repulsion, DWPs with a relatively low sp2/sp3 ratio enhanced bovine serum albumin adsorption, which favored cellular activities. Cytotoxicity assessment of DWPs can help establish an evaluation system for particle-related joint disease and can facilitate the clinical application of DLC-coated prostheses.

Development of Antimicrobial Surfaces Using Diamond-like Carbon or Diamond-like Carbon-Based Coatings

The medical device market is a high-growth sector expected to sustain an annual growth rate of over 5%, even in developed countries. Daily, numerous patients have medical devices implanted or inserted within their bodies. While medical devices have significantly improved patient outcomes, as foreign objects, their wider use can lead to an increase in device-related infections, thereby imposing a burden on healthcare systems. Multiple materials with significant societal impact have evolved over time: the 19th century was the age of iron, the 20th century was dominated by silicon, and the 21st century is often referred to as the era of carbon. In particular, the development of nanocarbon materials and their potential applications in medicine are being explored, although the scope of these applications remains limited. Technological innovations in carbon materials are remarkable, and their application in medicine is expected to advance greatly. For example, diamond-like carbon (DLC) has garnered considerable attention for the development of antimicrobial surfaces. Both DLC itself and its derivatives have been reported to exhibit anti-microbial properties. This review discusses the current state of DLC-based antimicrobial surface development.

Synthesis and biological properties of novel glucose-based fluoro segmented macromolecular architectures

The emergence of novel well-defined biological macromolecular architectures containing fluorine moieties displaying superior functionalities can satisfactorily address many biomedical challenges. In this research, ABA- and AB-type glucose-based biological macromolecules were synthesized using acryl-2,3,4,6-tetra-O-acetyl-D-glucopyranoside with pentafluorophenyl (FPM), pentafluorobenzyl (FBM), phenyl (PM) and benzyl (BM) methacrylate-based macro-RAFT agents following RAFT polymerization. The macro-RAFT agents and the corresponding copolymers were characterized by 19F, 1H, and 13C NMR and FTIR spectroscopic techniques to understand the chemical structure, molecular weight by size-exclusion chromatography, thermal analysis by TGA and DSC. Thermal stability (Td5%) of the FPM and FBM fluoro-based polymers was observed in the range of 219-267 °C, while the non-fluoro PM and BM polymers exhibited in the range of 216-264 °C. Among the macro-RAFT agents, PFPM (107 °C, ΔH: 0.613 J/g) and PPM (103 °C, ΔH: 0.455 J/g) showed higher Tm values, while among the block copolymers, PFBM-b-PG (123 °C, ΔH: 0.412 J/g) and PG-b-PFPM-b-PG (126 °C, ΔH: 0.525 J/g) exhibited higher Tm values. PFBMT and PPM macro-RAFT agents, PPM-b-PG and PG-b-PPM-b-PG copolymer spin-coated films showed the highest hydrophobicity (120°) among the synthesized polymers. The block copolymers exhibited self-assembled segregation by using relatively hydrophobic segments as the core and hydrophilic moieties as the corona. Synthesized biological macromolecules exhibit maximum antibacterial activity towards S. aureus than E. coli bacteria. Fluorophenyl (PFPM) and non-fluorobenzyl-based (PBMT) macro-RAFT agents exhibit low IC50 values, suggesting high cytotoxicity. All the triblock copolymers exhibit lesser cytotoxicity than the di-block polymers.

Antibacterial Food Packaging Nanomaterial Based on Atomic Layer Deposition for Long-Term Food Storage

The aim of the present work is to use the latest achievements of nanotechnology (atomic layer deposition, ALD) in the field of food packaging to prevent biofilm formation by food-associated bacteria. Some potential applications of nanotechnology in the food packaging industry are studied in the manuscript, in the field of antibacterial materials for food packaging. The ALD technique was used to synthesize vanadium (V)-doped TiO2 thin nanofilm on commercially available polypropylene (PP) food container to enhance an antibacterial activity for potential use in food packaging, to reduce spoilage, thereby, prolonging the food shelf- life. To better understand the ability and effectiveness of the antimicrobial packaging material of V-doped TiO2, to prevent the biofilm formation by dairy-associated pathogenic bacteria, the coated and uncoated PP containers with a fresh raw cow's milk were tested. We have illustrated the effectiveness of ALD Al2O3 + TiVOx nanocoating against populations of milk-borne pathogenic bacteria.

