Bacterial nanocellulose enables auxetic supporting implants.

Owing to its purity and exceptional mechanical performance, bacterial nanocellulose (BNC) is well suited for tissue engineering applications. BNC assembles as a network that features similarities with the extracellular matrix (ECM) while exhibiting excellent integrity in the wet state, suitable for suturing and sterilization. The development of complex 3D forms is shown by taking advantage of the aerobic process involved in the biogenesis of BNC at the air/culture medium interphase. Hence, solid supports are used to guide the formation of BNC biofilms that easily form auxetic structures. Such biomaterials are demonstrated as implantable meshes with prescribed opening size and infill density. The measured mechanical strength is easily adjustable (48-456 MPa tensile strength) while ensuring shape stability (>87% shape retention after 100 burst loading/unloading cycles). We further study the cytotoxicity, monocyte/macrophage pro-inflammatory activation, and phenotype to demonstrate the prospective use of BNC as supportive implants with long-term comfort and minimal biomaterial fatigue.