Development of an intraosseous transcutaneous orthopaedic implant (ITAP) resistant to bacteria infections through the combination of passive and active strategies

如果一条腿、手臂、手指或拇指必须被截肢，或者在出生时就缺失了，可以安装人工替代品（称为假肢或假体）。假肢通常有一个凹槽，通过吸力或绑在缺失肢体的残肢上来固定。然而，这导致了主要的缺点，如刺激残肢或幻肢综合征。在这种情况下，骨内经皮假体（ITAP）的植入被认为是最生理性的，因此可能是成功的，防止先前引发的问题的方法。在这个过程中，金属植入物通过皮肤插入到残肢骨的中心。然后将义肢连接到金属植入物上。目的是制造一种更舒适、更安全的假肢。不幸的是，ITAP从人体流出的地方往往是感染的地方，通过植入物周围的真皮和表皮组织的适当整合，在植入物周围形成软组织密封，可以潜在地消除感染。此外，完全预防感染还需要赋予假体装置杀菌特性。因此，我们的目标是提供具有两种功能特性的钛（这是我们的工业合作伙伴用于构建骨科植入物的材料），这两种功能特性都可能防止细菌定植。这些特性是1)促进皮肤细胞在表面的粘附和扩散的能力；这是一种被动功能和2)提供表面抗菌性能；这是一个主动功能。

If a leg, arm, finger or thumb has had to be amputated, or is missing at birth, an artificial substitute (known as aprosthetic limb or prosthesis) may be fitted. Prosthetic limbs usually have a socket and are held in place eitherby suction or by being strapped to the stump of the missing limb. However, this leads to major drawbacks suchas irritation of the stump or phantom limb syndrome. In this context, the implantation of intraosseoustranscutaneous prostheses (ITAP) was described as the most physiological, and thus probably successful,approach to prevent the previously evoked problems. In this procedure, a metal implant is inserted through theskin and into the centre of the bone of the stump. A prosthetic limb is then attached to the metal implant. Theaim is to produce a more comfortable and securely attached prosthetic limb.Unfortunately, the point where ITAP exits from the human body is often the site for infections which could bepotentially eliminated by proper integration of dermal and epidermal tissues around the implant, creating a softtissue seal around it. In addition, a complete prevention of the infection also requires endowing the prostheticdevice with bacteria-killing properties.Accordingly, our objective is to provide titanium (which is the material used by our industrial partner tobuild-up orthopaedic implants) with two functional properties that are both likely to prevent bacterialcolonization. These properties are 1) the capability of promoting skin cell adhesion and spreading on thesurface; this is a passive functionality and 2) providing the surface with antibacterial properties; this is anactive functionality.