Plasma surface modification strategies for the preparation of antibacterial biomaterials: A review of the recent literature

Plasma-based strategies offer several advantages for developing antibacterial biomaterials and can be used directly or combined with other surface modification techniques. Direct plasma strategies can be classified as plasma surface modifications that derive antibacterial property by tailoring surface topography or surface chemistry. Nano patterns induced by plasma modification can exhibit antibacterial property and promote the adhesion and proliferation of mammalian cells, creating antibacterial and biocompatible surfaces. Antibacterial effect by tailoring surface chemistry via plasma can be attained by either creating bacteriostatic surfaces or bactericidal surfaces. Plasma-assisted strategies incorporate plasma processes in combination with other surface modification techniques. Plasma coating can serve as a drug-eluting reservoir and diffusion barrier. The plasma-functionalized surface can serve as a platform for grafting antibacterial agents, and plasma surface activation can improve the adhesion of polymeric layers with antibacterial properties. This article critically reviews plasma-based strategies reported in the recent literature for the development of antibacterial biomaterial surfaces. Studies using both atmospheric and low-pressure plasmas are included in this review. The findings are discussed in terms of the trends in material and precursor selection, modification stability, antibacterial efficacy, the choice of bacterial strains tested, cell culture findings, critical aspects of in vitro performance testing and in vivo experimental design.