Biomedical textiles are increasingly required to provide more than passive mechanical support; they must actively contribute to healing, protection, and tissue regeneration. Polysaccharide biopolymers, owing to their natural origin, biocompatibility, biodegradability, and rich chemical functionality, offer a versatile platform for engineering next-generation bioactive textile materials. This review presents a comprehensive analysis of recent advances in the functionalization of natural, synthetic, and regenerated textile substrates using key polysaccharides, including chitosan, alginate, carrageenan, pectin, and cellulose derivatives. Functionalization strategies ranging from physical coatings and covalent grafting to hydrogel formation, nanoparticle-polysaccharide hybrids, and advanced plasma-assisted or layer-by-layer techniques are critically examined. These approaches enable textiles to acquire antimicrobial activity, enhanced biocompatibility, controlled drug-release capabilities, improved moisture management, and tissue-regenerative properties. The major biomedical applications, including wound dressings, surgical textiles, tissue engineering scaffolds, and smart therapeutic or sensing fabrics, are discussed alongside the relevant characterization methods and biological performance evaluations. Current limitations, regulatory considerations, and commercialization challenges are also highlighted. Finally, future research directions are outlined to guide the development of multifunctional, eco-friendly, and clinically translatable polysaccharide-functionalized biomedical textiles. This review underscores the strategic importance of polysaccharides as sustainable, high-performance functionalization agents that can transform traditional textiles into intelligent biomedical systems.
Aba-alkhayl et al. (Sat,) studied this question.