Infection-resistant implantable devices: Biofilm problems and design strategies

Advancements in medical and surgical technologies mean that indwelling devices are being used increasingly, either as permanent implants such as prosthetic joints and coronary arterial stents or for maintaining access to sites in the short term such as venous and urinary catheters. Increasing attention is being focussed on implantable matrices as devices to control the delivery of drugs to a particular target site. Inevitably, implanted devices of whatever composition provide an unwanted focus for infection through development of microbial biofilms. Biofilms represent a significant clinical challenge and frequently result in device failure. Here, we review the clinical challenge posed by microbial biofilms and present some of the strategies that have been proposed to reduce or prevent biofilm formation on implantable devices.