Application and Prospect of Modified Bacterial Cellulose in the Biomedical Field

Bacterial cellulose (BC) is an exopolysaccharide synthesized by certain bacterial strains under controlled conditions, known for its remarkable purity, crystallinity, tensile strength, water-holding capacity, and intrinsic biocompatibility. These unique physicochemical properties make BC a highly promising biomaterial across a wide range of biomedical applications. To tailor BC for specific clinical uses, functionalization is typically carried out via in situ or ex-situ strategies, which leverage its abundant hydroxyl groups for chemical derivatization, surface modification, or incorporation with bioactive agents. Through these approaches, composite BC materials can be engineered with enhanced mechanical properties, biological activity, and drug-loading capabilities. Applications in tissue engineering have shown great potential, especially in wound dressings, drug delivery systems, artificial blood vessels, and bone regeneration scaffolds. This review provides a comprehensive overview of current strategies for BC functionalization, summarizes their biomedical applications, and evaluates their performance in clinical or preclinical settings. Finally, it discusses the remaining challenges—such as large-scale production, biodegradability control, and regulatory hurdles—while highlighting future research directions and emerging opportunities in translating BC composites into advanced therapeutic platforms.