Roberts Richard Henry Randall, Gamble Charles, Malek Ibrahim
Department of Trauma and Orthopaedics, Wrexham Maelor Hospital, Wrexham LL13 7TD, United Kingdom.
Faculty of Social and Life Sciences, Wrexham University, Wrexham LL11 2AW, United Kingdom.
World J Orthop. 2025 Jul 18;16(7):107575. doi: 10.5312/wjo.v16.i7.107575.
Periprosthetic joint infections contribute significantly to patient morbidity, prolonged hospital stays, and escalating healthcare costs. Defensive antibacterial coating (DAC) hydrogel has emerged as a promising strategy to combat these infections. It forms a biodegradable barrier that reduces bacterial adhesion and can deliver local antibiotics, thereby addressing a key mechanism in biofilm formation. Early clinical evidence suggests that DAC effectively lowers infection recurrence in revision hip and knee arthroplasties, with additional benefits in trauma procedures and soft tissue repairs. Moreover, it has demonstrated compatibility with existing implants and surgical techniques, while potentially reducing overall antibiotic use and hospital stays. Despite these encouraging findings, data for its use in primary arthroplasty remains limited, underscoring the need for large-scale, high-quality studies. Future research is poised to refine DAC's antimicrobial efficacy through novel antibiotic combinations, personalised delivery systems, and broader applications beyond lower limb procedures. As the prevalence of comorbidities continues to rise, DAC represents a valuable addition to multifaceted infection control protocols, potentially transforming orthopaedic care by enhancing patient outcomes and mitigating the economic and clinical burden of implant-related infections.
人工关节周围感染显著增加了患者的发病率、延长了住院时间并使医疗费用不断攀升。防御性抗菌涂层（DAC）水凝胶已成为对抗这些感染的一种有前景的策略。它形成了一种可生物降解的屏障，可减少细菌粘附，并能递送局部抗生素，从而解决生物膜形成中的一个关键机制。早期临床证据表明，DAC能有效降低翻修髋关节和膝关节置换术中的感染复发率，在创伤手术和软组织修复中还有额外益处。此外，它已证明与现有植入物和手术技术兼容，同时有可能减少总体抗生素使用量和住院时间。尽管有这些令人鼓舞的发现，但其在初次关节置换术中的应用数据仍然有限，这凸显了开展大规模、高质量研究的必要性。未来的研究有望通过新型抗生素组合、个性化递送系统以及在下肢手术之外的更广泛应用来提高DAC的抗菌效果。随着合并症的患病率持续上升，DAC是多方面感染控制方案中的一项宝贵补充，有可能通过改善患者预后以及减轻植入物相关感染的经济和临床负担来改变骨科护理。
