No abstract

Understanding the interaction between biomaterials and blood is critical in the design of novel biomaterials for use in biomedical applications. Depending on the application, biomaterials can be designed to promote hemostasis, slow or stop bleeding in an internal or external wound, or prevent thrombosis for use in permanent or temporary medical implants. Bacterial nanocellulose (BNC) is a natural, biocompatible biopolymer that has recently gained interest for its potential use in blood-contacting biomedical applications (e.g., artificial vascular grafts), due to its high porosity, shapeability, and tissue-like properties. To promote hemostasis, BNC has been modified through oxidation or functionalization with various peptides, proteins, polysaccharides, and minerals that interact with the coagulation cascade. For use as an artificial vascular graft or to promote vascularization, BNC has been extensively researched, with studies investigating different modification techniques to enhance endothelialization such as functionalizing with adhesion peptides or extracellular matrix (ECM) proteins as well as tuning the structural properties of BNC such as surface roughness, pore size, and fiber size. While BNC inherently exhibits comparable mechanical characteristics to endogenous blood vessels, these mechanical properties can be enhanced through chemical functionalization or through altering the fabrication method. In this review, we provide a comprehensive overview of the various modification techniques that have been implemented to enhance the suitability of BNC for blood-contacting biomedical applications and different testing techniques that can be applied to evaluate their performance. Initially, we focused on the modification techniques that have been applied to BNC for hemostatic applications. Subsequently, we outline the different methods used for the production of BNC-based artificial vascular grafts and to generate vasculature in tissue engineered constructs. This sequential organization enables a clear and concise discussion of the various modifications of BNC for different blood-contacting biomedical applications and highlights the diverse and versatile nature of BNC as a natural biomaterial.

Bacterial nanocellulose (BNC) is a naturally derived hydrogel that has recently paved its way in several biomedical applications. Despite its remarkable tissue-like properties, BNC does not express innate anticoagulant or antimicrobial properties; therefore, appropriate post-modification procedures are required to prevent nonspecific adhesion and enhance the hemocompatibility properties of BNC-based biointerface. Here, we report a new class of flexible, lubricant-infused BNC membranes with superior antithrombotic and antibacterial properties. Using chemical vapor deposition, porous BNC membranes were functionalized with fluorosilane molecules and further impregnated with a fluorocarbon-based lubricant. Compared with unmodified BNC membranes and commercially available poly(tetrafluoroethylene) (PTFE) felts, our developed lubricant-infused BNC samples significantly attenuated plasma and blood clot formation, and prevented bacterial migration, adhesion, and biofilm formation and exhibited superior fat and enzyme repellency properties. Moreover, when subjected to mechanical testing, the lubricant-infused BNC membranes demonstrated a significantly higher tensile strength and greater fatigue resistance when compared with unmodified BNC samples and PTFE felts. Overall, the superior mechanical strength and antithrombotic, antibacterial, and fat/enzyme resistant properties observed in the developed super-repellent BNC-based membranes render their application promising for various biofluid-contacting medical implants and tissue engineering constructs.