Implantable Medical Devices, Biomaterials, and the Foreign Body Response: A Surgical Perspective

Area of Science:

• Biomaterials Science
• Immunology
• Surgical Innovation

Background:

• Implantable medical devices enhance quality of life and reduce mortality.
• Biomaterial surfaces trigger the host's foreign body response (FBR), causing inflammation and fibrous encapsulation.
• Dysregulated FBR leads to patient morbidity and implant failure, necessitating revision surgery.

Purpose of the Study:

• To review the mechanisms of the foreign body response to implantable medical devices.
• To examine factors influencing the FBR, including biomaterial, host, and surgical variables.
• To propose perioperative strategies for controlling FBR and minimizing implant complications.

Main Methods:

• Literature review of foreign body response mechanisms.
• Analysis of factors influencing FBR in common implantable devices.
• Synthesis of perioperative control strategies for FBR.

Main Results:

• The foreign body response involves a complex interplay between biomaterial properties and host immune reactions.
• Biomaterial characteristics, host physiology, and surgical technique significantly influence FBR severity.
• Perioperative interventions offer potential to modulate FBR and improve implant outcomes.

Conclusions:

• Understanding the FBR is crucial for designing better implantable medical devices.
• Controlling the FBR through perioperative management can reduce implant-related morbidity and revision surgeries.
• Future research should focus on targeted strategies to mitigate adverse FBR.