Biocellulose for Incisional Hernia Repair-An Experimental Pilot Study

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.

In vivo soft tissue reinforcement with bacterial nanocellulose

The use of surgical meshes to reinforce damaged internal soft tissues has been instrumental for successful hernia surgery; a highly prevalent condition affecting yearly more than 20 million patients worldwide. Intraperitoneal adhesions between meshes and viscera are one of the most threatening complications, often implying reoperation or side effects such as chronic pain and bowel perforation. Despite recent advances in the optimization of mesh porous structure, incorporation of anti-adherent coatings or new approaches in the mesh fixation systems, clinicians and manufacturers are still pursuing an optimal material to improve the clinical outcomes at a cost-effective ratio. Here, bacterial nanocellulose (BNC), a bio-based polymer, is evaluated as a soft tissue reinforcement material regarding mechanical properties and in vivo anti-adhesive performance. A double-layer BNC laminate proved sufficient to meet the standards of mechanical resistance for abdominal hernia reinforcement meshes. BNC-polypropylene (BNC-PP) composites incorporating a commercial mesh have also been prepared. The in vivo study of implanted BNC patches in a rabbit model demonstrated excellent anti-adherent characteristics of this natural nanofibrous polymer 21-days after implantation and the animals were asymptomatic after the surgery. BNC emerges as a novel and versatile hernioplasty biomaterial with outstanding mechanical and anti-adherent characteristics.

Nanocellulose in biomedical and biosensing applications: A review

Cellulose is abundant in the nature and nanocellulose (NC) in particular is regarded as a credible green substrate to be used in bio nanocomposites for various applications. NC exhibits excellent mechanical reinforcement properties comparable to conventionally used materials due to its high specific surface area and tunable surface chemistry. Additionally, low toxicity, biodegradability and biocompatibility of NC deem it a promising material for use in different biomedical applications. In this review, we highlight the biomedical applications of NC based hydrogels and aerogels/nanocomposites and advancements of their employment in the areas of wound dressing, drug delivery, tissue engineering, scaffolds and biomedical implants. This review also explores the recent use of NC in making biosensors for the detection of cholesterol, various enzymes and diseases, heavy metal ions in human sweat and urine, and for general health monitoring.

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.