Main Article Content
Approximately, 1 to 2% of the population in developed countries suffer from chronic wounds. Nearly 6.5 million Americans have suffered at least one chronic wound. Chronic wound treatment is critical for patients to maintain their mental and physical well-being and improve their life quality. Chronic wounds can be treated in various ways, including hyperbaric oxygen therapy, debridement, ultrasound, skin grafts, negative pressure wound therapy, electromagnetic therapies, and hydrogel dressings. Hydrogels are among the most viable and promising options since their tunable characteristics, such as adhesiveness, antimicrobial and biodegradability, pre-angiogenic bioactivities, and anti-inflammatory, are beneficial to healing chronic wounds. In in vivo studies utilizing animal models, hydrogel dressings emerged as multifunctional solutions for chronic wound healing. These investigations consistently demonstrated that hydrogel dressings accelerated wound healing rates compared to traditional methods and maintained an optimal moist wound environment, which fostered tissue regeneration while minimizing scarring. Moreover, the remarkable biocompatibility of hydrogel dressings became evident in these animal model experiments, as they showed minimal adverse reactions in chronic wound patients. The results of these in vivo studies collectively highlight the promising potential of hydrogel dressings as a versatile therapeutic option for effectively managing chronic wounds. This review discusses dressings made of hydrogel in animal models for their multifunctional properties and potential benefits in treating chronic wounds. The efficacy of hydrogel dressings over other kinds of dressings is also demonstrated by providing examples of commercially available hydrogel dressings.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Jeschke MG, van Baar ME, Choudhry MA, Chung KK, Gibran NS, Logsetty S. Burn injury. Nature Reviews Disease Primers. 2020;6(1):11.
Li R, Liu K, Huang X, Li D, Ding J, Liu B, et al. Bioactive materials promote wound healing through the modulation of cell behaviors. Advanced Science. 2022;9(10):2105152.
Falanga V, Isseroff RR, Soulika AM, Romanelli M, Margolis D, Kapp S, et al. Chronic wounds. Nature Reviews Disease Primers. 2022;8(1):50.
Las Heras K, Igartua M, Santos-Vizcaino E, Hernandez RM. Chronic wounds: Current status, available strategies, and emerging therapeutic solutions. Journal of controlled release. 2020;328:532-50.
McDermott K, Fang M, Boulton AJ, Selvin E, Hicks CW. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes Care. 2023;46(1):209-21.
Zhang K, Chai B, Ji H, Chen L, Ma Y, Zhu L, et al. Bioglass promotes wound healing by inhibiting endothelial cell pyroptosis through regulation of the connexin 43/reactive oxygen species (ROS) signaling pathway. Laboratory Investigation. 2022;102(1):90-101.
Dunnill C, Patton T, Brennan J, Barrett J, Dryden M, Cooke J, et al. Reactive oxygen species (ROS) and wound healing: the functional role of ROS and emerging ROS‐modulating technologies for augmentation of the healing process. International wound journal. 2017;14(1):89-96.
Menke NB, Ward KR, Witten TM, Bonchev DG, Diegelmann RF. Impaired wound healing. Clinics in dermatology. 2007;25(1):19-25.
Zhao R, Liang H, Clarke E, Jackson C, Xue M. Inflammation in chronic wounds. International journal of molecular sciences. 2016;17(12):2085.
Fan Z, Liu B, Wang J, Zhang S, Lin Q, Gong P, et al. A novel wound dressing based on Ag/graphene polymer hydrogel: effectively kill bacteria and accelerate wound healing. Advanced Functional Materials. 2014;24(25):3933-43.
Xu Z, Liu G, Huang J, Wu J. Novel glucose-responsive antioxidant hybrid hydrogel for enhanced diabetic wound repair. ACS applied materials & interfaces. 2022;14(6):7680-9.
Zhang Y, Wang T, Zhang D, Xia S, Jiao Z, Cai B, et al. Chitosan-based macromolecular hydrogel loaded total glycosides of paeony enhance diabetic wound healing by regulating oxidative stress microenvironment. International Journal of Biological Macromolecules. 2023;250:126010.
Xu Z, Liu G, Liu P, Hu Y, Chen Y, Fang Y, et al. Hyaluronic acid-based glucose-responsive antioxidant hydrogel platform for enhanced diabetic wound repair. Acta biomaterialia. 2022;147:147-57.
Zhang X, Feng J, Feng W, Xu B, Zhang K, Ma G, et al. Glycosaminoglycan-based hydrogel delivery system regulates the wound microenvironment to rescue chronic wound healing. ACS Applied Materials & Interfaces. 2022;14(28):31737-50.
