Surgical site infection associated

Surgical site infection associated with surgical instruments is one of the major63 contributions to a delayed post-operative recovery of patients. These patients that suffered64 from nosocomial infection are predominately infected by pathogens including Staphylococcus65 aureus, Pseudomonas aeruginosa, and Escherichia coli [1]. These strains of pathogens66 become more virulent when they form into a layer of biofilm on the surface of the surgical67 instruments. This biofilm is highly resistance to a spectrum of antibiotic load and supports a68 sustain release of pathogens at local tissue region as it is difficult to eradicate using ordinary69 decontamination process [2]. Therefore, an antimicrobial property to hinder the attachment of70 bacteria on the surface of the surgical instruments is highly warranted [3]. However, poor71 antimicrobial property is one of the major limitations for Stainless Steel 316 L (SS 316 L) that72 is primarily utilised in manufacturing the surgical instruments due to its characteristics such as73 ease of fabrication, good mechanical strength, reasonable corrosion resistance, biocompatible74 and low cost [4]. Furthermore, the exposure of the surgical instruments made of SS 316 L to75 the internal body fluid during surgical events can increase the chance of leaching its chemical76 ions including nickel, molybdenum, and chromium that can cause an inflammatory reaction77 and platelet activation [5]. Therefore, surface modification of SS 316 L becomes an78 opportunity to improve its antimicrobial activity as well as reducing the liberation of chemical79 ions without compromising its genuine properties.