| ZHI Shudi,YUAN Kunshan,ZHANG Haijun.Research Progress of Antibacterial Surfaces in Cardiovascular System Implants[J],54(6):47-61 |
| Research Progress of Antibacterial Surfaces in Cardiovascular System Implants |
| Received:August 14, 2024 Revised:October 29, 2024 |
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| DOI：10.16490/j.cnki.issn.1001-3660.2025.06.004 |
| KeyWord:cardiovascular system implants antimicrobial surface pH-responsive release renewable antibacterial |
| Author | Institution |
| ZHI Shudi |
National-Local United Engineering Laboratory for Biomedical Material Modification Technology, Shandong Dezhou , China;The Institute of Interventional and Vascular, Tongji University, Shanghai , China |
| YUAN Kunshan |
National-Local United Engineering Laboratory for Biomedical Material Modification Technology, Shandong Dezhou , China;The Institute of Interventional and Vascular, Tongji University, Shanghai , China |
| ZHANG Haijun |
National-Local United Engineering Laboratory for Biomedical Material Modification Technology, Shandong Dezhou , China;The Institute of Interventional and Vascular, Tongji University, Shanghai , China |
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| Abstract: |
| The cardiovascular system is a closed tube system consisting of heart and blood vessels. Cardiovascular system implants (CSI) are medical devices that are surgically implanted or interventional and left in the cardiovascular system for a long period (greater than 30 days), including cardiac implantable electronic devices, stents, vascular grafts and catheters. Improper aseptic procedures during surgery or improper care during indentation may cause bacteria to enter the blood circulation system, adhere to and multiply on the surface of the cardiovascular system implant. Usually, the surface of cardiovascular system implants has no antibacterial function. Once bacteria colonize and form biofilms on its surface, it will threaten the life safety of patients. Building antibacterial functions on the surface of cardiovascular system implants can effectively reduce the probability of bacterial infection and ensure the survival of patients. With the development of antibacterial surface research, there are two kinds of antibacterial strategies:anti-adhesion and bactericidal. The anti-adhesion surface does not contain bactericidal active substances, so it is rarely used for antibacterial purposes alone. In this paper, the bactericidal antibacterial surface modification of cardiovascular system implants in recent years is reviewed, mainly from three aspects:release antibacterial, contact antibacterial and regenerative antibacterial. The release antibacterial strategy is generally to kill bacteria on and around the device surface by releasing bactericidal substances in the coating. Common released antibacterial substances include antibiotics, metal particles and NO antibiotics. The antibacterial effect of releasing antibacterial strategy is affected by the release concentration of antibacterial substances, high release concentration, short antibacterial aging, low release concentration and poor antibacterial effect. Unplanned release of antimicrobial substances not only shortens antibacterial aging, but also may cause the generation of drug-resistant strains. Therefore, this paper also describes the construction of responsive controlled release surface, with emphasis on pH-responsive release coatings. Most of the pH-responsive release coatings studied at present accelerate the release of antimicrobial substances in acidic environments, because the local pH value is reduced after infection. The contact type antibacterial surface is to fix bactericidal active substances on the material surface through physical or chemical methods to kill the bacteria on the instrument surface. Common contact bactericidal active substances include quaternary ammonium salts, chitosan and antimicrobial peptides. These three bactericidal active substances all kill bacteria through electrostatic action, so their surfaces are highly susceptible to bacterial debris contamination. In fact, both bactericidal antibacterial surfaces and anti-adhesion antibacterial surfaces are easy to be covered by protein due to human rejection reaction, and lose antibacterial function. To solve this problem, this paper introduces the renewable antibacterial surface. The method is inspired by reptile molting behavior and a multi-layer antibacterial coating is designed. The antibacterial coating is alternately coated by a functional layer and a sacrificial layer. Through the dissolution or degradation of the sacrificial layer, the lost antibacterial function of the top layer is decayed, the new antibacterial surface is exposed, and the antibacterial surface is regenerated, providing a direction for long-term antibacterial function construction. Finally, the surface defects of antibacterial function of cardiovascular system implants are pointed out and the future is prospected. |
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