Published online Jul 18, 2025. doi: 10.5312/wjo.v16.i7.107575
Revised: April 18, 2025
Accepted: June 3, 2025
Published online: July 18, 2025
Processing time: 113 Days and 12.1 Hours
Periprosthetic joint infections contribute significantly to patient morbidity, prolonged hospital stays, and escalating healthcare costs. Defensive antibacterial coating (DAC®) hydrogel has emerged as a promising strategy to combat these infections. It forms a biodegradable barrier that reduces bacterial adhesion and can deliver local antibiotics, thereby addressing a key mechanism in biofilm formation. Early clinical evidence suggests that DAC® effectively lowers infection recurrence in revision hip and knee arthroplasties, with additional benefits in trauma procedures and soft tissue repairs. Moreover, it has demonstrated compatibility with existing implants and surgical techniques, while potentially reducing overall antibiotic use and hospital stays. Despite these encouraging findings, data for its use in primary arthroplasty remains limited, underscoring the need for large-scale, high-quality studies. Future research is poised to refine DAC®’s antimicrobial efficacy through novel antibiotic combinations, personalised delivery systems, and broader applications beyond lower limb procedures. As the prevalence of comorbidities continues to rise, DAC® represents a valuable addi
Core Tip: Orthopaedic implant-related infections, including prosthetic joint and osteosynthesis-associated infections, significantly burden healthcare systems clinically and economically. Defensive antibacterial coating (DAC®) hydrogel emerges as a promising bioresorbable adjunct to traditional prophylactic strategies, effectively reducing infection rates and antibiotic overuse in orthopaedic surgery. While robust evidence supports DAC® in revision arthroplasty and trauma surgery, further high-quality studies are needed to confirm its role in primary joint replacement and expand applications to diverse patient populations and anatomical sites.