In Vitro and In Vivo Bone Regeneration Assessment of Titanium-Doped Waste Eggshell-Derived Hydroxyapatite in the Animal Model

In this work, a titanium-doped hydroxyapatite (HAp) scaffold was produced from two different sources (natural eggshell and laboratory-grade reagents) to compare the efficacy of natural and synthetic resources of HAp materials on new bone regeneration. This comparative study also reports the effect of Ti doping on the physical, mechanical, and in vitro as well as in vivo biological properties of the HAp scaffold. Pellets were prepared in the conventional powder metallurgy route, compacted, and sintered at 900 °C, showing sufficient porosity for bony ingrowth. The physical-mechanical characterizations were performed by density, porosity evaluation, XRD, FTIR, SEM analysis, and hardness measurement. In vitro interactions were evaluated by bactericidal assay, hemolysis, MTT assay, and interaction with simulated body fluid. All categories of pellets showed absolute nonhemolytic and nontoxic character. Furthermore, significant apatite formation was observed on the Ti-doped HAp samples in the simulated body fluid immersion study. The developed porous pellets were implanted to assess the bone defect healing in the femoral condyle of healthy rabbits. A 2 month study after implantation showed no marked inflammatory reaction for any samples. Radiological analysis, histological analysis, SEM analysis, and oxytetracycline labeling studies depicted better invasion of mature osseous tissue in the pores of doped eggshell-derived HAp scaffolds as compared to the undoped HAp, and laboratory-made samples. Quantification using oxytetracycline labeling depicted 59.31 ± 1.89% new bone formation for Ti-doped eggshell HAp as compared to Ti-doped pure HAp (54.41 ± 1.93) and other undoped samples. Histological studies showed the presence of abundant osteoblastic and osteoclastic cells in Ti-doped eggshell HAp in contrast to other samples. Radiological and SEM data also showed similar results. The results indicated that Ti-doped biosourced HAp samples have good biocompatibility, new bone-forming ability, and could be used as a bone grafting material in orthopedic surgery.

Influence of Single-Wall Carbon Nanotube Suspension on the Mechanical Properties of Polymeric Films and Electrospun Scaffolds

Carbon nanotubes (CNTs) are used in applications ranging from electrical engineering to medical device manufacturing. It is well known that the addition of nanotubes can influence the mechanical properties of various industrial materials, including plastics. Electrospinning is a popular method for fabricating nanomaterials, widely suggested for polymer scaffold manufacturing. In this study, we aimed to describe the influence of single-walled carbon nanotube (SWCNT) suspensions on polymeric poured films and electrospun scaffolds and to investigate their structural and mechanical properties obtained from various compositions. To obtain films and electrospun scaffolds of 8 mm diameter, we used poly-ε-caprolactone (PCL) and poly(cyclohexene carbonate) (PCHC) solutions containing several mass fractions of SWCNT. The samples were characterized using tensile tests, atomic force and scanning electronic microscopy (AFM and SEM). All the studied SWCNT concentrations were shown to decrease the extensibility and strength of electrospun scaffolds, so SWCNT use was considered unsuitable for this technique. The 0.01% mass fraction of SWCNT in PCL films increased the polymer strength, while fractions of 0.03% and more significantly decreased the polymer strength and extensibility compared to the undoped polymer. The PHCH polymeric films showed a similar behavior with an extremum at 0.02% concentration for strength at break.

Hemp-Based Sustainable Slippery Surfaces: Icephobic and Antithrombotic Properties

With the passage of the 2018 Farm Bill that removed hemp from the Controlled Substances Act altogether, production of hemp is experiencing a renaissance. Building on this revival and re-emergence of hemp, we designed and fabricated hemp-based sustainable and robust slippery surfaces by coating hemp paper with beeswax and subsequently infusing it with hemp oil. A wide variety of aqueous liquids and beverages easily slide on our hemp-based sustainable slippery surfaces, without leaving a trace. We also fabricated hemp-based sustainable slippery surfaces using different textured metals. Our hemp-based sustainable slippery metal surfaces display good icephobic and antithrombotic properties. With these attributes, we envision that our hemp-based sustainable slippery surfaces will pave the path to more safe, non-toxic, and biodegradable or recyclable slippery surfaces for applications in food packaging, anti-icing or de-icing coatings, and antithrombotic medical devices.

