Biomaterial-associated surgery and infection - a review of the literature

The incidence of wound infection after clean surgery is often underestimated. Infection rates up to 15% can be found by meticulous follow up. The consequences of these infectious complications can be troublesome for the patient involved. Most of the time the post-operative recovery will be delayed and secondary healing of the operative wound will occur. The long-term consequences of these infectious complications will be within acceptable limits. However, when biomaterials are involved in post-operative infectious complications, a totally different scenario is likely to occur - the longevity of these artificial organs and temporary assist devices is limited by biomaterial-associated infection of the implant. In this chapter we present an overview of the mechanisms of biomaterial-associated infection and its occurrence in various medical disciplines. Surgical procedures are critically reviewed for nonbiomaterial associated versus biomaterial-associated surgery and recommendations are given for biomaterial-associated surgery.