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Polyhydroxyalkanoates (PHAs) are bacteria derived bio-based polymers that are synthesised under limited conditions of nutritional elements with excess carbon sources. Among the members of PHAs, poly(3-hydroxybutyrate- co -4-hydroxybutyrate) [(P(3HB- co -4HB)] emerges as an attractive biomaterial to be applied in medical applications owing to its desirable mechanical and physical properties, non-genotoxicity and biocompatibility eliciting appropriate host tissue responses. The tailorable physical and chemical properties and easy surface functionalisation of P(3HB- co -4HB) increase its practicality to be developed as functional medical substitutes. However, its applicability is sometimes limited due to its hydrophobic nature due to fewer bio-recognition sites. In this review, we demonstrate how surface modifications of PHAs, mainly P(3HB- co -4HB), will overcome these limitations and facilitate their use in diverse medical applications. The integration of nanotechnology has drastically enhanced the functionality of P(3HB- co -4HB) biomaterials for application in complex biological environments of the human body. The design of versatile P(3HB- co -4HB) materials with surface modifications promise a non-cytotoxic and biocompatible material without inducing severe inflammatory responses for enhanced effective alternatives in healthcare biotechnology. The enticing work carried out with P(3HB- co -4HB) promises to be one of the next-generation materials in biomedicines which will facilitate translation into the clinic in the future.

Surface-Modified Highly Biocompatible Bacterial-poly(3-hydroxybutyrate-co-4-hydroxybutyrate): A Review on the Promising Next-Generation Biomaterial