Efficiency of using antibacterial coatings on titanium implants in the treatment of gunshot fractures

Introduction High risk of infectious complications in gunshot wounds remains a pressing issue in military medicine. Analysis of the structure of sanitary losses shows that limb injuries account for 55 % to 81.4 %, with about 35 % of them accompanied by bone fractures. Performing operations for the final stabilization of these fractures under the conditions of primary microbial contamination is associated with a high risk of infectious complications. However, the use of antibacterial coatings on internal implants significantly reduces the risk of such complications. The purpose of the work, based on the analysis of Russian and foreign literary sources, is to determine the effectiveness of using antibacterial coatings on titanium implants for gunshot fractures. Materials and methods The search for scientific publications was carried out in the search engines eLibrary, PubMed and Connected Papers using the keywords: antibacterial coatings, gunshot fractures, implant-associated infection, internal osteosynthesis, infectious complications, antibacterial coating, gunshot fractures, infectious complications, peri-implant infection. The sources were selected based on the hypothesis of the possibility of using antibacterial coatings in clinical practice. The search depth was from 2009 to 2025. Results and discussion The existing systems for delivering antibacterial drugs to the surgical intervention area demonstrate high clinical efficacy in the prevention of peri-implant infection. To date, the most studied agents for creating coatings are metal ions, polymers, as well as composites containing antibacterial / antiseptic drugs. The most effective are multifunctional and intelligent coatings that have a combined effect on microbial biofilms due to their pronounced anti-adhesive and biocidal properties. There is a shortage of research on the use of multifunctional coatings in traumatological and orthopedic practice. There are no publications in the world literature devoted to the use of antibacterial coatings in the treatment of gunshot fractures and their consequences. Conclusion The use of polymer and multifunctional antibacterial coatings, hydrogels, as well as oxides of silver, iodine and zinc demonstrate high efficiency in the prevention of infectious complications after internal osteosynthesis, and, in our opinion, can be considered for use in clinical practice in the treatment of gunshot fractures of limb bones.