In Vitro Antibacterial Efficacy of a New TiO₂-Cu-Coated Titanium Surface for Biomedical Applications

Despite advancements in surgical care, the management of surgical site infections (SSIs) associated with fracture-fixation devices is still a challenge after implant fixation, especially in open fractures. Staphylococcus aureus (S. aureus) is a common pathogen of SSIs and contaminates by penetrating the trauma itself (preoperatively) or during insertion of the fixation device (intraoperatively). A unique technology was developed to address this issue, consisting of an antibacterial surface obtained after depositing copper on a porous titanium oxide surface. This study aims to characterise and evaluate the in vitro bactericidal effect of this surface against S. aureus. Furthermore, the topography, elemental composition and other physicochemical properties of the copper coating were determined. In vitro assays have demonstrated a reduction of up to 5 log₁₀ in the bacteria colonisation, and additional quantitative and qualitative methods further supported these observations. This study illustrates the antibacterial efficacy and killing mechanisms of the surface, therefore demonstrating its potential for minimising infection progression post-implantation in clinical scenarios and bringing important insights for the design of future in vivo evaluations.