Assessing Antimicrobial Efficacy on Plastics and Other Non-Porous Surfaces: A Closer Look at Studies Using the ISO 22196:2011 Standard

The survival and spread of foodborne and nosocomial-associated bacteria through high-touch surfaces or contamination-prone sites, in either healthcare, domestic or food industry settings, are not always prevented by the employment of sanitary hygiene protocols. Antimicrobial surface coatings have emerged as a solution to eradicate pathogenic bacteria and prevent future infections and even outbreaks. Standardised antimicrobial testing methods play a crucial role in validating the effectiveness of these materials and enabling their application in real-life settings, providing reliable results that allow for comparison between antimicrobial surfaces while assuring end-use product safety. This review provides an insight into the studies using ISO 22196, which is considered the gold standard for antimicrobial surface coatings and examines the current state of the art in antimicrobial testing methods. It primarily focuses on identifying pitfalls and how even small variations in methods can lead to different results, affecting the assessment of the antimicrobial activity of a particular product.

The Toughness-Enhanced Atelocollagen Double-Network Gel for Biomaterials

A tough gel composed of atelocollagen, which lacks an immunogenetic site, is a promising material for biomedical application. In this study, we created a composite hydrogel composed of atelocollagen gel cross-linked with glutaraldehyde (GA) and poly-(N,N-dimethylacrylamide) gel exhibiting biocompatibility based on the double-network (DN) gel principle. The tensile toughness of atelocollagen gel remained constant regardless of the amount of cross-linker (GA) used. In contrast, tensile tests of the DN gel indicated that mechanical properties, such as fracture stress and toughness, were significantly higher than those of the atelocollagen gel. Moreover, fibroblast cells adhered and spread on the gels, the Schiff bases of which were treated via reductive amination for detoxification from GA. These findings demonstrate the potential of the proposed gel materials as artificial alternative materials to soft tissues with sub-MPa fracture stress.

Hydrophilic Surface Modification of Amorphous Hydrogenated Carbon Nanocomposite Films via Atmospheric Oxygen Plasma Treatment

Herein we investigated hydrophilic surface modification of SiO_x containing amorphous hydrogenated carbon nanocomposite films (DLC:SiO_x) via the use of atmospheric oxygen plasma treatment. The modified films exhibited effective hydrophilic properties with complete surface wetting. More detailed water droplet contact angle (CA) measurements revealed that oxygen plasma treated DLC:SiO_x films maintained good wetting properties with CA of up to 28 ± 1° after 20 days of aging in ambient air at room temperature. This treatment process also increased surface root mean square roughness from 0.27 nm to 1.26 nm. Analysis of the surface chemical states suggested that the hydrophilic behavior of DLC:SiO_x treated with oxygen plasma is attributed to surface enrichment with C-O-C, SiO₂, and Si-Si chemical bonds as well as significant removal of hydrophobic Si-CH_x functional groups. The latter functional groups are prone to restoration and are mainly responsible for the increase in CA with aging. Possible applications of the modified DLC:SiO_x nanocomposite films could include biocompatible coatings for biomedical applications, antifogging coatings for optical components, and protective coatings to prevent against corrosion and wear.

Soot-Embedded Extruded Talus Fracture After a 5-Story Fall: A Case Report

CASE

A 17-year-old boy presented with an open talus fracture complicated by soot contamination after a chimney-related accident. Standard irrigation and debridement (I&D) methods were used, but complete removal of soot was not possible. At the latest follow-up, there was no evidence of infection, hardware failure, or avascular necrosis.

CONCLUSION

There is a lack of well-established guidelines regarding I&D of traumatic wounds contaminated with fine particulates. A review of potential debridement methods is discussed. Orthoapedic surgeons should be aware of hydrosurgical debridement as a potential treatment approach in these unique scenarios.

Advances in Multifunctional Bioactive Coatings for Metallic Bone Implants

To fix the bone in orthopedics, it is almost always necessary to use implants. Metals provide the needed physical and mechanical properties for load-bearing applications. Although widely used as biomedical materials for the replacement of hard tissue, metallic implants still confront challenges, among which the foremost is their low biocompatibility. Some of them also suffer from excessive wear, low corrosion resistance, infections and shielding stress. To address these issues, various coatings have been applied to enhance their in vitro and in vivo performance. When merged with the beneficial properties of various bio-ceramic or polymer coatings remarkable bioactive, osteogenic, antibacterial, or biodegradable composite implants can be created. In this review, bioactive and high-performance coatings for metallic bone implants are systematically reviewed and their biocompatibility is discussed. Updates in coating materials and formulations for metallic implants, as well as their production routes, have been provided. The ways of improving the bioactive coating performance by incorporating bioactive moieties such as growth factors, osteogenic factors, immunomodulatory factors, antibiotics, or other drugs that are locally released in a controlled manner have also been addressed.

