  Bacterial colonization ofimplanted biomedical devicesis themain cause of
healthcare-associated infections, estimated to be 8.8 million per year in
Europe. Many infections originate from damaged skin, which lets microorganisms
exploit injuries and surgical accesses as passageways to reach the implant site
and inner organs. Therefore, an effective treatment of skin damage is highly
desirable for the success of many biomaterial-related surgical procedures. Due
to gained resistance to antibiotics, new antibacterial treatments are becoming
vital to control nosocomial infections arising as surgical and post-surgical
complications. Surface coatings can avoid biofouling and bacterial colonization
thanks to biomaterial inherent properties (e.g., super hydrophobicity),
specifically without using drugs, which may cause bacterial resistance. The
focus of this review is to highlight the emerging role of degradable polymeric
micro- and nano-structures that show intrinsic antifouling and antimicrobial
properties, with a special outlook towards biomedical applications dealing with
skin and skin damage. The intrinsic properties owned by the biomaterials
encompass three main categories: (1) physical-mechanical, (2) chemical, and (3)
electrostatic. Clinical relevance in ear prostheses and breast implants is
reported. Collecting and discussing the updated outcomes in this field would
help the development of better performing biomaterial-based antimicrobial
strategies, which are useful to prevent infections.
