Biomaterials Science: An Introduction to Materials in Medicine

Citation

Wagner, W. R., Sakiyama-Elbert, S. E., Zhang, G., & Yaszemski, M. J. (Eds.). (2020). Biomaterials Science: An Introduction to Materials in Medicine (4th ed.). Elsevier.

Chapter Summary

This is a very large edited reference of about 1,600 printed pages, organised in three parts and a set of appendices. Rather than a few long chapters, the publisher's contents list is a sequence of close to one hundred short, numbered units (for example 1.3.2E on hydrogels or 2.2.4 on the complement system), each written by specialists.

Part 1: Materials Science and Engineering

Section 1.1, "Overview of Biomaterials", opens with "Introduction to Biomaterials Science: An Evolving, Multidisciplinary Endeavor" and "A History of Biomaterials". Section 1.2, "Properties of Materials", covers the nature of matter and materials, bulk properties, surface properties and surface characterization, and the role of water in biomaterials.

Section 1.3, "Classes of Materials Used in Medicine", is the longest in this part. It gives basic principles and specific families for polymers (polyurethanes, silicones, fluorinated materials, restorative composites and adhesives, hydrogels, degradable polymers, "smart polymers"), metals (titanium alloys including nitinol, stainless steels, CoCr alloys, biodegradable metals), ceramics, glasses and glass-ceramics (hydroxyapatites, structural oxides), carbon biomaterials, natural materials (processed tissues, extracellular matrix proteins), composites, and micro- and nanoparticles.

Section 1.4, "Materials Processing", deals with how materials are turned into devices and surfaces: physicochemical surface modification, nonfouling and nonthrombogenic surfaces, surface-immobilized biomolecules, surface patterning, medical fibers and biotextiles, textured and porous materials, and additive manufacturing.

Part 2: Biology and Medicine

Section 2.1, "Some Background Concepts", introduces the biology a materials-trained reader needs: adsorbed proteins, cells and surfaces in vitro, tissue architecture and responses to injury, the extracellular matrix and cell-biomaterial interactions, and the effect of mechanical forces on cells and tissues.

Section 2.2, "Host Reaction to Biomaterials and Their Evaluation", covers inflammation, wound healing and the foreign-body response; innate and adaptive immunity; the complement system; systemic and immune toxicity; blood coagulation and blood-material interactions; tumorigenesis; and biofilms and device-related infection.

Section 2.3, "Characterization of Biomaterials", turns to testing: the concept and assessment of biocompatibility, in vitro and in vivo tests of tissue compatibility, evaluation of blood-material interactions, and animal surgery and care. Section 2.4, "Degradation of Materials in the Biological Environment", treats chemical and biochemical degradation of polymers, metallic corrosion, degradation of ceramics and pathological calcification.

Section 2.5, "Applications of Biomaterials", is a tour of clinical areas: cardiovascular devices (heart valves, pacemakers, circulatory support, stents and grafts), extracorporeal artificial organs, orthopedic, dental and ophthalmologic applications, bioelectronic neural implants, burn dressings and skin substitutes, adhesives, immunoengineering, tumor-microenvironment model systems, drug delivery systems and enzyme-based biosensors. Section 2.6, "Applications of Biomaterials in Functional Tissue Engineering", covers tissue engineering concepts, scaffolds and their micromechanical design criteria, and tendon, bone, cardiovascular and soft-tissue engineering.

Part 3: The Medical Product Life Cycle

The final part follows a biomaterial-based device from concept to the clinic and beyond: the total product lifecycle, safety and risk, sterilization and disinfection, verification and validation, commercial considerations, regulatory constraints, the role of standards, implant retrieval and failure analysis, legal concepts, and moral and ethical issues. Appendices list properties of biological fluids and soft materials, the chemical composition of implant metals and ceramics, and the biomaterials literature; one further appendix on assessing cell and matrix components in tissues is online only.

