Pharmaceutical applications of chitosan on medical implants: A viable alternative for construction of new biomaterials?

The cytocompatibility, good degradability and antimicrobial action of chitosan (CS) makes this polysaccharide a highly sought after candidate for applications in medical devices. Thus, development of biofunctional implants associated with CS has been proposed in regenerative medicine as these biomaterials can improve and accelerate the osseointegration process on the implants' surface. The antimicrobial potential of CS has also been investigated in experiments performed on implantable materials associated with CS in different forms, since the incidence of implant-associated infections (IAIs) is increasing worldwide. Biodegradable scaffolds based on CS, and commonly developed as hydrogels, have received lots of attention as implants for controlled release and delivery of drugs. Given this scenario, the present review will focus on methodologies used to coat implant surfaces with CS as well as pharmaceutical applications of these functionalized implants, focusing on cellular, immunological, and antimicrobial responses as well as controlled drug release.