In recent years, the development of new and modification of existing biomaterials was driven by and relied heavily on novel chemistries. In spite of substantial advances in our understanding of how the physical properties of materials determine cell–surface dynamics at nano-, molecular- and atomic scales, many conflicting reports exist. The interdependence of surface chemistry and physics and their synergistic effect as an adequate predictor of biological performance with respect to bacteria and mammalian cells requires in- depth investigation (Mitragotri and Lahann, 2009).
As the complexity of biomaterial constructs and the biological functions they are required to perform is increasing, there is a clear need to investigate the effect of these physical parameters using a standardised and structured approach so that objec- tive comparisons can be made between distinct surfaces, both natural and modified.
Yet, this knowledge gap cannot be bridged without the development of strategies for highly controlled modification of biomaterials. Future research ought to be directed towards development of surface fabrication and modification methodologies with the capacity to independently control chemical, physical and biological properties of the material. Since the future of medicine is believed to be strongly influenced by biodegradable materials that sustain tissue regeneration, rather than simply replac- ing lost tissue/function, the processing environment should be flexible and robust to accommodate a variety of surface modifications and novel biomaterial types.
To complement these technologies, studies should be designed to comprehensively
124 Biomaterials and Medical Device-associated Infections
investigate bacterial attachment in combination with protein fouling and eukaryotic cell–surface interactions, as the first and foremost function of the biomaterial is to interact with the host in some pre- determined, desirable fashion.
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