Enhanced antibacterial properties on superhydrophobic micro-nano structured titanium surface

Micro/nano scale surface modifications of titanium based orthopedic and cardiovascular implants has shown to augment biocompatibility. However, bacterial infection remains a serious concern for implant failure, aggravated by increasing antibiotic resistance and over usage of antibiotics. Bacteria cell adhesion on implant surface leads to colonization and biofilm formation resulting in morbidity and mortality. Hence, there is a need to develop new implant surfaces with high antibacterial properties. Recent developments have shown that superhydrophobic surfaces prevent protein and bacteria cell adhesion. In this study, a thermochemical treatment was used modify the surface properties for high efficacy antibacterial activity on titanium surface. The modification led to a micro-nano surface topography and upon modification with polyethylene glycol (PEG) and silane the surfaces were superhydrophilic and superhydrophobic, respectively. The modified surfaces were characterized for morphology, wettability, chemistry, corrosion resistance and surface charge. The antibacterial capability was characterized with Staphylococcus aureus and Escherichia coli by evaluating the bacteria cell inhibition, adhesion kinetics, and biofilm formation. The results indicated that the superhydrophobic micro-nano structured titanium surface reduced bacteria cell adhesion significantly (>90%) and prevented biofilm formation compared to the unmodified titanium surface after 24 h of incubation.

Robust and durable liquid-repellent surfaces

This review provides a comprehensive summary of characterization, design, fabrication, and application of robust and durable liquid-repellent surfaces.

Surface modification strategies to improve titanium hemocompatibility: a comprehensive review

Titanium and its alloys are widely used in different biomaterial applications due to their remarkable mechanical properties and bio-inertness. However, titanium-based materials still face some challenges, with an emphasis on hemocompatibility. Blood-contacting devices such as stents, heart valves, and circulatory devices are prone to thrombus formation, restenosis, and inflammation due to inappropriate blood-implant surface interactions. After implantation, when blood encounters these implant surfaces, a series of reactions takes place, such as protein adsorption, platelet adhesion and activation, and white blood cell complex formation as a defense mechanism. Currently, patients are prescribed anticoagulant drugs to prevent blood clotting, but these drugs can weaken their immune system and cause profound bleeding during injury. Extensive research has been done to modify the surface properties of titanium to enhance its hemocompatibility. Results have shown that the modification of surface morphology, roughness, and chemistry has been effective in reducing thrombus formation. The main focus of this review is to analyze and understand the different modification techniques on titanium-based surfaces to enhance hemocompatibility and, consequently, recognize the unresolved challenges and propose scopes for future research.

Potential of Superhydrophobic Surface for Blood-Contacting Medical Devices

Medical devices are indispensable in the healthcare setting, ranging from diagnostic tools to therapeutic instruments, and even supporting equipment. However, these medical devices may be associated with life-threatening complications when exposed to blood. To date, medical device-related infections have been a major drawback causing high mortality. Device-induced hemolysis, albeit often neglected, results in negative impacts, including thrombotic events. Various strategies have been approached to overcome these issues, but the outcomes are yet to be considered as successful. Recently, superhydrophobic materials or coatings have been brought to attention in various fields. Superhydrophobic surfaces are proposed to be ideal blood-compatible biomaterials attributed to their beneficial characteristics. Reports have substantiated the blood repellence of a superhydrophobic surface, which helps to prevent damage on blood cells upon cell-surface interaction, thereby alleviating subsequent complications. The anti-biofouling effect of superhydrophobic surfaces is also desired in medical devices as it resists the adhesion of organic substances, such as blood cells and microorganisms. In this review, we will focus on the discussion about the potential contribution of superhydrophobic surfaces on enhancing the hemocompatibility of blood-contacting medical devices.

