Pushing the limits of bacterial cellulose for biomedicine: a review

Bacterial cellulose (BC) has emerged as a highly promising biomaterial due to its exceptional purity, high mechanical strength, excellent biocompatibility, and tunable nanostructure. Although its potential in a wide range of biomedical applications is well recognized, its clinical translation remains limited by a fragmented research landscape. Key aspects such as microbial production, material optimization, and application-specific functionalization are often studied independently by researchers from different disciplines, slowing the development of integrated, effective biomedical solutions. This review aims to bridge these gaps by offering a comprehensive and interdisciplinary synthesis that connects advances in BC biosynthesis, its physicochemical properties, and its diverse biomedical applications. We first explore engineering and processing strategies to enhance BC production, including bioprocess optimization and genetic engineering. We then highlight what makes BC particularly suitable for biomedical use, followed by an in-depth discussion of its roles in wound healing, drug delivery, tissue engineering (e.g., blood vessels, cartilage, cornea), bone regeneration, biosensors, and dental applications. Special attention is given to recent innovations and ongoing challenges in functionalization and clinical scalability. By providing a clear and structured overview of the field, this review seeks to promote dialogue across disciplines and support the development of robust, application-ready BC-based biomaterials for the next generation of biomedical solutions.