Strategies, constructions and biomedical applications of antibiofilm surfaces

Bacterial infections remain a major challenge for biomaterials. Once bacteria colonize on surfaces, they can form biofilms protected by extracellular polymeric matrices. These matrices, together with local microenvironment changes and altered bacterial physiology, increase tolerance to antibiotics and host immune clearance, often causing recurrent infections and compromised device performance. To address these issues, antibiofilm surfaces have been developed as an effective strategy. This review highlights recent progress in biomedical antibiofilm surfaces, focusing on antibiofilm strategies, construction methods, and representative applications. Based on the developmental stages of biofilms, five main strategies are discussed, including antifouling, bactericidal, interference-based, disruption-based, and multifunctional strategies. Different construction methods, including physical and chemical strategies, are summarized for building functional antibiofilm interfaces. Representative applications are discussed in biomedical fields such as blood contacting materials, urological devices, and bone implants. Key challenges are also highlighted, especially long-term stability, biocompatibility, and clinical translation. This review summarizes the latest advancements in biomedical antibiofilm surfaces and provide insights into optimizing advanced antibiofilm surfaces to meet the dynamic demands of the biomedical field.