Fabrication of Bacteria- and Blood-Repellent Superhydrophobic Polyurethane Sponge Materials

Biofilm and thrombus formation on surfaces results in significant morbidity and mortality worldwide, which highlights the importance of the development of efficacious fouling-prevention approaches. In this work, novel highly robust and superhydrophobic coatings with outstanding multiliquid repellency, bactericidal performance, and extremely low bacterial and blood adhesion are fabricated by a simple two-step dip-coating method. The coatings are prepared combining 1H,1H,2H,2H-perfluorooctyltriethoxysilane (FAS-17)-coated hydrophobic zinc oxide and copper nanoparticles to construct hierarchical micro/nanostructures on commercial polyurethane (PU) sponges followed by polydimethylsiloxane (PDMS) treatment that is used to improve the binding degree between the nanoparticles and the sponge surface. The micro/nanotextured samples can repel various liquids including water, milk, coffee, juice, and blood. Relative to the original PU, the superhydrophobic characteristics of the fabricated sponge cause a significant reduction in the adhesion of bacteria (Staphylococcus aureus) by up to 99.9% over a 4-day period in a continuous drip-flow bioreactor. The sponge is also highly resistant to the adhesion of fibrinogen and activated platelets with ∼76 and 64% reduction, respectively, hence reducing the risk of blood coagulation and thrombus formation. More importantly, the sponge can sustain its superhydrophobicity even after being subjected to different types of harsh mechanical damage such as finger-wiping, knife-scratching, tape-peeling, hand-kneading, hand-rubbing, bending, compress-release (1000 cycles) tests, and 1000 cm sandpaper abrasion under 250 g of loading. Hence, this novel hybrid surface with robustness and the ability to resist blood adhesion and bacterial contamination makes it an attractive candidate for use in diverse application areas.

Multifunctional 3D Micro-Nanostructures Fabricated through Temporally Shaped Femtosecond Laser Processing for Preventing Thrombosis and Bacterial Infection

Blood-contacting medical devices that directly inhibit thrombosis and bacterial infection without using dangerous anticoagulant and antibacterial drugs can save countless lives but have proved extremely challenging. Here, a useful methodology is proposed that employs temporally shaped femtosecond laser ablation combined with fluorination to fabricate multifunctional three-dimensional (3D) micro-nanostructures with excellent hemocompatibility, zero cytotoxicity, outstanding biocompatibility, bacterial infection prevention, and long-term effectiveness on NiTi alloys. These multifunctional 3D micro-nanostructures present 0.1% hemolysis ratio and almost no platelet adhesion and activation, repel blood to inhibit blood coagulation in vitro, maintain 100% cell viability, and have exceptional stability over 6 months. Moreover, the multifunctional 3D micro-nanostructures simultaneously suppress bacterial colonization to form biofilm and kill 100% colonized Pseudomonas aeruginosa (P. aeruginosa) and 95.6% colonized Staphylococcus aureus (S. aureus) after 24 h of incubation, and bacterial residues can be easily removed. The fabrication method in this work has the advantages of simple processing, high efficiency, high quality, and high repeatability, and the new multifunctional 3D micro-nanostructures can effectively prevent thrombosis and bacterial infection, which can be widely applied to various clinical needs such as biomedical devices and implants.

