Implantable medical devices – we have come a long way, but where<br/><br/>next?
While the technology and engineering of the devices themselves has become very sophisticated, one aspect of these devices has not changed very much over their history. That aspect is our detailed understanding of how the device and the body interact. Biocompatibility is the catch-all phrase used in connection with the device-body interface. It refers to the body being able to tolerate the device, and in turn, the device’s ability to being able to reliably function in the body. We have come to understand that the main criteria for biocompatibility is a well behaved, inert material. That means a stable material that will not interact with the body at a rate that would be detrimental to either the body or the device. However, this is an empirical criteria and there is little understanding of what actually happens at either a molecular, or a cellular level. Such a knowledge gap puts limitations on our ability to improve existing devices or create new ones as we have little idea how to best engineer the interfaces for optimum performance; in fact we really do not know if there is any meaningful engineering we can do to control how the device and body interact. The goal of this talk is to suggest some frames for thinking about how the body and devices interact at fundamental levels.