BIOPLASMAS & PLASMAS WITH LIQUIDS - Joint Conference of COST ACTIONS TD1208 “Electrical discharges with liquids for future
applications” & MP1101 Biomedical Applications of Atmospheric Pressure Plasma Technology, Bertinoro, Italy, 13th-17th September 2015
Biofilm Inactivation and Prevention On Common Implant Material
Surfaces by Non-Thermal DBD Plasma Treatment
Fatma Ibis1, Hakan Oflaz1, Utku Kursat Ercan1
1
Department of Biomedical Engineering, İzmir Katip Çelebi University, İzmir, Turkey,
35620
304 and 316 L stainless steels, Ti6Al4V and UHMWPE are common metallic and polymeric
materials used in orthopaedic surgery for arthroplasty and fracture fixation procedures. Even though 304
stainless steel is not used as implant or prosthesis material, surgical tools and trial implants and prosthesis are
made of 304 stainless steel. Implanted materials are highly susceptible to infections that lead implant failure
and require revision operations [1]. Also sterilization method of implant materials play important role on the
success and performance of the implant. Mechanical properties of UHMWPE are compromised as
consequence of gamma irradiation. Repetitive autoclaving of implants and surgical tools reduces material
performance. Also custom orthopaedic prosthesis production requires, cheap, onsite and fast sterilization
procedure [2,3].
In the current study, we have evaluated inactivation and prevention of biofilm formation of E. coli
and, S. aureus on UHMWPE, Ti6Al4V, 304 stainless steel and 316 L stainless steel surfaces. For biofilm
inhibition tests 1-day-old biofilms of E. coli and, S. aureus were grown on surfaces of UHMWPE, Ti6Al4V,
304 stainless steel and 316 L stainless steel discs and then treated with non-thermal DBD plasma. Plasma
treatment of disks were evaluated by XTT viability assay which shows that 95% of both bacterial biofilms
were inactivated after 3 minutes of plasma treatment. For the biofilm prevention tests, UHMWPE, Ti6Al4V,
304 stainless steel and 316 L stainless steel discs were first treated with non-thermal DBD plasma and then 1day-old biofilms of E. coli and, S. aureus were grown on the disc surfaces and biofilm formation was evaluated
with XTT assay similarly. Plasma treatment of implant surfaces prevents biofilm formation up to 50%. Also
safranin assay, which used to evaluate extracellular polymeric substance, has shown that plasma treatment of
UHMWPE, Ti6Al4V, 304 stainless steel and 316 L stainless steel discs not only inactivates biofilm, but also
disrupts extracellular polymeric substance that is secreted by bacteria during biofilm growth, and provides
structural support and integrity of the biofilm.
In conclusion, non-thermal plasma treatment of metallic and polymeric materials seems to be an
alternative method for sterilization of implant materials and prevention of implant associated infections. In
order to better understand effects of non-thermal plasma on implant materials, further tests are in progress.
Acknowledgment: This study is supported by Izmir Katip Celebi University, Department of Scientific Research Projects (BAP,
2014-1-FMBP-01)
[1] N. Damani, “Manual of Infection Prevention and Control”, Oxford University Press, 2012
[2] W.L. Sauer, K.D. Weaver, N.B. Beals, Biomaterials 20 (1996) 195.
[3] R.E. Baier, A.E. Meyer, C.K. Akers, J.R. Natiella, M. Meenaghan, J.M. Carter, Biomaterials 4 (1982) 241