Volume 5 Number 1 2026
Bacterial Cellulose Nanocomposite Dressings Loaded with Antimicrobial Nanoparticles for Diabetic Foot Ulcers: Fabrication, Mechanisms, and Preclinical Evidence
Razieh Shahbazi 1*, Roya Mirzaei 2
Biosensors and Nanotheranostics 5 (1) 1-8 https://doi.org/10.25163/biosensors.5110999
Submitted: 09 October 2026 Revised: 26 November 2026 Accepted: 05 December 2026 Published: 07 December 2026
Diabetic foot ulcers (DFUs) remain among the most stubborn complications of diabetes mellitus. Up to one-third of people with diabetes will develop one, roughly two-thirds of healed ulcers recur within five years, and infected, non-healing wounds precede most major lower-limb amputations. Healing stalls because several problems arrive together: hyperglycaemia-driven oxidative stress, macrophages locked in a pro-inflammatory state, protease-mediated matrix breakdown, poor angiogenesis, and polymicrobial biofilms that tolerate systemic antibiotics. Conventional gauze-type dressings address none of these. Bacterial cellulose (BC), a pure nanofibrillar polymer secreted by Komagataeibacter species, is an attractive starting point: it holds up to 99% water, transmits vapour at a balanced rate, stays strong when wet, and resembles the dermal extracellular matrix. Yet BC alone has no antimicrobial activity, which limits its value in infected ulcers. This review examines how loading BC with antimicrobial nanoparticles (silver, zinc oxide, copper-doped metal–organic frameworks, and graphene oxide) might close that gap. Drawing on 25 sources published between 2007 and 2026, we compare ex situ, in situ, chemical, and green fabrication routes, summarise antimicrobial and antibiofilm performance against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli, and collate outcomes from diabetic rodent models. Functionalised dressings generally achieved >99% bacterial reduction in vitro and 95–100% wound closure within 12–21 days, alongside lower IL-1α, IL-6, and TNF-α, higher VEGF, PDGF, and CD31, and better-organised collagen. The evidence, however, remains preclinical, heterogeneous, and short-term. Standardised dosing, long-term nanotoxicity data, scalable manufacturing, and well-designed clinical trials are still needed before these dressings can enter routine DFU care.
Keywords: bacterial cellulose; diabetic foot ulcer; silver nanoparticles; zinc oxide nanoparticles; biofilm; wound dressing; angiogenesis; nanocomposite
Alzahrani, A., Tawfik, E. A., & Al-Daihan, S. (2024). Dual drug-loaded coaxial nanofiber dressings for diabetic wound applications. International Journal of Pharmaceutics, 650, Article 123712.
Armstrong, D. G., Boulton, A. J. M., & Bus, S. A. (2017). Diabetic foot ulcers and their recurrence. New England Journal of Medicine, 376(24), 2367–2375.
Barud, H. S., Regiani, T., Marques, R. F. C., Lustri, W. R., Messaddeq, Y., & Ribeiro, S. J. L. (2011). Antimicrobial bacterial cellulose-silver nanoparticles composite membranes. Journal of Nanomaterials, 2011, Article 721631.
Ciecholewska-Jusko, D., Zywicka, A., Junka, A., Drozd, R., Sobolewski, P., Migdal, P., & Fijalkowski, K. (2021). Superabsorbent crosslinked bacterial cellulose biomaterials for chronic wound dressings. Carbohydrate Polymers, 253, Article 117247. https://doi.org/10.1016/j.carbpol.2020.117247
Czaja, W. K., Young, D. J., Kawecki, M., & Brown, R. M., Jr. (2007). The future prospects of microbial cellulose in biomedical applications. Biomacromolecules, 8(1), 1–12.
Galateanu, B., Bunea, M. C., Stanescu, P., Vasile, E., Casarica, A., Iovu, H., Hermenean, A., Zaharia, C., & Costache, M. (2015). In vitro studies of bacterial cellulose and magnetic nanoparticles smart nanocomposites for efficient chronic wounds healing. Stem Cells International, 2015, Article 195096.
Gupta, A., Briffa, S. M., Swingler, S., Gibson, H., Kannappan, V., Adamus, G., Kowalczuk, M., Martin, C., & Radecka, I. (2020). Synthesis of silver nanoparticles using curcumin-cyclodextrins loaded into bacterial cellulose-based hydrogels for wound dressing applications. Biomacromolecules, 21(5), 1802–1811. https://doi.org/10.1021/acs.biomac.9b01724
Gürsoy, E. N., Sener, K., Külahci, M. B., Balabanli, K. B., & Cevher, S. C. (2025). Modern strategies in wound healing: The rise of bacterial cellulose dressings. Advanced Therapeutics, 8(2), Article 2400115.
Ibraheem, I. K., & Shaker, A. W. (2025). Bacterial cellulose–silver nanoparticle composites for antimicrobial wound dressing: A review of recent advances from 2020 to 2025. Haya Saudi Journal of Life Sciences, 10(9), 476–495. https://doi.org/10.36348/sjls.2025.v10i09.009
Kart, N. B., Sulak, M., Mutlu, D., Kuzucu, V., Arslan, S., & Dogan, N. M. (2024). Evaluation of anti-biofilm and in vitro wound healing activity of bacterial cellulose loaded with nanoparticles and borax. Journal of Polymers and the Environment, 32(10), 4520–4535. https://doi.org/10.1007/s10924-024-03308-3
Khalid, A., Khan, R., Ul-Islam, M., Khan, T., & Wahid, F. (2017). Bacterial cellulose-zinc oxide nanocomposites as a novel dressing system for burn wounds. Carbohydrate Polymers, 164, 214–221.
