In vivo soft tissue reinforcement with bacterial nanocellulose

In situ shaping of intricated 3D bacterial cellulose constructs using sacrificial agarose and diverted oxygen inflow

Bacterial cellulose (BC) is gathering increased attention due to its remarkable physico-chemical features. The high biocompatibility, hydrophilicity, and mechanical and thermal stability endorse BC as a suitable candidate for biomedical applications. Nonetheless, exploiting BC for tissue regeneration demands three-dimensional, intricately shaped implants, a highly ambitious endeavor. This challenge is addressed here by growing BC within a sacrificial viscoelastic medium consisting of an agarose gel cast inside polydimethylsiloxane (PDMS) molds imprinted with the features of the desired implant. BC produced with and without agarose has been compared through SEM, TGA, FTIR, and XRD, probing the mild impact of the agarose on the BC properties. As a first proof of concept, a PDMS mold shaped as a doll's ear was used to produce a BC perfect replica, even for the smallest features. The second trial comprised a doll face imprinted on a PDMS mold. In that case, the BC production included consecutive deactivation and activation of the aerial oxygen stream. The resulting BC face clone fitted perfectly and conformally with the template doll face, while its rheological properties were comparable to those of collagen. This streamlining concept conveys to the biosynthesized nanocelluloses broader opportunities for more advanced prosthetics and soft tissue engineering uses.

Trilayered nanocellulose-based patches loaded with acyclovir and hyaluronic acid for the treatment of herpetic lesions

This study focuses on the preparation of layered bacterial nanocellulose (BNC) patches for drug delivery and wound healing in the context of herpes labialis. Nanostructured patches were prepared by selective aqueous diffusion of acyclovir (ACV, antiviral drug), hyaluronic acid (HA, skin healing promoter), and glycerol (GLY, plasticizer and humectant) in the BNC network, followed by assembly into trilayered patches with ACV on the central layer of the patch (ACVT) or divided between two layers (ACVH), to modulate drug release. Both patches showed good layers' adhesion and thermal stability (125 °C), UV barrier properties, good static (Young's modulus up to 0.9 GPa (dry) and 0.7 GPa (wet)) and dynamic mechanical performance, and adhesion strength (21 kPa) comparable to or higher than other materials and commercial adhesives for wound healing. In vitro drug dissolution showed faster ACV release from the ACVH patch (77 ± 5 %, 10 min) than from the ACVT one (50 ± 7 %), suggesting efficient drug delivery. ACVH closely resembled a commercial cream formulation in terms of release and permeation profiles. The patches were non-cytotoxic toward L929 fibroblasts, promoting cell adhesion and wound closure (in vitro). These results underscore the dual-action potential of the layered patches for managing herpetic lesions.

An antibacterial biologic patch based on bacterial cellulose for repair of infected hernias

Infection-associated complications and repair failures and antibiotic resistance have emerged as a formidable challenge in hernia repair surgery. Consequently, the development of antibiotic-free antibacterial patches for hernia repair has become an exigent clinical necessity. Herein, a GBC/Gel/LL37 biological patch (biopatch) with exceptional antibacterial properties is fabricated by grafting 2-Methacryloyloxyethyl trimethylammonium chloride (METAC), a unique quaternary ammonium salt with vinyl, onto bacterial cellulose (GBC), followed by compounding with gelatin (Gel) and LL37. The GBC/Gel/LL37 biopatch exhibits stable swelling capacity, remarkable mechanical properties, flexibility, and favorable biocompatibility. The synergistic effect of METAC and LL37 confers upon the GBC/Gel/LL37 biopatch excellent antibacterial efficacy against Staphylococcus aureus and Escherichia coli, effectively eliminating invading bacteria without the aid of exogenous antibiotics in vivo while significantly reducing local acute inflammation caused by infection. Furthermore, the practical efficacy of the GBC/Gel/LL37 biopatch is evaluated in an infected ventral hernia model, revealing that the GBC/Gel/LL37 biopatch can prevent the formation of visceral adhesions, facilitate the repair of infected ventral hernia, and effectively mitigate chronic inflammation. The prepared antibacterial GBC/Gel/LL37 biopatch is very effective in dealing with the risk of infection in hernia repair surgery and offers potential clinical opportunities for other soft injuries, exhibiting considerable clinical application prospects.

