Combinatorial Design of Slippery, Nitric Oxide-Releasing Surfaces Incorporating Copper Nanoparticles for Blood-Contacting Devices.

Hospital acquired infections (HAIs) remain a prevailing issue in clinical settings. These challenges are associated with the health and economic burdens of complications such as bloodstream infections, biomedical device fouling, and antimicrobial resistance. Nitric oxide (NO) is an endogenous gasotransmitter that has vasodilatory, antimicrobial, and antiplatelet effects. This has allowed NO to surface as a potential bioactive strategy for integration into medical device technologies. When combined with other surface modifications, such as liquid infusion (LI) and copper nanoparticles(CuNPs), this approach yields slippery, antifouling surfaces with dual antibacterial and NO-catalysis properties. Herein, we combined S-nitroso-N-acetylpenicillamine (SNAP), a promising nitric oxide donor that releases NO at physiological levels for 7 days in the presence of heat and light, with catalytic tuning via CuNPs with a LI polymeric surface. In addition, SNAP Cu LI samples exhibited minimal donor leaching and slippery behavior with sliding angles of <20° across a 7-day test period. These propertiesof NO support its antimicrobial and antiplatelet effects in addition to enhanced catalysis induced by metal-donor interactions. This eradicates microorganisms such as methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli with >99.8% and 98.7% reduction in bacterial cell viability, respectively. In addition, LI reduced blood protein adsorption by >80% and prevented platelet activation by >72%. By integrating nitric oxide-releasing silicone rubber with copper nanoparticles and a liquid-infused layer, these surface modifications produce a multifunctional medical device surface with antibacterial, antithrombotic, and antifouling capabilities.