Scaffold-based Anti-infection Strategies in Bone Repair

Abstract

Bone fractures and non-union defects often require surgical intervention where biomaterials are used to correct the defect, and approximately 10% of these procedures are compromised by bacterial infection. Currently, treatment options are limited to sustained, high doses of antibiotics and surgical debridement of affected tissue, leaving a significant, unmet need for the development of therapies to combat device-associated biofilm and infections. Engineering implants to prevent infection is a desirable material characteristic. Tissue engineered scaffolds for bone repair provide a means to both regenerate bone and serve as a base for adding antimicrobial agents. Incorporating anti-infection properties into regenerative medicine therapies could improve clinical outcomes and reduce the morbidity and mortality associated with biomaterial implant-associated infections. This review focuses on current animal models and technologies available to assess bone repair in the context of infection, antimicrobial agents to fight infection, the current state of antimicrobial scaffolds, and future directions in the field.

Reconstruction of a mandibular segmental defect with a customized 3-dimensional–printed titanium prosthesis in a cat with a mandibular osteosarcoma

“…Future considerations to minimize the risk of implantassociated infection include the use of tissue engineering technology to embed slow-release antimicrobial or silver nanoparticles into the prosthesis. [63][64][65][66][67][68] Implant failure has been reported in humans following mandibular reconstruction with free fibular grafts because of failure to counteract the complex biomechanical forces (bending, torsional, and shearing) acting on the mandible as a result of the actions of individual masticatory muscles during chewing and the magnitude of forces generated during biting. 42,43 As mentioned previously, biomechanical studies are required to further elucidate the direction and magnitude of the these forces in clinically normal cats to provide information for the optimal design of CAD-CAM customized 3-Dprinted mandibular prostheses to minimize the risk of implant-prosthesis failure.…”

Proteins and Peptides as Important Modifiers of the Polymer Scaffolds for Tissue Engineering Applications—A Review

“…However, it should be taken into account that incorporated antibacterial agents not only inhibit growth of bacterial cells, but they also may exhibit toxic effect towards eukaryotic ones. The combination of polymer scaffolds with biocompatible proteins/peptides and antibacterial agents allows keeping a balance between suitable antibacterial protection and cytotoxicity [276][277][278][279][280][281]. For instance, Mantripragada and Jayasuriya [279] fabricated chitosan microparticles enriched with BMP-7 and antibiotics, i.e., vancomycin and cefazolin.…”

Use of anodized titanium alloy as drug carrier: Ibuprofen as model of drug releasing

“…The potential use of different biomaterials as drug carriers, aimed to the local treatment of many conditions, has been analysed in many reports, aiming to obtain the ideal "intelligent material" (Brohede et al, 2009;Johnson and Garcia, 2014;Park et al, 2014;Przekora et al, 2014;Vallet-Regi et al, 2007;Vallet-Regi and Ruiz-Hernandez, 2011).…”