Recent advances and biomedical application of 3D printed nanocellulose-based adhesive hydrogels: A review

Nanocellulose-based tissue adhesives show promise for achieving rapid hemostasis and effective wound healing. Conventional methods, such as sutures and staples, have limitations, prompting the exploration of bioadhesives for direct wound adhesion and minimal tissue damage. Nanocellulose, a hydrolysis product of cellulose, exhibits superior biocompatibility and multifunctional properties, gaining interest as a base material for bioadhesive development. This study explores the potential of nanocellulose-based adhesives for hemostasis and wound healing using 3D printing techniques. Nanocellulose enables the creation of biodegradable adhesives with minimal adverse effects and opens avenues for advanced wound healing and complex tissue regeneration, such as skin, blood vessels, lungs, cartilage, and muscle. This study reviews recent trends in various nanocellulose-based 3D printed hydrogel patches for tissue engineering applications. The review also introduces various types of nanocellulose and their synthesis, surface modification, and bioadhesive fabrication techniques via 3D printing for smart wound healing.

Soft, Long-Lived, Bioresorbable Electronic Surgical Mesh with Wireless Pressure Monitor and On-Demand Drug Delivery

Current research in the area of surgical mesh implants is somewhat limited to traditional designs and synthesis of various mesh materials, whereas meshes with multiple functions may be an effective approach to address long-standing challenges including postoperative complications. Herein, a bioresorbable electronic surgical mesh is presented that offers high mechanical strength over extended timeframes, wireless post-operative pressure monitoring, and on-demand drug delivery for the restoration of tissue structure and function. The study of materials and mesh layouts provides a wide range of tunability of mechanical and biochemical properties. Dissolvable dielectric composite with porous structure in a pyramidal shape enhances sensitivity of a wireless capacitive pressure sensor, and resistive microheaters integrated with inductive coils provide thermo-responsive drug delivery system for an antibacterial agent. In vivo evaluations demonstrate reliable, long-lived operation, and effective treatment for abdominal hernia defects, by clear evidence of suppressed complications such as adhesion formation and infections.

Cell-Laden 3D Hydrogels of Type I Collagen Incorporating Bacterial Nanocellulose Fibers

There is a growing interest in developing natural hydrogel-based scaffolds to culture cells in a three-dimensional (3D) millieu that better mimics the in vivo cells' microenvironment. A promising approach is to use hydrogels from animal tissues, such as decellularized extracellular matrices; however, they usually exhibit suboptimal mechanical properties compared to native tissue and their composition with hundreds of different protein complicates to elucidate which stimulus triggers cell's responses. As simpler scaffolds, type I collagen hydrogels are used to study cell behavior in mechanobiology even though they are also softer than native tissues. In this work, type I collagen is mixed with bacterial nanocellulose fibers (BCf) to develop reinforced scaffolds with mechanical properties suitable for 3D cell culture. BCf were produced from blended pellicles biosynthesized from Komagataeibacter xylinus. Then, BCf were mixed with concentrated collagen from rat-tail tendons to form composite hydrogels. Confocal laser scanning microscopy and scanning electron microscopy images confirmed the homogeneous macro- and microdistribution of both natural polymers. Porosity analysis confirmed that BCf do not disrupt the scaffold structure. Tensile strength and rheology measurements demonstrated the reinforcement action of BCf (43% increased stiffness) compared to the collagen hydrogel while maintaining the same viscoelastic response. Additionally, this reinforcement of collagen hydrogels with BCf offers the possibility to mix cells before gelation and then proceed to the culture of the 3D cell scaffolds. We obtained scaffolds with human bone marrow-derived mesenchymal stromal cells or human fibroblasts within the composite hydrogels, allowing a homogeneous 3D viable culture for at least 7 days. A smaller surface shrinkage in the reinforced hydrogels compared to type I collagen hydrogels confirmed the strengthening of the composite hydrogels. These collagen hydrogels reinforced with BCf might emerge as a promising platform for 3D in vitro organ modeling, tissue-engineering applications, and suitable to conduct fundamental mechanobiology studies.

