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Abstract
The increased use of polymeric medical devices such as catheters, ventilators, ventricular assist devices, vascular grafts, cannulas, etc., has considerably improved patient healthcare. However, the introduction of these medical devices has manifested as a significant clinical challenge by predisposing patients to the risk of infection. Few commercial medical device surfaces are designed to prevent or reduce infection effectively. Therefore, the progress of medical device surfaces is dependent on the development of infection-resistance strategies that maintain optimal device performance. From an engineering perspective, inspiration from nature has enabled alternative approaches in next-generation device surface design and functionality. One example is nitric oxide (NO), a gasotransmitter produced by the innate immune system to thwart infectious agents in the body. NO donating molecules within a polymer matrix have shown potent antimicrobial activity, but major shortcomings remain. Several limitations include a) fouling resistance and b) inability to tackle chronic bacterial infection due to the finite nature of NO donors. In this dissertation, combination surface strategies are developed to enhance the antibacterial activity of NO-releasing medical-grade polymer coatings. Major focus areas are to reduce bacterial colonization by preventing adhesion through bioactive and biopassive coatings. Metal/metalloid nanoparticles were also successfully utilized to control NO release flux, thereby improving antibacterial outcomes.