Khalid, A., Ullah, H., Ul-Islam, M., Khan, R., Khan, S., Ahmad, F., Khan, T., & Wahid, F. (2026). Synergistic bacterial cellulose-graphene oxide nanocomposite films promote cutaneous diabetic wound healing through immunomodulation and enhanced angiogenesis. Materials Today Communications, 51, Article 114693.
Kushwaha, P., Ansari, M. A., & Farooqui, Z. (2022). Nanotechnology-based therapeutic interventions in the management of diabetic foot ulcers: A review of preclinical and clinical perspectives. Experimental and Clinical Endocrinology & Diabetes, 130(10), 678–686.
Luo, Z., Liu, J., Lin, H., Ren, X., Tian, H., Liang, Y., Wang, W., Wang, Y., Yin, M., Huang, Y., & Zhang, J. (2020). In situ fabrication of nano ZnO/BCM biocomposite based on MA modified bacterial cellulose membrane for antibacterial and wound healing. International Journal of Nanomedicine, 15, 1–15. https://doi.org/10.2147/IJN.S231556
Mansur, A. A. P., Capanema, N. S. V., Carvalho, I. C., Lage, A. P., Lobato, Z. I. P., & Mansur, H. S. (2023). Functionalized hybrid carboxymethyl cellulose hydrogels functionalized with silver nanoparticles for diabetic wound healing. Polymers, 15(22), Article 4542.
Melnikova, N., Knyazev, A., Nikolskiy, V., Peretyagin, P., Belyaeva, K., Nazarova, N., Liyaskina, E., Malygina, D., & Revin, V. (2021). Wound healing composite materials of bacterial cellulose and zinc oxide nanoparticles with immobilized betulin diphosphate. Nanomaterials, 11(3), Article 713. https://doi.org/10.3390/nano11030713
Renuka, R. R., Julius, A., Yoganandham, S. T., Umapathy, D., Ramadoss, R., Samrot, A. V., & Vijay, D. D. (2023). Diverse nanocomposites as a potential dressing for diabetic wound healing. Frontiers in Endocrinology, 13, Article 1074568.
Revin, V. V., Liyaskina, E. V., Parchaykina, M. V., & Ullah, M. W. (2023). Bacterial cellulose-based biomaterials for wound healing, drug delivery, and skin tissue engineering. Pharmaceutics, 15(2), Article 424.
Sajjad, W., Xiong, Y., Ahmad, W., Dutta, D., Mukerabigwi, J. F., Theoneste, M., Lu, T., & Ge, Z. (2025). Multifunctional bacterial cellulose hydrogel membranes with antibacterial and tissue-regenerating properties for treatment of infected diabetic wound. Biomacromolecules, 26(8), Article 5c00841. https://doi.org/10.1021/acs.biomac.5c00841
Singla, R., Soni, S., Patial, V., Kulurkar, P. M., Kumari, A., Mahesh, S., Padwad, Y. S., & Yadav, S. K. (2017). Cytocompatible anti-microbial dressings of Syzygium cumini cellulose nanocrystals decorated with silver nanoparticles accelerate acute and diabetic wound healing. Scientific Reports, 7, Article 8897.
Singla, R., Soni, S., Patial, V., Kulurkar, P. M., Kumari, A., Mahesh, S., Padwad, Y. S., & Yadav, S. K. (2018). In vivo diabetic wound healing potential of nanobiocomposites containing bamboo cellulose nanocrystals impregnated with silver nanoparticles. International Journal of Biological Macromolecules, 105, 45–55.
Stanescu, P. O., Bunea, M. C., Vasile, E., Casarica, A., Iovu, H., Hermenean, A., Zaharia, C., & Galateanu, B. (2021). Novel chitosan and bacterial cellulose biocomposites tailored with polymeric nanoparticles for modern wound dressing development. Drug Delivery, 28(1), 1932–1950.
Wang, L., Yang, Y., Han, W., & Ding, H. (2024). Multifunctional poloxamer/zinc oxide nanocomposites incorporated with Centella asiatica extract for chronic diabetic wound healing. Regenerative Therapy, 27, 92–103. https://doi.org/10.1016/j.reth.2024.03.006
Yang, M. (2021). Smart bacterial cellulose-based biomaterials for chronic wound monitoring and dressing applications [Doctoral dissertation, University of Wolverhampton]. University of Wolverhampton Repository.
Zheng, L., Li, S., Luo, J., & Wang, X. (2020). Latest advances on bacterial cellulose-based antibacterial materials as wound dressings. Frontiers in Bioengineering and Biotechnology, 8, Article 593768. https://doi.org/10.3389/fbioe.2020.593768
Sustainable and Green Nanomaterials in Biosensing and Nanotheranostics: Life-Cycle, Toxicity, and Circular Design Perspectives
Probiotics as Unintended Vectors of Horizontal Gene Transfer, the Gut Resistome, and the Biosafety of Live Biotherapeutic Products
Marine Collagen–Hydroxyapatite Nanocomposites from Fish Processing Waste for Dental Tissue Engineering: A Review of Extraction, Structure, Fabrication, and Preclinical Performance