Ce1-xZrxO2 nanoparticles in bacterial cellulose, bio-based composites with self-regenerating antioxidant capabilities

Bacterial cellulose (BC) is an emerging biopolymer with ever-widening uses in the biomedical field due to its purity, mechanical stability, conformability, moisture control, and biocompatibility. In the wet form, its highly porous nanofibrillar structure and abundant surface hydroxyl groups enable the functionalisation of BC with inorganic nanoparticles (NPs), granting the material additional purposive capabilities. As oxidative stress caused by reactive oxygen species (ROS) negatively affects various cellular structures, the functionalisation of BC with CeO2 NPs, known antioxidants, is pursued in this work to achieve composites capable of minimising inflammation and tissue damage. We report on low-temperature in situ syntheses of CeO2 NPs in BC enabling the formation of BC-CeO2 composites that exhibit self-regenerating antioxidant properties, as verified by 2,2-diphenyl-1-picrylhydrazyl (DPPH) assays and studies of the evolution in the CeO2 absorption edge (indicative of the Ce3+ and Ce4+ fractions). X-Ray photoelectron spectroscopy (XPS) further reveals that incorporation of zirconium into the CeO2 lattice leads to a four-fold increase in the Ce3+: Ce4+ ratio, thereby enhancing the composite antioxidant performance as exemplified by BC-Ce0.6Zr0.4O2 recording the highest %DPPH scavenging per unit mass of NPs among the BC-Ce1-xZrxO2 studied systems.

Mechanical Properties of Smart Polypropylene Meshes: Effects of Mesh Architecture, Plasma Treatment, Thermosensitive Coating, and Sterilization Process

Smart polypropylene (PP) hernia meshes were proposed to detect surgical infections and to regulate cell attachment-modulated properties. For this purpose, lightweight and midweight meshes were modified by applying a plasma treatment for subsequent grafting of a thermosensitive hydrogel, poly(N-isopropylacrylamide) (PNIPAAm). However, both the physical treatment with plasma and the chemical processes required for the covalent incorporation of PNIPAAm can modify the mechanical properties of the mesh and thus have an influence in hernia repair procedures. In this work, the mechanical performance of plasma-treated and hydrogel-grafted meshes preheated at 37 °C has been compared with standard meshes using bursting and the suture pull out tests. Furthermore, the influence of the mesh architecture, the amount of grafted hydrogel, and the sterilization process on such properties have been examined. Results reveal that although the plasma treatment reduces the bursting and suture pull out forces, the thermosensitive hydrogel improves the mechanical resistance of the meshes. Moreover, the mechanical performance of the meshes coated with the PNIPAAm hydrogel is not influenced by ethylene oxide gas sterilization. Micrographs of the broken meshes evidence the role of the hydrogel as reinforcing coating for the PP filaments. Overall, results confirm that the modification of PP medical textiles with a biocompatible thermosensitive hydrogel do not affect, and even improve, the mechanical requirements necessary for the implantation of these prostheses in vivo.

