Advances in biomedical applications of bacterial cellulose: from synthesis mechanisms to commercial innovations

Bacterial cellulose (BC) has various unique properties, such as sustainability and biocompatibility, which make it a "rising star" in biomedical applications. This comprehensive review delves into the intricacies of BC production and elucidates the pivotal role of rosette terminal complexes in the synthesis of BC. Moreover, it explores the diverse range of in-situ and ex-situ modifications, such as coating, genetic modification, and esterification, that can enhance its performance in biomedical applications, notably in tissue engineering, drug delivery and wound healing applications Beginning with an in-depth examination of BC synthesis mechanisms, this review sheds light on the fundamental processes underlying its unique structure and properties and subsequently delves into the vast landscape of modification strategies, encompassing techniques such as chemical functionalization, surface patterning, and composite formation. Of particular significance are the insights provided into commercial products derived from BC, which offers a comprehensive overview of their features and applications, followed by several recent case studies. By consolidating knowledge from the basic principles of BC synthesis to cutting-edge advancements in the field, this review illuminates the transformative impact of BC on the landscape of health and medical breakthroughs, paving the way for future advancements in biomedicine.