Cellulose-based suture: State of art, challenge, and future outlook

Surgical sutures as the most widely used and high-value implanted materials are of vital importance in wound closure and healing. Among them, cellulose-based sutures with multifunctionality have been developed in recent decades, and are very promising to replace the fossil-based synthetic sutures. Therefore, this paper aims at covering the history and recent advances of cellulose-based suture, mainly including the materials used (e.g., natural cellulose, nanocellulose, and regenerated cellulose), fabrication methods and mechanism of wet spinning and the recently developed interfacial polyelectrolyte complexation spinning, as well as suture application performance (such as mechanical properties, cytocompatibility, biodegradability, absorbable properties, and antibacterial properties). More importantly, it summarizes all cellulose-based sutures, and then delves deep into the challenges and future outlook. Thus, this review provides an important reference for the development of high-end cellulose-based medical sutures.