In Vivo Antibacterial Efficacy of Nanopatterns on Titanium Implant Surface: A Systematic Review of the Literature

Background: Bionic surface nanopatterns of titanium (Ti) materials have excellent antibacterial effects in vitro for infection prevention. To date, there is a lack of knowledge about the in vivo bactericidal outcomes of the nanostructures on the Ti implant surfaces. Methods: A systematic review was performed using the PubMed, Embase, and Cochrane databases to better understand surface nanoscale patterns’ in vivo antibacterial efficacy. The inclusion criteria were preclinical studies (in vivo) reporting the antibacterial activity of nanopatterns on Ti implant surface. Ex vivo studies, studies not evaluating the antibacterial activity of nanopatterns or surfaces not modified with nanopatterns were excluded. Results: A total of five peer-reviewed articles met the inclusion criteria. The included studies suggest that the in vivo antibacterial efficacy of the nanopatterns on Ti implants’ surfaces seems poor. Conclusions: Given the small number of literature results, the variability in experimental designs, and the lack of reporting across studies, concluding the in vivo antibacterial effectiveness of nanopatterns on Ti substrates’ surfaces remains a big challenge. Surface coatings using metallic or antibiotic elements are still practical approaches for this purpose. High-quality preclinical data are still needed to investigate the in vivo antibacterial effects of the nanopatterns on the implant surface.

ALD coated polypropylene hernia meshes for prevention of mesh-related post-surgery complications: an experimental study in animals

In this work, thermal atomic layer deposition (ALD) was used to synthesize vanadium (V)-doped TiO₂thin nanofilm on polypropylene (PP) hernia meshes. Multiple layers of (Al₂O₃+ TiVO_x) nano-films were coated on the PP hernia mesh surface to provide a layer with a total thickness of 38 nm to improve its antibacterial properties, thereby, prevent mesh-related post-surgery complications. Highly conformal V-doped TiO₂nanofilm were deposited on PP mesh at a temperature of 85 °C. Rats and rabbits have been used to evaluate the tissue reaction on coated PP hernia meshes and biomechanical testing of the healed tissue. Five rabbits and ten rats have been implanted with ALD coated and uncoated (control) PP meshes into the back of rats and abdominal wall of rabbits. Histology of the mesh-adjacent tissues and electron microscopy of the explanted mesh surface were performed to characterize host tissue response to the implanted PP meshes. The effect of V-doped TiO₂coating on a living organism and fibroblast functions and bacterial activities were studied. The present results indicated that ALD coating improves adhesion properties and exhibited enhanced antibacterial activity compared to uncoated PP mesh. It was shown that V-doped TiO₂coatings were highly effective in inhibitingS. aureusandE. coliadhesion and exhibited excellent antibacterial activity. We found that V-doping of TiO₂, unlike bare TiO₂, allows generated and further procured strong redox reactions which effectively kills bacteria under visible light. We have reported comparative analysis of the use of undoped (bare) TiO₂and V-doped TiO₂as a coating for PP meshes and their action in biological environment and preventing biofilms formation compared with uncoated PP meshes. The PP meshes coated with V-doped TiO₂showed significantly lower shrinkage rates compared with an identical PP mesh without a coating. We have shown that ALD coatings provide non-adhesive and functional (antibacterial) properties.

Use of Plasma Technologies for Antibacterial Surface Properties of Metals

Bacterial infections of medical devices present severe problems connected with long-term antibiotic treatment, implant failure, and high hospital costs. Therefore, there are enormous demands for innovative techniques which would improve the surface properties of implantable materials. Plasma technologies present one of the compelling ways to improve metal's antibacterial activity; plasma treatment can significantly alter metal surfaces' physicochemical properties, such as surface chemistry, roughness, wettability, surface charge, and crystallinity, which all play an important role in the biological response of medical materials. Herein, the most common plasma treatment techniques like plasma spraying, plasma immersion ion implantation, plasma vapor deposition, and plasma electrolytic oxidation as well as novel approaches based on gaseous plasma treatment of surfaces are gathered and presented. The latest results of different surface modification approaches and their influence on metals' antibacterial surface properties are presented and critically discussed. The mechanisms involved in bactericidal effects of plasma-treated surfaces are discussed and novel results of surface modification of metal materials by highly reactive oxygen plasma are presented.

Activated Porous Carbon Derived from Tea and Plane Tree Leaves Biomass for the Removal of Pharmaceutical Compounds from Wastewaters

The aim of the present study is the synthesis of activated carbon (AC) from different agricultural wastes such as tea and plane tree leaves in order to use them for the removal of pramipexole dihydrochloride (PRM) from aqueous solutions. Two different carbonization and synthetic activation protocols were followed, with the herein-proposed ultrasound-assisted two-step protocol leading to better-performing carbon, especially for the tea-leaf-derived material (TEA(char)-AC). Physicochemical characterizations were performed by Fourier-transform infrared spectroscopy (FTIR), N₂ physisorption, and scanning electron microscopy (SEM). TEA(char)-AC presented the highest surface area (1151 m²/g) and volume of micro and small mesopores. Maximum capacity was found at 112 mg/g for TEA(char)-AC at an optimum pH equal to 3, with the Langmuir isotherm model presenting a better fitting. The removal efficiency of TEA(char)-AC is higher than other biomass-derived carbons and closer to benchmark commercial carbons.