Staphylococci and implant surfaces: a review.

Surfaces of internal fracture fixation implants are generally designed to encourage soft- and/or hard-tissue adherence, eventually leading to tissue or osseo integration. Unfortunately, this feature may also encourage bacterial adhesion. About half of the two million cases of nosocomial infections per year in the US are associated with indwelling devices. In the UK, implant-associated infections are estimated to cost pound 7-11 million per year, and with the rise in antibiotic-resistant bacteria, are an important issue. Soft-tissue infections and osteomyelitis are serious complications associated with implants, particularly open fractures, external fixation devices, and intramedullary nailing. Consequences of implant-associated infections include prolonged hospitalization with systemic antibiotic therapy, several revision procedures, possible amputation, and even death. This review discusses the issue of implant-associated infections and some of the methods used to prevent bacterial adhesion to osteosynthesis implants.