Abstract
In this review, strategies for improving the antimicrobial properties of stainless steel (SS) are presented. The main focus given is to present current strategies for surface modification of SS, which alter surface characteristics in terms of surface chemistry, topography and wettability/surface charge, without influencing the bulk attributes of the material. As SS exhibits excellent mechanical properties and satisfactory biocompatibility, it is one of the most frequently used materials in medical applications. It is widely used as a material for fabricating orthopedic prosthesis, cardiovascular stents/valves and recently also for three dimensional (3D) printing of custom made implants. Despite its good mechanical properties, SS lacks desired biofunctionality, which makes it prone to bacterial adhesion and biofilm formation. Due to increased resistance of bacteria to antibiotics, it is imperative to achieve antibacterial properties of implants. Thus, many different approaches were proposed and are discussed herein. Emphasis is given on novel approaches based on treatment with highly reactive plasma, which may alter SS topography, chemistry and wettability under appropriate treatment conditions. This review aims to present and critically discuss different approaches and propose novel possibilities for surface modification of SS by using highly reactive gaseous plasma in order to obtain a desired biological response.
Highlights
Metallic biomaterials, especially stainless steel and titanium alloys, are one of the most widely used materials for biomedical application, as they possess excellent mechanical properties and biocompatibility
It should be emphasized that the antibacterial properties are one of the key issues to be considered in all implantable materials, various strategies for surface modification of biomaterials are used to decrease/prevent bacterial adhesion and biofilm formation [5]
The environment and surface properties important factor is the ability of a biomaterial to produce ions, which influence the growth of bacteria
Summary
Especially stainless steel and titanium alloys, are one of the most widely used materials for biomedical application, as they possess excellent mechanical properties and biocompatibility. SS materials are used for permanent (bone implants, stents, dental implants etc.) and temporary implants (plates, nails, screws etc.) as well as for surgical tools (scalpels, guiding templates etc.) This is mainly due to its comparatively low cost, ease of manufacturing, good fatigue properties and reasonable corrosion resistance and biocompatibility. SS is a widely used biomaterial, there are still limited amounts of available reviews that critically present various types of surface finishing strategies for the prevention of bacterial adhesion and biofilm formation on SS. Discussion on bacterial infections and the biological response of SS surfaces used for specific applications is presented (surgical tools, cardiovascular implants, bone implants), and known strategies used for bacterial prevention are discussed. At the end of this review, strategies for surface modification of SS involving different types of plasma technologies are presented and examples of surface modification of SS 316L obtained using highly reactive radiofrequency plasma are given and discussed
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