Bioinspired and living multiscale composites for regenerative medicine in the treatment of surgical site infections.

Surgical site infections are a major postoperative complication because microbial contamination may destabilize healing and undermine the effectiveness of regenerative biomaterials. Conventional approaches tend to focus on infection control and tissue regeneration in isolation, thereby restricting their efficacy in complicated surgical procedures. Recent advancements in bioinspired and living multiscale composite materials offer new methods of antimicrobial functionality and regenerative support through hierarchical material design and bioinspired strategies. This review presents an extensive discussion on bioinspired and living multiscale composites in regenerative medicine to address surgical site infections. This review discusses the principles of biology, design of multiscale architectures, and provides an overview of how inert implants have evolved into bioactive, antimicrobial, and adaptive multiscale material systems. Most important material classes and fabrication strategies are addressed, with literature on the modes of incorporating structural hierarchy, antimicrobial strategies, and biological integration through the composite platform. The existing uses in preventing infections, regeneration of contaminated defects, delivering infection-responsive drugs, and biosensing have been critically evaluated. Translational, industrial, and regulatory issues, as well as the problems of scale-up, manufacturing obstacles, biosafety, standardization, and clinical integration specifically for living and hybrid systems, are also discussed here. This review summarizes the prospects and shortcomings of multiscale composite strategies through the synthesis of materials science, biology, and translational research to identify key directions for creating effective, safe, and clinically viable anti-infective regenerative materials.