Bacterial cellulose in neurosurgery: prospects for dural mater repair

The dura mater plays a key role in protecting the central nervous system by providing mechanical and barrier functions. Various injuries, surgical interventions, and pathological conditions may require its repair or replacement. The use of synthetic implants or autografts often carries risks, including infections, allergic reactions, and rejection. In recent years, bacterial cellulose has gained attention as a biomaterial with unique properties that could significantly improve surgical outcomes. This review explores the potential of bacterial cellulose as a dura mater substitute and analyzes its advantages. A literature search was conducted in PubMed and Google Scholar (2014–2024), focusing on key studies of biocompatibility and neurosurgical applications. Keywords included bacterial nanocellulose, properties of bacterial nanocellulose, dura mater defects, biocompatibility. Out of 127 sources (in vitro, in vivo, and clinical studies), 32 articles were selected based on novelty, depth of research (mechanical properties, immune response, tissue regeneration), and relevance to dura mater repair. Priority was given to publications from the last decade (2014–2024), experimental in vivo models (rabbits, rats), and reviews on neurosurgical applications. A literature review has shown that bacterial cellulose is a promising biomaterial with unique properties, including high biocompatibility, hypoallergenicity, and the ability to modulate the immune response toward an anti-inflammatory phenotype. A key factor in its efficacy is thorough endotoxin removal, which minimizes inflammatory reactions. Bacterial cellulose demonstrates particular potential in experimental and clinical neurosurgery as a potential medical device for dura mater defect repair.