In Vitro Investigation of Hemocompatibility of Hydrothermally Treated Titanium and Titanium Alloy Surfaces

For decades, titanium and its alloys have been established as a biocompatible material for cardiovascular medical devices such as heart valves, stents, vascular grafts, catheters, etc. However, thrombosis is one of the reasons for implant failure, where blood clot forms on the implant surface, thus obstructing the flow of the blood and that leads to some serious complications. Various surface modification techniques such as heparin modification, albumin coating, surface anodization, plasma etching, and hydrothermal treatments have been explored to improve the hemocompatibility of titanium-based materials. However, there are several limitations related to the robustness of the surfaces and long-term efficacy in vivo. In this study, titanium and its alloy Ti-6Al-4V were hydrothermally treated to form nanostructured surfaces with the aim to enhance their hemocompatibility. These modified surfaces were characterized for their wettability, surface morphology, surface chemistry, and crystallinity. The hemocompatibility of these surfaces was characterized by evaluating blood plasma protein adsorption, platelet adhesion and activation, platelet-leukocyte complex formation, and whole blood clotting. The results indicate lower fibrinogen adsorption, cell adhesion, platelet activation, and whole blood clotting on hydrothermally treated surfaces. Thus, these surfaces may be a promising approach to prevent thrombosis for several titanium blood-contacting medical devices.

Hemocompatibility of Super-Repellent surfaces: Current and Future

Virtually all blood-contacting medical implants and devices initiate immunological events in the form of thrombosis and inflammation. Typically, patients receiving such implants are also given large doses of anticoagulants, which pose a high risk and a high cost to the patient. Thus, the design and development of surfaces with improved hemocompatibility and reduced dependence on anticoagulation treatments is paramount for the success of blood-contacting medical implants and devices. In the past decade, the hemocompatibility of super-repellent surfaces (i.e., surfaces that are extremely repellent to liquids) has been extensively investigated because such surfaces greatly reduce the blood-material contact area, which in turn reduces the area available for protein adsorption and blood cell or platelet adhesion, thereby offering the potential for improved hemocompatibility. In this review, we critically examine the progress made in characterizing the hemocompatibility of super-repellent surfaces, identify the unresolved challenges and highlight the opportunities for future research on developing medical implants and devices with super-repellent surfaces.

Interaction of blood plasma proteins with superhemophobic titania nanotube surfaces

The need to improve blood biocompatibility of medical devices is urgent. As soon as blood encounters a biomaterial implant, proteins adsorb on its surfaces, often leading to several complications such as thrombosis and failure of the device. Therefore, controlling protein adsorption plays a major role in developing hemocompatible materials. In this study, the interaction of key blood plasma proteins with superhemophobic titania nanotube substrates and the blood clotting responses was investigated. The substrate stability was evaluated and fibrinogen adsorption and thrombin formation from plasma were assessed using ELISA. Whole blood clotting kinetics was also investigated, and Factor XII activation on the substrates was characterized by an in vitro plasma coagulation time assay. The results show that superhemophobic titania nanotubes are stable and considerably decrease surface protein adsorption/Factor XII activation as well as delay the whole blood clotting, and thus can be a promising approach for designing blood contacting medical devices.

Antibacterial activity on superhydrophobic titania nanotube arrays

Bacterial infections are a serious issue for many implanted medical devices. Infections occur when bacteria colonize the surface of an implant and form a biofilm, a barrier which protects the bacterial colony from antibiotic treatments. Further, the anti-bacterial treatments must also be tailored to the specific bacteria that is causing the infection. The inherent protection of bacteria in the biofilm, differences in bacteria species (gram-positive vs. gram-negative), and the rise of antibiotic-resistant strains of bacteria makes device-acquired infections difficult to treat. Recent research has focused on reducing biofilm formation on medical devices by modifying implant surfaces. Proposed methods have included antibacterial surface coatings, release of antibacterial drugs from surfaces, and materials which promote the adhesion of non-pathogenic bacteria. However, no approach has proven successful in repelling both gram-positive and gram-negative bacteria. In this study, we have evaluated the ability of superhydrophobic surfaces to reduce bacteria adhesion regardless of whether the bacteria are gram-positive or gram-negative. Although superhydrophobic surfaces did not repel bacteria completely, they had minimal bacteria attached after 24 h and more importantly no biofilm formation was observed.