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Bacterial colonization ofimplanted biomedical devicesis themain cause ofhealthcare-associated infections, estimated to be 8.8 million per year inEurope. Many infections originate from damaged skin, which lets microorganismsexploit injuries and surgical accesses as passageways to reach the implant siteand inner organs. Therefore, an effective treatment of skin damage is highlydesirable for the success of many biomaterial-related surgical procedures. Dueto gained resistance to antibiotics, new antibacterial treatments are becomingvital to control nosocomial infections arising as surgical and post-surgicalcomplications. Surface coatings can avoid biofouling and bacterial colonizationthanks to biomaterial inherent properties (e.g., super hydrophobicity),specifically without using drugs, which may cause bacterial resistance. Thefocus of this review is to highlight the emerging role of degradable polymericmicro- and nano-structures that show intrinsic antifouling and antimicrobialproperties, with a special outlook towards biomedical applications dealing withskin and skin damage. The intrinsic properties owned by the biomaterialsencompass three main categories: (1) physical-mechanical, (2) chemical, and (3)electrostatic. Clinical relevance in ear prostheses and breast implants isreported. Collecting and discussing the updated outcomes in this field wouldhelp the development of better performing biomaterial-based antimicrobialstrategies, which are useful to prevent infections.

journal of functional biomaterials

Biodegradable Polymeric Micro/Nano-Structures with Intrinsic  Antifouling/Antimicrobial Properties:Relevance in Damaged Skin and Other  Biomedical Applications