BODIPY-Functionalized Natural Polymer Coatings for Multimodal Therapy of Drug-Resistant Bacterial Infection

The fact that multidrug resistance (MDR) could induce medical device-related infections, along with the invalidation of traditional antibiotics has become an intractable global medical issue. Therefore, there is a pressing need for innovative strategies of antibacterial functionalization of medical devices. For this purpose, a multimodal antibacterial coating that combines photothermal and photodynamic therapies (PTT/PDT) is developed here based on novel heavy atom-free photosensitizer compound, BDP-6 (a kind of boron-dipyrromethene). The photothermal conversion efficiency of BDP-6 is of 55.9%, which could improve biocompatibility during PTT/PDT process by reducing the exciting light power density. Furthermore, BDP-6, together with oxidized hyaluronic acid, is crosslinked with a natural polymer, gelatin, to fabricate a uniform coating (denoted as polyurethane (PU)-GHB) on the surface of polyurethane. PU-GHB has excellent synergistic in vitro PTT/PDT antibacterial performance against both susceptible bacteria and MDR bacteria. The antibacterial mechanisms are revealed as that hyperthermia could reduce the bacterial activity and enhance the permeability of inner membrane to reactive oxygen species by disturbing cell membrane. Meanwhile, in an infected abdominal wall hernia model, the notable anti-infection performance, good in vivo compatibility, and photoacoustic imaging property of PU-GHB are verified. A promising strategy of developing multifunctional antibacterial coatings on implanted medical devices is provided here.

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.

Highly Aligned Bacterial Nanocellulose Films Obtained During Static Biosynthesis in a Reproducible and Straightforward Approach

Bacterial nanocellulose (BNC) is usually produced as randomly-organized highly pure cellulose nanofibers films. Its high water-holding capacity, porosity, mechanical strength, and biocompatibility make it unique. Ordered structures are found in nature and the properties appearing upon aligning polymers fibers inspire everyone to achieve highly aligned BNC (A-BNC) films. This work takes advantage of natural bacteria biosynthesis in a reproducible and straightforward approach. Bacteria confined and statically incubated biosynthesized BNC nanofibers in a single direction without entanglement. The obtained film is highly oriented within the total volume confirmed by polarization-resolved second-harmonic generation signal and Small Angle X-ray Scattering. The biosynthesis approach is improved by reusing the bacterial substrates to obtain A-BNC reproducibly and repeatedly. The suitability of A-BNC as cell carriers is confirmed by adhering to and growing fibroblasts in the substrate. Finally, the thermal conductivity is evaluated by two independent approaches, i.e., using the well-known 3ω-method and a recently developed contactless thermoreflectance approach, confirming a thermal conductivity of 1.63 W mK-1 in the direction of the aligned fibers versus 0.3 W mK-1 perpendicularly. The fivefold increase in thermal conductivity of BNC in the alignment direction forecasts the potential of BNC-based devices outperforming some other natural polymer and synthetic materials.

Nanocellulose, a versatile platform: From the delivery of active molecules to tissue engineering applications

Nanocellulose, a biopolymer, has received wide attention from researchers owing to its superior physicochemical properties, such as high mechanical strength, low density, biodegradability, and biocompatibility. Nanocellulose can be extracted from wide range of sources, including plants, bacteria, and algae. Depending on the extraction process and dimensions (diameter and length), they are categorized into three main types: cellulose nanocrystals (CNCs), cellulose nanofibrils (CNFs), and bacterial nanocellulose (BNC). CNCs are a highly crystalline and needle-like structure, whereas CNFs have both amorphous and crystalline regions in their network. BNC is the purest form of nanocellulose. The nanocellulose properties can be tuned by chemical functionalization, which increases its applicability in biomedical applications. This review highlights the fabrication of different surface-modified nanocellulose to deliver active molecules, such as drugs, proteins, and plasmids. Nanocellulose-mediated delivery of active molecules is profoundly affected by its topographical structure and the interaction between the loaded molecules and nanocellulose. The applications of nanocellulose and its composites in tissue engineering have been discussed. Finally, the review is concluded with further opportunities and challenges in nanocellulose-mediated delivery of active molecules.

