Opportunities for bacterial nanocellulose in biomedical applications: Review on biosynthesis, modification and challenges

Bacterial nanocellulose (BNC) is a natural polysaccharide produced as extracellular material by bacterial strains and has favorable intrinsic properties for primary use in biomedical applications. In this review, an update on state-of-the art and challenges in BNC production, surface modification and biomedical application is given. Recent insights in biosynthesis allowed for better understanding of governing parameters improving production efficiency. In particular, introduction of different carbon/nitrogen sources from alternative feedstock and industrial upscaling of various production methods is challenging. It is important to have control on the morphology, porosity and forms of BNC depending on biosynthesis conditions, depending on selection of bacterial strains, reactor design, additives and culture conditions. The BNC is intrinsically characterized by high water absorption capacity, good thermal and mechanical stability, biocompatibility and biodegradability to certain extent. However, additional chemical and/or physical surface modifications are required to improve cell compatibility, protein interaction and antimicrobial properties. The novel trends in synthesis include the in-situ culturing of hybrid BNC nanocomposites in combination with organic material, inorganic material or extracellular components. In parallel with toxicity studies, the applications of BNC in wound care, tissue engineering, medical implants, drug delivery systems or carriers for bioactive compounds, and platforms for biosensors are highlighted.