An approach to the soft tissue/synthetic material interface.

It is argued that chemical modification of soft tissue implants in the hope of obtaining an associated tissue response is unlikely to succeed as a method for studying the fundamentals of implant/tissue interactions. An alternative approach is proposed which places greater emphasis on the interfacial interactions (such as protein adsorption) which occur after implantation, in a manner paralleling current advances in knowledge of the blood/material interface. From simple arguments, it is proposed that the observed similarities in soft tissue response of hydrophobic materials may result from irreversible protein adsorption, and that if unusual tissue responses are possible they are likely to be found only with hydrophilic implants. The possiblity of a critical hydrophilic/hydrophobic character which an implant must possess for essentially irreversible protein adsorption is also discussessed.