Cellulose in Modern Wound Care
From Ancient Remedies to Advanced Biomaterials
Cellulose is the basic building block of most plant life and is therefore the most abundantly available biopolymer of our planet. It has long been used in medical applications, particularly for wound care applications. Historically, cellulose-based materials such as cotton gauze were used for wound dressing due to their absorbency and availability. Today, advancements in material science provide ample opportunity for Cellulose as both a versatile platform for developing wound care devices as well as a powerful enhancer of advanced wound management systems. Its multitude of possible properties based on morphology, mechanical and chemical treatment as well as application form provide options for a wide range of applications from simple wound protection over hemostasis to advanced wound care systems.
Historical Context and Current Trends
Cellulose's use in wound care dates back to the early 20th century with the introduction of cotton-based gauze. Over time, the limitations of traditional dressings—such as poor moisture retention and lack of bioactivity—led to the development of engineered cellulose derivatives. Today, cellulose is central to the design of smart wound dressings that integrate antimicrobial agents, drug delivery systems, and tissue scaffolds.
Forms of Cellulose in Wound Care
Modern wound dressings incorporate various forms of cellulose, each offering distinct properties. While chemical derivatives of cellulose open a wide spectrum of possible properties, this overview focuses on the forms most closely resembling the natural chemical structure of cellulose:
Viscose (Regenerated Cellulos)
Chemical treatment of natural cellulose allows for its dissolution and wet spinning into fibers or production of sheets, sponges, and many more application forms. Most common are viscose fibers. They are soft, absorbent, and commonly used in nonwoven wound dressings. Their ability to retain moisture supports a balanced wound environment conducive to healing.
Microcrystalline Cellulose (MC)
MCC is a purified, partially depolymerized cellulose, which, based on particle morphology, can provide porous carriers or serve as an interesting structural additive. It is mostly used as an enhancer to modify the properties of polymers and multilayer systems. In such composite dressings, MCC enhances mechanical strength and supports a moist healing environment.
Powdered Cellulose
Powdered cellulose can range from pure milled cellulose powder to milled pulp that also contains hemicellulose. After milling, the cellulose has the form of a fibrous powder. This form is often used for its absorbent properties, particularly in managing exudate-heavy wounds. It can be incorporated into absorbent pads or act as a filler in superabsorbent dressings.
Nanocellulose
Derived from cellulose nanocrystals (CNCs) or nanofibrils (CNFs), nanocellulose exhibits high surface area, mechanical strength, and biocompatibility. It mimics the extracellular matrix, promoting cell adhesion and tissue regeneration. Nanocellulose is used in hydrogels, films, and electrospun nanofibers for advanced wound dressings.
Applications in Wound Management
Hemostasis: Cellulose-based materials can promote clot formation by providing a scaffold that activates coagulation pathways. Oxidized cellulose, in particular, has been shown to accelerate hemostasis in trauma settings.
Primary Wound Care: Viscose and MCC are widely used in initial wound dressings. While Viscose fibers are a well suited dressing themselves, MCC finds use as additive in CMC Dressings and Alginates. These materials help protect the wound from external contaminants while maintaining a moist healing environment.
Exudate Absorption: Powdered Cellulose and nanocollulose are particularly effective in absorbing wound exudate. Their high surface area and porosity allow for efficient fluid management, reducing the risk of maceration. Nanocellulose can be used in a multitude of forms ranging from gels, over foams, to fibers and foils, while powdered cellulose is mostly used in powder form or as an additive to super absorber systems.
Chronic Wound Treatment: Chronic wounds, such as diabetic ulcers, benefit from cellulose-based hydrogels and nanofiber mats that deliver bioactive compounds (e.g., antibiotics, growth factors) and support tissue regeneration. Functionalized cellulose materials can also enhance cell adhesion and proliferation.
Conclusion
Cellulose continues to evolve as a cornerstone material in wound care, offering sustainable, biocompatible, and multifunctional solutions. From basic absorbent pads to advanced nanocomposite dressings, its versatility supports a wide range of clinical needs. Ongoing research into functionalization and composite technologies promises further improvements in healing outcomes, particularly for complex and chronic wounds.