Qi L, Zhang C, Wang B, Yin J, Yan S. Progress in hydrogels for skin wound repair. Macromolecular Bioscience. 2022;22(7):2100475.
Kumar R, Keshamma E, Kumari B, Kumar A, Kumar V, Janjua D, et al. Burn Injury Management, Pathophysiology, and Its Future Prospectives. Journal for Research in Applied Sciences and Biotechnology. 2022;1(4):78-89.
Lai-Cheong JE, McGrath JA. Structure and function of skin, hair, and nails. Medicine. 2013;41(6):317-20.
Lai-Cheong JE, McGrath JA. Structure and function of skin, hair, and nails. Medicine. 2017;45(6):347-51.
Losquadro WD. Anatomy of the skin and the pathogenesis of nonmelanoma skin cancer. Facial Plastic Surgery Clinics. 2017;25(3):283-9.
Kanitakis J. Anatomy, histology and immunohistochemistry of normal human skin. European journal of dermatology. 2002;12(4):390-401.
Enoch S, Leaper DJ. Basic science of wound healing. Surgery (Oxford). 2008;26(2):31-7.
Yang Y, Du Y, Zhang J, Zhang H, Guo B. Structural and functional design of electrospun nanofibers for hemostasis and wound healing. Advanced Fiber Materials. 2022;4(5):1027-57.
Guo B, Dong R, Liang Y, Li M. Haemostatic materials for wound healing applications. Nature Reviews Chemistry. 2021;5(11):773-91.
Nosrati H, Khodaei M, Alizadeh Z, Banitalebi-Dehkordi M. Cationic, anionic and neutral polysaccharides for skin tissue engineering and wound healing applications. International Journal of Biological Macromolecules. 2021;192:298-322.
Huang C, Dong L, Zhao B, Lu Y, Huang S, Yuan Z, et al. Anti‐inflammatory hydrogel dressings and skin wound healing. Clinical and Translational Medicine. 2022;12(11):e1094.
Čoma M, Fröhlichová L, Urban L, Zajíček R, Urban T, Szabo P, et al. Molecular changes underlying hypertrophic scarring following burns involve specific deregulations at all wound healing stages (inflammation, proliferation, and maturation). International Journal of Molecular Sciences. 2021;22(2):897.
Al Sadoun H. Macrophage phenotypes in normal and diabetic wound healing and therapeutic interventions. Cells. 2022;11(15):2430.
Mutluoglu M, Karabacak E, Karagöz H, Uzun G, Ay H. Topical ozone and chronic wounds: improper use of therapeutic tools may delay wound healing. North American journal of medical sciences. 2012;4(11):615.
Nischwitz SP, Popp D, Shubitidze D, Luze H, Zrim R, Klemm K, et al. The successful use of polylactide wound dressings for chronic lower leg wounds: A retrospective analysis. International Wound Journal. 2022;19(5):1180-7.
Kharaziha M, Baidya A, Annabi N. Rational design of immunomodulatory hydrogels for chronic wound healing. Advanced Materials. 2021;33(39):2100176.
Malone‐Povolny MJ, Maloney SE, Schoenfisch MH. Nitric oxide therapy for diabetic wound healing. Advanced healthcare materials. 2019;8(12):1801210.
Shaikh‐Kader A, Houreld NN, Rajendran NK, Abrahamse H. The link between advanced glycation end products and apoptosis in delayed wound healing. Cell Biochemistry and Function. 2019;37(6):432-42.
Xiong W, Zhang R, Zhou H, Liu Y, Liang M, Li K, et al. Application of nanomedicine and mesenchymal stem cells in burn injuries for the elderly patients. Smart Materials in Medicine. 2023;4:78-90.
Chen J, Bao X, Meng T, Sun J, Yang X. Zeolitic imidazolate framework-67 accelerates infected diabetic chronic wound healing. Chemical Engineering Journal. 2022;430:133091.
Tottoli EM, Dorati R, Genta I, Chiesa E, Pisani S, Conti B. Skin wound healing process and new emerging technologies for skin wound care and regeneration. Pharmaceutics. 2020;12(8):735.
Demidova-Rice TN, Hamblin MR, Herman IM. Acute and impaired wound healing: pathophysiology and current methods for drug delivery, part 1: normal and chronic wounds: biology, causes, and approaches to care. Advances in skin & wound care. 2012;25(7):304.
Rezvani Ghomi E, Khalili S, Nouri Khorasani S, Esmaeely Neisiany R, Ramakrishna S. Wound dressings: Current advances and future directions. Journal of Applied Polymer Science. 2019;136(27):47738.