Bacterial Cellulose Properties Fulfilling Requirements for a Biomaterial of Choice in Reconstructive Surgery and Wound Healing

Although new therapeutic approaches for surgery and wound healing have recently made a great progress, there is still need for application of better and use novel methods to enhance biocompatibility as well as recovery and healing process. Bacterial Cellulose (BC) is natural cellulose in the form of nanostructure which has the advantages of being used in human body. The medical application of BC in reconstructive, cardiac and vascular surgery as well as wound healing is still under development, but without proved success of repetitive results. A review of studies on Bacterial Cellulose (BC) since 2016 was performed, taking into account the latest reports on the clinical use of BC. In addition, data on the physicochemical properties of BC were used. In all the works, satisfactory results of using Bacterial Cellulose were obtained. In all presented studies various BC implants demonstrated their best performance. Additionally, the works show that BC has the capacity to reach physiological as well as mechanical properties of relevance for various tissue replacement and can be produced in surgeons as well as patient specific expectations such as ear frames, vascular tubes or heart valves as well as wound healing dressings. Results of those experiments conform to those of previous reports utilizing ADM (acellular dermal matrix) and demonstrate that the use of BC has no adverse effects such as ulceration or extrusion and possesses expected properties. Based on preliminary animal as well as the few clinical data BC fittings are promising implants for various reconstructive applications since they are biocompatible with properties allowing blood flow, attach easily to wound bed and remain in place until donor site is healed properly. Additionally, this review shows that BC can be fabricated into patient specific shapes and size, with capability to reach mechanical properties of relevance for heart valve, ear, and muscle replacement. Bacterial cellulose appears, as shown in the above review, to be one of the materials that allow extensive application in the reconstruction after soft tissue defects. Review was created to show the needs of surgeons and the possibilities of using BC through the eyes and knowledge of biotechnologists.

A Versatile Strategy for the Fabrication of Poly(ethyl methacrylate) Composites

Poly(ethyl methacrylate) (PEMA) is dissolved in ethanol, known to be a non-solvent for PEMA, due to the solubilizing ability of an added bile acid biosurfactant, lithocholic acid (LA). The ability to avoid traditional toxic and carcinogenic solvents is important for the fabrication of composites for biomedical applications. The formation of concentrated solutions of high molecular weight PEMA is a key factor for the film deposition using the dip coating method. PEMA films provide corrosion protection for stainless steel. Composite films are prepared, containing bioceramics, such as hydroxyapatite and silica, for biomedical applications. LA facilitates dispersion of hydroxyapatite and silica in suspensions for film deposition. Ibuprofen and tetracycline are used as model drugs for the fabrication of composite films. PEMA-nanocellulose films are successfully prepared using the dip coating method. The microstructure and composition of the films are investigated. The conceptually new approach developed in this investigation represents a versatile strategy for the fabrication of composites for biomedical and other applications, using natural biosurfactants as solubilizing and dispersing agents.

Assessing effectiveness of Komagataeibacter strains for producing surface-microstructured cellulose via guided assembly-based biolithography

In this study, a medical device made of surface microstructured bacterial cellulose was produced using cellulose-producing acetic acid bacteria wild-type strains in combination with guided assembly-based biolithography. The medical device aims at interfering with the cell's focal adhesion establishment and maturation around implantable devices placed in soft tissues by the symmetrical array on its surface. A total of 25 Komagataeibacter strains was evaluated over a three-step selection. In the first step, the ability of strains to produce a suitable bacterial cellulose layer with high production yield was examined, then nine strains, with a uniform and smooth layer of bacterial cellulose, were cultured in a custom-made silicone bioreactor and finally the characteristics of the symmetrical array of topographic features on the surface were analysed. Selected strains showed high inter and intra species variability in bacterial cellulose production. The devices obtained by K2G30, K1G4, DSM 46590 (Komagataeibacter xylinus), K2A8 (Komagataeibacter sp.) and DSM 15973^T (Komagataeibacter sucrofermentas) strains were pouched-formed with hexagonal surface pattern required for reducing the formation of fibrotic tissue around devices, once they are implanted in soft tissues. Our findings revealed the effectiveness of the selected Komagataeibacter wild-type strains in producing surface microstructured bacterial cellulose pouches for making biomedical devices.