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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 2, issue 1
J. Bone Joint Infect., 2, 63–72, 2017
© Author(s) 2017. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 2, 63–72, 2017
© Author(s) 2017. This work is distributed under
the Creative Commons Attribution 4.0 License.

Review 01 Jan 2017

Review | 01 Jan 2017

Hyaluronic Acid and Its Composites as a Local Antimicrobial/Antiadhesive Barrier

C.L. Romanò1, E. De Vecchi3, M. Bortolin3, I. Morelli1, and L. Drago2,3 C.L. Romanò et al.
  • 1Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milano, Italy
  • 3Laboratory of Clinical Chemistry and Microbiology, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milan, Italy
  • 2Laboratory of Technical Sciences for Laboratory Medicine, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy

Keywords: Hyaluronic Acid, Biofilm, Adhesion, Bacteria, Infection, Implant

Abstract. Living in biofilms is probably the most common condition for bacteria and fungi and biofilm-related infections account for the majority of bacterial infectious diseases worldwide.

Among others biofilm-related infections, those associated with implanted biomaterials have an enormous and still largely underestimated impact in orthopaedics and trauma, cardio-surgery and several other surgical disciplines.

Given the limited efficacy of existing antibiotics in the prevention and treatment of bacterial biofilms, new strategies are needed to protect implants and host tissues, overcoming the striking ability of the microorganisms to adhere on different surfaces and to immediately protect themselves by forming the biofilm matrix.

Adhesion is a necessary first step in microbial colonization and pathogenesis and provides a potential target for new preventive and treatment approach.

Among various polymers, tested as antibacterial coatings, hyaluronic acid and some of its composites do offer a well-established long-term safety profile and a proven ability to reduce bacterial adhesion and biofilm formation.

Aim of the present review is to summarize the available evidence concerning the antiadhesion/antibiofilm activity of hyaluronic acid and some of its derivatives to reduce/prevent bacterial adhesion and biofilm formation in various experimental and clinical settings.

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