Improved hemocompatibility and reduced bacterial adhesion on superhydrophobic titania nanoflower surfaces

Thrombosis formation and bacterial infection are key challenges for blood-contacting medical devices. When blood components encounter a device's surface, proteins are adsorbed, followed by the adhesion and activation of platelets as well as an immune response. This culminates in clot formation via the trapping of red blood cells in a fibrin matrix, which can block the device's function and cause severe complications for the patient. In addition, bacteria may adhere to a device's surface. This can lead to the formation of a biofilm, a protective layer for bacteria that significantly increases resistance to antibiotics. Despite years of research, no long-term solutions have been discovered to combat these issues. To impede thrombosis, patients often take antiplatelet drugs for the life of their device, which can cause excess bleeding and other complications. Patients can take antibiotics to fight bacterial infection, but these are often ineffective if biofilms are formed. Superhydrophobic surfaces show promise in reducing both thrombosis and bacterial infection on devices by impeding contact between biological components and the biomaterial. In this study, superhydrophobic titania nanoflower surfaces were successfully fabricated on a titanium alloy Ti-6Al-4V substrate with hydrothermal synthesis and vapor-phase silanization. The surface topography, surface wettability, surface chemistry, and surface crystallography of the surfaces was subsequently characterized. Surface hemocompatibility was investigated through lactate dehydrogenase (LDH) cytotoxicity analysis, blood-plasma protein adsorption, platelet and leukocyte adhesion and activation, and whole blood clotting analysis. Surface bacterial infection was characterized through Gram-positive and Gram-negative bacterial adhesion and biofilm morphology. The results indicated a reduction of protein adsorption, platelet and leukocyte adhesion and activation, bacterial adhesion, and biofilm formation as well as improved contact angle stability compared to control surfaces.