Key Concepts

Part 1: Materials Science and Engineering

• Classes of biomaterials: polymers, metals, ceramics and glasses, carbon, natural materials and composites, each introduced by basic principles before specific materials.
• Surface properties and modification: the surface, not the bulk, meets the body first, so the book treats characterization, patterning, immobilized biomolecules and nonfouling coatings in detail.
• Degradable and biodegradable materials: polymers and metals designed to be resorbed rather than to last.

Part 2: Biology and Medicine

• Protein adsorption: proteins coat a material within moments of contact and mediate what cells do next.
• Foreign-body response and immunity: the sequence of inflammation, wound healing and immune activation set off by an implant.
• Biocompatibility assessment: the concept itself and the in vitro and in vivo tests used to judge it.
• Degradation in the body: corrosion, hydrolysis and calcification that limit how long an implant performs.
• Tissue engineering scaffolds: porous materials designed to support cells while new tissue forms.

Part 3: The Medical Product Life Cycle

• Total product lifecycle: planning a device from design through validation, regulation and retrieval.
• Sterilization, risk and regulation: the safety, standards and legal steps between a material and a marketed device.

Critical Analysis

Strengths

• Breadth under one cover. The contents list runs from atomic-level properties and every major material family, through immunology and blood interactions, to specific clinical devices and the regulatory life cycle. A single volume therefore follows a material from its chemistry to the analysis of an implant retrieved after failure.
• Biology treated alongside materials. Part 2 opens with background sections on adsorbed proteins, cells, tissue architecture and mechanical forces before the host-response and testing sections, so a reader trained mainly in materials is not left to supply the biology.
• A product-development part. The publisher highlights new content on medical device development, global issues in translation, quality assurance and reimbursement, so the book covers how a laboratory material becomes a regulated product.
• Currency of the fourth edition. The publisher lists additions on nanotechnology, additive manufacturing, regenerative engineering, personalized medicine and organs on a chip, and says redundant material was consolidated. The book is also described as endorsed by the Society for Biomaterials, and online exercises are provided for most chapters.

Limitations

• Size and structure. At about 1,600 pages with many short contributed units, it is a reference more than a course text; coverage and depth vary with each contributor, and a reader cannot work through it in order in one course.
• Level. The publisher names undergraduate and graduate students, postdoctoral researchers and practitioners as its readers. A student with no prior materials science or biology may find individual units demanding without a gentler first text.
• Exercises are online. The publisher's description mentions online chapter exercises for most chapters, so problem practice is not part of the printed volume.

Where It Fits in the Course

Within the biomaterials course list this is the comprehensive reference rather than the first course. Chen and Thouas's Biomaterials: A Basic Introduction is written for students who arrive without a strong background in either materials science or biology, and Temenoff and Mikos's Biomaterials: The Intersection of Biology and Materials Science is an undergraduate textbook that builds the two sides in parallel; either is a more natural starting point. Agrawal and colleagues' Introduction to Biomaterials is a shorter, single-voice course text designed to be read through in one term.

Black's Biological Performance of Materials is a single-author monograph focused on biocompatibility, and is the more focused choice when biocompatibility is the main interest. This volume is the one to keep for looking things up across the whole field and for the device-development material in Part 3. The site also lists an earlier edition of the same title, from 2004, edited by Ratner, Hoffman, Schoen and Lemons.

How to Use This Book

Use it as a companion to a course, not as a text to read cover to cover. A reader who already has an introductory course can build a core path from Sections 1.1 to 1.3 (what the material classes are), Sections 2.1 and 2.2 (how the body responds), Section 2.3 (biocompatibility testing) and Section 2.4 (degradation). Section 1.4 is the place to go for surface modification and processing, and Section 2.5 or 2.6 can be chosen according to the application a course or project emphasises.

Part 3 is the section to read when a course or project involves bringing a device to market: lifecycle, sterilization, validation, regulation, standards and failure analysis. The appendices on properties of biological fluids and soft materials are useful for data lookup. Readers with a weaker background should start with a shorter introduction and return here for depth on specific topics; check the publisher's online materials for the chapter exercises.