Degradable polymers in medicine: updating strategies and terminology

Today, the field of biodegradable materials and devices attracts polymer scientists and healthcare professionals in surgery, dentistry, pharmacology and regenerative medicine. More than one thousand papers are published per year in the literature, while the topic appears in the title of many patents. However, the number of devices or systems that have been successfully developed for clinical and commercial uses is still very small. A critical examination of the literature suggests two main reasons for this. Firstly, biodegradation is generally considered the main goal to reach, so that academic strategies do not take into account the criteria specific to targeted applications. Secondly, the term "biodegradable" is too often used inappropriately and creates confusion. This paper aims specifically to remind readers of the complexity of in vivo polymer degradation and the need for an enriched and universally recognized terminology in order to clearly distinguish between the various possible stages, and to enable clear communication between specialists when discussing related issues. It also emphasizes the need for any novel polymer to be well characterized and to include application-specific requirements in the research strategy from the very beginning, since these determine its potential clinical and commercial uses. Based on more than a decade of efforts, this would appear to be paramount in order to provide a chance for novel polymers to reach the market.