Overview of bacterial cellulose: Biosynthesis strategies, functionalization and biomedical marketing

Bacterial cellulose (BC) is reported as an extracellular polysaccharide distinguished by its exceptional purity, mechanical features, and biocompatibility, making it an attractive material for applications in food, plant tissue culture, and Biomedicine. Traditionally, BC production relies on chemically defined synthetic media under either static or agitated fermentation conditions. However, the high production cost remains a critical barrier, limiting its large-scale utilization and broader adoption. To address this challenge, recent advances in sustainable strategies, such as employing agro-industrial byproducts and low-cost carbon sources, have significantly reduced costs while improving yield and functional properties. In particular, diverse environmental waste streams, including agricultural residues, industrial wastes, and food processing byproducts, have been explored as renewable substrates for BC synthesis. BC can be obtained through static fermentation, yielding gelatinous films (pellicles), or agitated fermentation, generating suspended fibers or pellets, each with unique structural features. Moreover, innovative functionalization approaches, including in situ and ex situ modifications, incorporation of bioactive agents, and the development of BC-based nanocomposites, have further expanded its biomedical potential. This review emphasizes sustainable strategies to overcome the cost limitations of BC production, while also highlighting recent advances in functionalization techniques and their pivotal role in advancing medical applications, including cartilage engineering, bone regeneration, wound healing, and dentistry.