**Author details**

Malik Anjelh Baqiya<sup>1</sup> , Ahmad Taufiq<sup>2</sup> , Sunaryono2 , Munaji<sup>3</sup> , Dita Puspita Sari<sup>1</sup> , Yanurita Dwihapsari<sup>1</sup> and Darminto<sup>1</sup> \*

\*Address all correspondence to: darminto@physics.its.ac.id

1 Department of Physics, Faculty of Mathematics and Natural Sciences, Institut Teknologi Sepuluh Nopember (ITS), Kampus ITS Keputih Sukolilo, Surabaya, Indonesia

2 Department of Physics, Faculty of Mathematics and Natural Sciences, Universitas Negeri Malang, Malang, Indonesia

3 Faculty of Engineering, Universitas Muhammadiyah Ponorogo, Ponorogo, Indonesia

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**Chapter 9**

**Provisional chapter**

**Hyaluronic-Based Antibacterial Hydrogel Coating for**

**Implantable Biomaterials in Orthopedics and Trauma:** 

**Hyaluronic-Based Antibacterial Hydrogel Coating for** 

DOI: 10.5772/intechopen.73203

**Implantable Biomaterials in Orthopedics and Trauma:**

Bacterial colonization of implanted biomaterials remains one of the most challenging complications in orthopedics and trauma surgery, with extremely high social and economic costs. Antibacterial coating of implants has been advocated by many experts as a possible solution to reduce the burden of implant-related infection and several different solutions have been proposed in the last decades. However, while most of the investigated technologies have shown their efficacy *in vitro* and/or *in vivo*, only few were able to reach the market, due to clinical, industrial, economic and regulatory issues. Hyaluronic acid composites have been previously shown to possess antifouling capabilities and have been used in various clinical settings to reduce bacterial adhesion and mitigate biofilm-related infections. Recently, a fast-resorbable, hyaluronic-based hydrogel coating was developed to protect implanted biomaterials in orthopedics, trauma and maxillofacial surgery. Preclinical and clinical testing did show the safety and efficacy of the device that can be intraoperatively loaded with one or more antibiotics and directly applied by the surgeon to the implant surface, at the time of surgery. Here, we review the current evidence concerning this very first antibacterial coating of implants and outline the

economic impact of the possible large-scale application of this technology.

**Keywords:** coating, hydrogel, hyaluronic acid, DAC, infection, implant, orthopedic,

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

**From Basic Research to Clinical Applications**

**From Basic Research to Clinical Applications**

Giammona Gaetano, Pitarresi Giuseppe, Palumbo Fabio Salvatore, Maraldi Susanna,

Gaetano Giammona, Giuseppe Pitarresi, Fabio Salvatore Palumbo, Susanna Maraldi, Sara Scarponi and Carlo Luca Romanò

Scarponi Sara and Romanò Carlo Luca

http://dx.doi.org/10.5772/intechopen.73203

trauma, prosthesis, prevention

**Abstract**

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter


**Provisional chapter**

## **Hyaluronic-Based Antibacterial Hydrogel Coating for Implantable Biomaterials in Orthopedics and Trauma: From Basic Research to Clinical Applications Implantable Biomaterials in Orthopedics and Trauma: From Basic Research to Clinical Applications**

**Hyaluronic-Based Antibacterial Hydrogel Coating for** 

DOI: 10.5772/intechopen.73203

Giammona Gaetano, Pitarresi Giuseppe, Palumbo Fabio Salvatore, Maraldi Susanna, Scarponi Sara and Romanò Carlo Luca Fabio Salvatore Palumbo, Susanna Maraldi, Sara Scarponi and Carlo Luca Romanò Additional information is available at the end of the chapter

Gaetano Giammona, Giuseppe Pitarresi,

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.73203

#### **Abstract**

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Bacterial colonization of implanted biomaterials remains one of the most challenging complications in orthopedics and trauma surgery, with extremely high social and economic costs. Antibacterial coating of implants has been advocated by many experts as a possible solution to reduce the burden of implant-related infection and several different solutions have been proposed in the last decades. However, while most of the investigated technologies have shown their efficacy *in vitro* and/or *in vivo*, only few were able to reach the market, due to clinical, industrial, economic and regulatory issues. Hyaluronic acid composites have been previously shown to possess antifouling capabilities and have been used in various clinical settings to reduce bacterial adhesion and mitigate biofilm-related infections. Recently, a fast-resorbable, hyaluronic-based hydrogel coating was developed to protect implanted biomaterials in orthopedics, trauma and maxillofacial surgery. Preclinical and clinical testing did show the safety and efficacy of the device that can be intraoperatively loaded with one or more antibiotics and directly applied by the surgeon to the implant surface, at the time of surgery. Here, we review the current evidence concerning this very first antibacterial coating of implants and outline the economic impact of the possible large-scale application of this technology.

**Keywords:** coating, hydrogel, hyaluronic acid, DAC, infection, implant, orthopedic, trauma, prosthesis, prevention

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons
