A History of Biomaterials

Buddy D. Ratner

At the dawn of the 21st century, biomaterials are widely (Crubezy et al., 1998). This implant, too, was described as
used throughout medicine, dentistry and biotechnology. Just properly bone integrated. There were no materials science, bio-
50 years ago biomaterials as we think of them today did not logical understanding, or medicine behind these procedures.
exist. The word “biomaterial” was not used. There were no Still, their success (and longevity) is impressive and highlights
medical device manufacturers (except for external prosthetics two points: the forgiving nature of the human body and the
such as limbs, fracture fixation devices, glass eyes, and den- pressing drive, even in prehistoric times, to address the loss of
tal devices), no formalized regulatory approval processes, no physiologic/anatomic function with an implant.
understanding of biocompatibility, and certainly no academic
courses on biomaterials. Yet, crude biomaterials have been
used, generally with poor to mixed results, throughout his- Sutures for 32,000 Years
tory. This chapter will broadly trace from the earliest days of
human civilization to the dawn of the 21st century the his- There is evidence that sutures may have been used as
tory of biomaterials. It is convenient to organize the history of long as 32,000 years ago (NATNEWS, 1983, 20(5): 15–7).
biomaterials into four eras: prehistory, the era of the surgeon Large wounds were closed early in history by one of two
hero, designed biomaterials/engineered devices, and the con- methods—cautery or sutures. Linen sutures were used by the
temporary era leading into a new millennium. However, the early Egyptians. Catgut was used in the Middle Ages in Europe.
emphasis of this chapter will be on the experiments and stud- Metallic sutures are first mentioned in early Greek literature.
ies that set the foundation for the field we call biomaterials, Galen of Pergamon (circa 130–200 a.d.) described ligatures of
largely between 1920 and 1980. gold wire. In 1816, Philip Physick, University of Pennsylvania
Professor of Surgery, suggested the use of lead wire sutures
noting little reaction. In 1849, J. Marion Sims, of Alabama,
BIOMATERIALS BEFORE WORLD WAR II had a jeweler fabricate sutures of silver wire and performed
many successful operations with this metal.
Before Civilization Consider the problems that must have been experienced
with sutures in eras with no knowledge of sterilization, toxi-
The introduction of nonbiological materials into the human cology, immunological reaction to extraneous biological mate-
body was noted far back in prehistory. The remains of a human rials, inflammation, and biodegradation. Yet sutures were a
found near Kennewick, Washington, USA (often referred to as relatively common fabricated or manufactured biomaterial for
the “Kennewick Man”) was dated (with some controversy) thousands of years.
to be 9000 years old. This individual, described by arche-
ologists as a tall, healthy, active person, wandered through
the region now know as southern Washington with a spear
point embedded in his hip. It had apparently healed in and did
Artificial Hearts and Organ Perfusion
not significantly impede his activity. This unintended implant In the 4th century b.c., Aristotle called the heart the most
illustrates the body’s capacity to deal with implanted foreign important organ in the body. Galen proposed that veins con-
materials. The spear point has little resemblance to modern nected the liver to the heart to circulate “vital spirits throughout
biomaterials, but it was a “tolerated” foreign material implant, the body via the arteries.” English physician William Harvey
just the same. in 1628 espoused a relatively modern view of heart function
when he wrote, “The heart’s one role is the transmission of
Dental Implants in Early Civilizations the blood and its propulsion, by means of the arteries, to the
extremities everywhere.” With the appreciation of the heart as
Unlike the spear point described above, dental implants a pump, it was a logical idea to think of replacing the heart
were devised as implants and used early in history. The with an artificial pump. In 1812, the French physiologist Le
Mayan people fashioned nacre teeth from sea shells in roughly Gallois expressed his idea that organs could be kept alive by
600 a.d. and apparently achieved what we now refer to as pumping blood through them. A number of experiments on
bone integration (see Chapter 7.8), basically a seamless inte- organ perfusion with pumps were performed from 1828–1868.
gration into the bone (Bobbio, 1972). Similarly, an iron dental In 1881, Étienne-Jules Marey, a brilliant scientist and thinker
implant in a corpse dated 200 a.d. was found in Europe who published and invented in photography theory, motion

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