Xu Z, Han S, Gu Z, Wu J. Advances and impact of antioxidant hydrogel in chronic wound healing. Advanced healthcare materials. 2020;9(5):1901502.
Boateng JS, Matthews KH, Stevens HN, Eccleston GM. Wound healing dressings and drug delivery systems: a review. Journal of pharmaceutical sciences. 2008;97(8):2892-923.
Skórkowska-Telichowska K, Czemplik M, Kulma A, Szopa J. The local treatment and available dressings are designed for chronic wounds. Journal of the American Academy of Dermatology. 2013;68(4):e117-e26.
Dhivya S, Padma VV, Santhini E. Wound dressings–a review. BioMedicine. 2015;5(4):22.
Chang R, Zhao D, Zhang C, Liu K, He Y, Guan F, et al. Nanocomposite multifunctional hyaluronic acid hydrogel with photothermal antibacterial and antioxidant properties for infected wound healing. International Journal of Biological Macromolecules. 2023;226:870-84.
Liang Y, He J, Guo B. Functional hydrogels as a wound dressing to enhance wound healing. ACS Nano. 2021;15(8):12687-722.
Thomas S, Uzun M. Testing dressings and wound management materials. Advanced textiles for wound care: Elsevier; 2019. p. 23-54.
Atiyeh BS, Ioannovich J, Al-Amm CA, El-Musa KA. Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing. Current pharmaceutical biotechnology. 2002;3(3):179-95.
Toppo FA, Pawar RS. Novel drug delivery strategies and approaches for wound healing management. J Crit Rev. 2015;2(2):12À20.
Savencu I, Iurian S, Porfire A, Bogdan C, Tomuță I. Review of advances in polymeric wound dressing films. Reactive and Functional Polymers. 2021;168:105059.
Kuddushi M, Shah AA, Ayranci C, Zhang X. Recent Advances in Novel Materials and Techniques for Developing Transparent Wound Dressings. Journal of Materials Chemistry B. 2023.
Jing X, Sun Y, Ma X, Hu H. Marine polysaccharides: Green and recyclable resources as wound dressings. Materials Chemistry Frontiers. 2021;5(15):5595-616.
Venkatrajah B, Malathy VV, Elayarajah B, Rajendran R, Rammohan R. Synthesis of carboxymethyl chitosan and coating on wound dressing gauze for wound healing. Pakistan Journal of Biological Sciences: PJBS. 2013;16(22):1438-48.
Obagi Z, Damiani G, Grada A, Falanga V. Principles of wound dressings: a review. Surg Technol Int. 2019;35:50-7.
Fries C, Ayalew Y, Penn-Barwell J, Porter K, Jeffery S, Midwinter M. Prospective randomized controlled trial of nanocrystalline silver dressing versus plain gauze as the initial post-debridement management of military wounds on wound microbiology and healing. Injury. 2014;45(7):1111-6.
Powers JG, Morton LM, Phillips TJ. Dressings for chronic wounds. Dermatologic therapy. 2013;26(3):197-206.
Nielsen J, Fogh K. Clinical utility of foam dressings in wound management: A review. Chronic Wound Care Management and Research. 2015:31-8.
Alvarez OM, Granick MS, Reyzelman A, Serena T. A prospective, randomized, controlled, crossover study comparing three multilayered foam dressings for the management of chronic wounds. Journal of Comparative Effectiveness Research. 2021;10(6):481-93.
Atkin L, Stephenson J, Bateman S. Foam dressings: a review of the literature and evaluation of the fluid-handling capacity of four leading foam dressings. Wounds UK. 2015;11(1):75-81.
Rezvani Ghomi E, Niazi M, Ramakrishna S. The evolution of wound dressings: From traditional to smart dressings. Polymers for Advanced Technologies. 2023;34(2):520-30.
Kamińska MS, Cybulska AM, Skonieczna-Żydecka K, Augustyniuk K, Grochans E, Karakiewicz B. Effectiveness of hydrocolloid dressings for treating pressure ulcers in adult patients: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2020;17(21):7881.
Mahmoudi M, Gould LJ. Opportunities and challenges of the management of chronic wounds: a multidisciplinary viewpoint. Chronic Wound Care Management and Research. 2020:27-36.
Firlar I, Altunbek M, McCarthy C, Ramalingam M, Camci-Unal G. Functional hydrogels for treatment of chronic wounds. Gels. 2022;8(2):127.
Wu SD, Dai NT, Liao CY, Kang LY, Tseng YW, Hsu Sh. Planar‐/Curvilinear‐Bioprinted Tri‐Cell‐Laden Hydrogel for Healing Irregular Chronic Wounds. Advanced Healthcare Materials. 2022;11(16):2201021.
Puertas-Bartolomé M, Benito-Garzon L, Fung S, Kohn J, Vázquez-Lasa B, San Román J. Bioadhesive functional hydrogels: Controlled release of catechol species with antioxidant and antiinflammatory behavior. Materials Science and Engineering: C. 2019;105:110040.
Xue L, Deng T, Guo R, Peng L, Guo J, Tang F, et al. A composite hydrogel containing mesoporous silica nanoparticles loaded with artemisia argyi extract for improving chronic wound healing. Frontiers in Bioengineering and Biotechnology. 2022;10:825339.
Zhang W, Liu W, Long L, He S, Wang Z, Liu Y, et al. Responsive multifunctional hydrogels are emulating the chronic wound healing cascade for skin repair. Journal of Controlled Release. 2023;354:821-34.
Tu C, Lu H, Zhou T, Zhang W, Deng L, Cao W, et al. Promoting the healing of infected diabetic wounds by an anti-bacterial and nano-enzyme-containing hydrogel with inflammation-suppressing, ROS-scavenging, oxygen, and nitric oxide-generating properties. Biomaterials. 2022;286:121597.
Pei J, Palanisamy CP, Alugoju P, Anthikapalli NVA, Natarajan PM, Umapathy VR, et al. A comprehensive review on bio-based materials for chronic diabetic wounds. Molecules. 2023;28(2):604.
Bandehali S, Sanaeepur H, Amooghin AE, Shirazian S, Ramakrishna S. Biodegradable polymers for membrane separation. Separation and Purification Technology. 2021;269:118731.
Franz S, Rammelt S, Scharnweber D, Simon JC. Immune responses to implants–a review of the implications for the design of immunomodulatory biomaterials. Biomaterials. 2011;32(28):6692-709.
Pereira RF, Bártolo PJ. 3D bioprinting of photocrosslinkable hydrogel constructs. Journal of Applied Polymer Science. 2015;132(48).
Divyashri G, Badhe RV, Sadanandan B, Vijayalakshmi V, Kumari M, Ashrit P, et al. Applications of hydrogel‐based delivery systems in wound care and treatment: an up‐to‐date review. Polymers for Advanced Technologies. 2022;33(7):2025-43.
Hu H, Xu F-J. Rational design and latest advances of polysaccharide-based hydrogels for wound healing. Biomaterials science. 2020;8(8):2084-101.
Fang W, Yang M, Wang L, Li W, Liu M, Jin Y, et al. Hydrogels for 3D bioprinting in tissue engineering and regenerative medicine: Current progress and challenges. International Journal of Bioprinting. 2023;9(5).
Utech S, Boccaccini AR. A review of hydrogel-based composites for biomedical applications: enhancement of hydrogel properties by addition of rigid inorganic fillers. Journal of materials science. 2016;51:271-310.
Zhu J, Zhou H, Gerhard EM, Zhang S, Rodríguez FIP, Pan T, et al. Smart bioadhesives for wound healing and closure. Bioactive Materials. 2023;19:360-75.
He JJ, McCarthy C, Camci-Unal G. Development of Hydrogel‐Based Sprayable Wound Dressings for Second‐and Third‐Degree Burns. Advanced NanoBiomed Research. 2021;1(6):2100004.
Li M, Pan G, Zhang H, Guo B. Hydrogel adhesives for generalized wound treatment: Design and applications. Journal of Polymer Science. 2022;60(8):1328-59.
Sun C, Zeng X, Zheng S, Wang Y, Li Z, Zhang H, et al. Bio-adhesive catechol-modified chitosan wound healing hydrogel dressings through glow discharge plasma technique. Chemical Engineering Journal. 2022;427:130843.
Zhang Y, Wang Y, Li Y, Yang Y, Jin M, Lin X, et al. Application of Collagen-Based Hydrogel in Skin Wound Healing. Gels. 2023;9(3):185.
Maheswary T, Nurul AA, Fauzi MB. The insights of microbes’ roles in wound healing: A comprehensive review. Pharmaceutics. 2021;13(7):981.
Zhang X, Qin M, Xu M, Miao F, Merzougui C, Zhang X, et al. The fabrication of antibacterial hydrogels for wound healing. European Polymer Journal. 2021;146:110268.
Cao Z, Luo Y, Li Z, Tan L, Liu X, Li C, et al. Antibacterial hybrid hydrogels. Macromolecular Bioscience. 2021;21(1):2000252.
Satti MK, Humayun S, Sajid M, Asdaq KN, Ashraf T, Aftab M. Hydrogels for Wound Dressing Applications-A Systematic Review. Pakistan Journal of Medical & Health Sciences. 2023;17(03):2-.
Carpa R, Remizovschi A, Culda CA, Butiuc-Keul AL. Inherent and composite hydrogels are promising materials to limit antimicrobial resistance. Gels. 2022;8(2):70.
Del Olmo JA, Pérez-Álvarez L, Sáez-Martínez V, Benito-Cid S, Ruiz-Rubio L, Pérez-González R, et al. Wound healing and antibacterial chitosan-genipin hydrogels with controlled drug delivery for synergistic anti-inflammatory activity. International Journal of Biological Macromolecules. 2022;203:679-94.
Chen R, Han Z, Huang Z, Karki J, Wang C, Zhu B, et al. Antibacterial activity, cytotoxicity, and mechanical behavior of nano-enhanced denture base resin with different kinds of inorganic antibacterial agents. Dental materials journal. 2017;36(6):693-9.
Li S, Dong S, Xu W, Tu S, Yan L, Zhao C, et al. Antibacterial hydrogels. Advanced science. 2018;5(5):1700527.
Díez-Pascual AM. Antibacterial activity of nanomaterials. MDPI; 2018. p. 359.
Yu R, Zhang H, Guo B. Conductive biomaterials as bioactive wound dressing for wound healing and skin tissue engineering. Nano-micro letters. 2022;14:1-46.
Vargas-Reus MA, Memarzadeh K, Huang J, Ren GG, Allaker RP. Antimicrobial activity of nanoparticulate metal oxides against peri-implantitis pathogens. International journal of antimicrobial agents. 2012;40(2):135-9.
Wang X, Song R, Johnson M, Shen P, Zhang N, Lara‐Sáez I, et al. Chitosan‐Based Hydrogels for Infected Wound Treatment. Macromolecular Bioscience. 2023:2300094.
Sahu A, Jeon J, Lee MS, Yang HS, Tae G. Antioxidant and anti-inflammatory activities of Prussian blue enzyme promotes full-thickness skin wound healing. Materials Science and Engineering: C. 2021;119:111596.
Feng P, Luo Y, Ke C, Qiu H, Wang W, Zhu Y, et al. Chitosan-based functional materials for skin wound repair: Mechanisms and applications. Frontiers in Bioengineering and Biotechnology. 2021;9:650598.
Saravanakumar K, Park S, Santosh SS, Ganeshalingam A, Thiripuranathar G, Sathiyaseelan A, et al. Application of hyaluronic acid in tissue engineering, regenerative medicine, and nanomedicine: A review. International Journal of Biological Macromolecules. 2022.
Lei H, Zhao J, Li H, Fan D. Paramylon hydrogel: A bioactive polysaccharides hydrogel that scavenges ROS and promotes angiogenesis for wound repair. Carbohydrate Polymers. 2022;289:119467.
Landén NX, Li D, Ståhle M. Transition from inflammation to proliferation: a critical step during wound healing. Cellular and Molecular Life Sciences. 2016;73:3861-85.
Haque ST, Saha SK, Haque ME, Biswas N. Nanotechnology-based therapeutic applications: in vitro and in vivo clinical studies for diabetic wound healing. Biomaterials science. 2021;9(23):7705-47.
Augustine R, Rehman SRU, Ahmed R, Zahid AA, Sharifi M, Falahati M, et al. Electrospun chitosan membranes containing bioactive and therapeutic agents for enhanced wound healing. International journal of biological macromolecules. 2020;156:153-70.
Saghazadeh S, Rinaldi C, Schot M, Kashaf SS, Sharifi F, Jalilian E, et al. Drug delivery systems and materials for wound healing applications. Advanced drug delivery reviews. 2018;127:138-66.
Li J, Mooney DJ. Designing hydrogels for controlled drug delivery. Nature Reviews Materials. 2016;1(12):1-17.
Li Z, Zhao Y, Liu H, Ren M, Wang Z, Wang X, et al. pH-responsive hydrogel loaded with insulin as a bioactive dressing for enhancing diabetic wound healing. Materials & Design. 2021;210:110104.
Güiza-Argüello VR, Solarte-David VA, Pinzón-Mora AV, Ávila-Quiroga JE, Becerra-Bayona SM. Current advances in the development of hydrogel-based wound dressings for diabetic foot ulcer treatment. Polymers. 2022;14(14):2764.