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Abstract
Biomedical devices are often targeted by bacteria leading to biofilm development and device-associated infections. Infections arising from biomedical devices not only exhibit detrimental effects which severely impact the quality of life for patients, but also bar advancements in the healthcare system by significantly increasing the cost of treatment. Each year >1 million people are affected by medical device-associated infections in the United States alone. The complex nature of bacterial biofilm, increasing bacterial resistance to conventional antibiotics, and failure of current hospital regimens to treat infections are one of the several factors that result in a continuous escalation of medical device-associated infections. The antimicrobial efficacy of polymeric medical devices is greatly reliant upon the deterrence of the first step of biofilm formation. This can be attained by preventing the bacteria from attaching to the surface of a medical device. Therefore, strategies that can prevent or eradicate life-threatening infections are urgently needed to thwart the occurrence of bacterial infections. Nitric oxide (NO) is a diatomic gaseous molecule endogenously synthesized by the body via nitric oxide synthase (NOS) enzymes and is often found to regulate several important functions such as pathogen invasion, wound healing, and prevention of platelet activation. Various NO donor molecules have been designed by researchers that can be exogenously utilized to emulate the physiological roles of NO in biomaterials and medical device materials. Materials with NO-releasing properties have been demonstrated to eradicate pathogenic bacteria and inhibit the attachment of viable bacteria on the surface. However, NO-releasing materials have historically faced the challenges of uncontrolled NO release, thermal instability of NO donors during the polymer fabrication process, limited shelf-life at room temperature, and failure to prevent biofouling. This dissertation is focused on developing NO-releasing antibacterial medical devices using additive manufacturing and photosensitivity of NO donors to regulate the NO release from medical device surfaces, synergy with other active antibacterial drugs such as chlorhexidine to improve efficacy and biocompatibility, and slippery surface technology to prevent biofouling on biomedical devices. These approaches hold great potential to enhance biocompatibility and antimicrobial properties to biomedical surfaces to enhance their efficiency in the patient care setting.