Surface Active Systems: Evolving Surfaces for Lifetime Implants

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Author:
Arjun Luthra, BSc, MBA
Commercial Director
BioInteractions Ltd

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Preventing and protecting medical devices against infection is becoming increasingly critical as the prevalence of healthcare-associated infections (HCAIs) continues to rise. While researchers have identified some causes of HCAIs, complex surfaces — such as those of implants — remain particularly vulnerable to device-related infections. Even surgical equipment requires robust protection from germs and microbes.

Strengthening infection prevention across all healthcare surfaces is vital to advancing safety for patients, professionals, providers, and visitors. The need for implantable devices to be part of this prevention infrastructure is growing rapidly. Applying highly effective, permanent surface-active agents to these devices can significantly improve patient safety by reducing device-related and surgical site infections, while enhancing the longevity and performance of the implant. The result is superior therapeutic outcomes and improved long-term health results.

Combatting Pathogens at the Surface: The Role of Surface Active Therapeutics in Modern Medical Devices

A new generation of medical devices is emerging where active surface coatings are not just additional features — they’re fundamental to the device’s performance. 

This shift is influencing the next wave of device innovation. As healthcare-associated HCAIs continue to rise, the role of zero-leaching antimicrobial coatings is becoming increasingly critical to the infection prevention infrastructure across hospitals, clinics, and long-term care. 

Enter Surface-Active Systems: a pioneering new category of high performance and extremely safe biocompatible coating solutions designed to enhance implant performance, improve patient safety and evolve the quality of life for patients worldwide. Comprising both Surface-Active Therapeutics (SAT) and Surface-Active Materials (SAM), Surface-Active Systems address the rising demands in infection prevention, thrombosis control and device longevity across a growing range of minimally invasive and implantable devices.  

Within this category of advanced coatings — Surface Active Therapeutics (the application of permanent surface-active agents to a wide range of substrates and geometries such as catheters, drainage systems, ventricular devices, heart valves, and neurovascular stents) — represents a state-of-the-art solution for today’s medical devices.

TridAnt®, an enhanced antimicrobial coating, forms a continuously protective shield over the device surface. Its polymeric matrix combines active and passive components to deliver:
• A rapid, broad-spectrum contact-kill mechanism
• Continuous residual protection
• The ability to disrupt and prevent biofilm formation

This multi-action approach provides complete and lasting protection, ensuring devices remain safe for the entire lifetime of the patient.

TridAnt® offers full-spectrum efficacy against gram-negative (e.g., E. coli) and gram-positive bacteria (including drug-resistant strains such as MRSA), as well as yeast, fungi, and spores. The technology is proven to disrupt and prevent biofilm formation throughout the life of the device.

It is compatible with a wide range of substrates and geometries — from soft materials like silicone, woven, and non-woven fabrics to hard materials such as stainless steel, nitinol, polyamides, polycarbonates, and polyurethanes.

TridAnt® acts only at the device surface, targeting microbial cells without affecting surrounding tissues or causing systemic effects. This biocompatible, non-leaching mechanism ensures patient safety while maintaining long-term antimicrobial performance.

The Future of Medical Devices: Innovations Driving Infection Prevention and Surface Protection

While significant advances have been made in implanted medical devices, many still require replacement or are supported by long-term systemic drug regimens. This has driven the development of coatings that meet both clinical and engineering demands.

Devices such as total artificial hearts (TAHs), ventricular assist devices (VADs), vascular stents, and prosthetic mechanical heart valves face a common challenge: lifetime hemocompatibility, particularly in preventing thrombosis.

AstutePlus® is an advanced antithrombogenic Surface Active Therapeutic that delivers superior biocompatibility, lifetime antithrombogenicity, and reduces the risk of stenosis. Used successfully for over 25 years on chronic, blood-contacting implants, AstutePlus® combines:
• Active components that interrupt the blood cascade mechanism, preventing platelet activation
• Passive components that resist the deposition of blood components on the device surface

This dual-action approach provides a surface that mimics the natural endothelium, maintaining device performance and safety for the patient’s lifetime.

In parallel, the growth of miniaturised and minimally invasive procedures creates new requirements — such as reducing friction to minimise tissue trauma during device insertion and removal. Less trauma means improved surgical outcomes, reduced pain, and greater patient comfort during recovery.

Assist™, a hydrophilic Surface Active Material, meets these demands by delivering a highly lubricious, flexible coating that dramatically reduces friction. Proven in high-stress, high-movement applications, Assist™ avoids particulate shedding and delamination, while filling surface microstructures to improve laminar flow. This reduces the deposition and adhesion of bodily components, maintaining functionality and safety throughout implantation. Assist™ activates instantly upon wetting — eliminating the need for pre-soaking — and streamlines device preparation for surgical use.

Understanding Today’s Customer Pain Points: Challenges and Opportunities

Medical device developers and manufacturers operate in an environment of stringent regulation and constant change. Under current European Union regulations, many medical devices undergo the same rigorous assessment as pharmaceuticals, including evaluation by the European Medicines Agency (EMA).

Our Product Pathway Partnership supports customers through every stage of the process, from application optimisation and tooling design to biocompatibility testing, regulatory compliance, and commercial coating services. We tailor our approach to meet evolving requirements while accelerating market access.

Our integrated end-to-end service also advances innovation through targeted R&D of new coating materials, drawing on over 30 years of expertise and specialised analytical resources. This enables us to design bespoke coatings for a wide range of applications, extending the benefits of Surface Active Therapeutics into new clinical and engineering domains.

Conclusion

As healthcare-associated infections (HCAIs) continue to rise, the need for robust infection prevention has never been greater. Surface Active Therapeutics represent a transformative advance in protecting medical devices — particularly complex, long-term implants — against harmful pathogens.

By integrating permanent surface-active agents into implants and surgical tools, we can not only reduce the incidence of device-related and surgical site infections but also extend device longevity and performance. This leads to improved patient outcomes, better therapeutic efficacy, and enhanced confidence for clinicians and healthcare providers.

Looking ahead, embedding Surface Active Therapeutics across all points of care will be essential to building a more resilient infection prevention infrastructure — one that benefits patients, practitioners, and the entire healthcare system.