Funct. Mater. 2026; 33 (2): 143-153.

Biomedical devices have made significant contributions to the development of modern medicine by restoring physiological functions and improving quality of life. Nevertheless, their use is often associated with an increased risk of infection, particularly in Intensive Care Units. Biofilms, which are structured communities of microorganisms embedded in an extracellular polymeric substance matrix, exhibit heightened tolerance to antimicrobial agents and are key factors in the development of chronic infections. These biofilms can disperse, forming new foci of infection. Silicone, one of the most widely used biomaterials in medical devices, such as catheters and endotracheal tubes, is especially susceptible to bacterial adhesion and biofilm formation due to its hydrophobic surface properties. A number of natural compounds have shown potential in preventing or controlling infections and may therefore serve as promising candidates for modifying biomaterials with anti-infective properties. Various chemical, physical and physicochemical modification strategies were investigated. This review analyzed 14 experimental studies published between 2015 and 2025 on silicone modification with 13 natural compounds in mono or mixture form, with particular emphasis on surface modification techniques. Despite promising outcomes, the number of in vivo studies assessing efficacy is limited, as only 30% of the prototypes have been tested in animal models. In conclusion, surface modification of medical devices with natural substances represents an interesting approach to reducing bacterial colonization and biofilm formation, thereby potentially preventing infections and enhancing device performance, which warrants further investigation.