Bacterial Cellulose as a Versatile Platform for Research and Development of Biomedical Materials

The unique pool of features found in intracellular and extracellular bacterial biopolymers attracts a lot of research, with bacterial cellulose (BC) being one of the most versatile and common. BC is an exopolysaccharide consisting solely of cellulose, and the variation in the production process can vary its shape or even its composition when compounding is applied in situ. Together with ex situ modification pathways, including specialised polymers, particles or exclusively functional groups, BC provides a robust platform that yields complex multifunctional compounds that go far beyond ultra-high purity, intrinsic hydrophilicity, mechanical strength and biocompatibility to introduce bioactive, (pH, thermal, electro) responsive, conductive and ‘smart’ properties. This review summarises the research outcomes in BC-medical applications, focusing mainly on data from the past decade (i.e., 2010–2020), with special emphasis on BC nanocomposites as materials and devices applicable in medicine. The high purity and unique structural/mechanical features, in addition to its capacity to closely adhere to irregular skin surfaces, skin tolerance, and demonstrated efficacy in wound healing, all stand as valuable attributes advantageous in topical drug delivery. Numerous studies prove BC compatibility with various human cells, with modifications even improving cell affinity and viability. Even BC represents a physical barrier that can reduce the penetration of bacteria into the tissue, but in its native form does not exhibit antimicrobial properties, therefore carious modifications have been made or specific compounds added to confer antimicrobial or anti-inflammatory properties. Progress in the use of BC-compounds as wound dressings, vascular grafts, and scaffolds for the treatment of cartilage, bone and osteochondral defects, the role as a basement membrane in blood-brain barrier models and many more are discussed to particular extent, emphasising the need for BC compounding to meet specific requirements.