Bacterial nanocellulose as a plastic material for closure of defects of the dura mater: literature review

Objective . To analyze publications devoted to the possibility of using bacterial nanocellulose as a plastic material for defects in the dura mater associated with spine and spinal cord pathology. Material and Methods . The PubMed database was searched with keywords “bacterial cellulose properties” and “bacterial cellulose”. The search was limited to articles published in English- and Russian-language journals in 2009–2019. The limitation was caused by the need for up-to-date evaluation of the properties of bacterial nanocellulose. The search with keywords “bacterial cellulose properties” returned a list of 963 articles and with key words “bacterial cellulose” – a list of 3908 articles. The Google search engine was also used, in which articles were found actually reflecting properties of bacterial nanocellulose without which complete understanding of its nature is impossible. After assessing the found data, 76 articles were selected that reflect this issue to the fullest extent. More than fifty percent of the reviewed articles were published within the last 10 years. Evidence level: IV; recommendation grade: C, though randomized trials with evidence level Ib and recommendation level A are used. Results . Implants made of bacterial nanocellulose are able to perform the function of the extracellular matrix by providing a barrier function, creating conditions for the circulation of metabolites and oxygen, and preventing the achievement of excess cell concentration. Conclusion . The use of bacterial nanocellulose as an implant for closure of the dura mater defects associated with the spinal cord pathology is a promising direction in neurosurgery, since nanocellulose does not cause adhesions to the nervous tissue and performs a barrier function.