Abstract

Chronic and complex wounds remain a major clinical and socioeconomic burden, particularly in aging and diabetic populations. Modern wound dressings have gradually shifted from passive coverage to bioactive and device-integrated systems that actively modulate the wound microenvironment. Conventional moist dressings are typified by hydrocolloids, in which hydrophilic particles such as gelatin, pectin and carboxymethylcellulose are dispersed in an adhesive matrix usually supported by an occlusive polyurethane film. These dressings primarily provide passive treatment by absorbing exudate, maintaining a moist environment and relying on intrinsic self-healing capacity. In contrast, hydrogels are pre-hydrated three-dimensional networks that can conform closely to the wound bed, allow gas exchange and act as versatile carriers for bioactive molecules. Recent hydrogel systems have evolved into multifunctional platforms with adhesive, antibacterial, hemostatic, conductive and self-healing properties, often designed to deliver small molecules, growth factors or nanoparticles to address infection, oxidative stress and impaired angiogenesis. Hydrocolloids and other moist-retentive dressings are still widely used in clinical practice, but are increasingly complemented by Extracellular Matrix (ECM) based and decellularized scaffolds that better recapitulate native dermal architecture and provide bioactive cues for re-epithelialization. In parallel, drug-eluting dressings and nanoparticle-reinforced hydrogels offer spatiotemporally controlled therapy tailored to diabetic and pressure ulcers. Advanced treatment technologies such as negative pressure wound therapy and electroceutical or self-powered electrical dressings are being integrated with soft, conformable materials to deliver mechanical microdeformation, manage exudate and provide controlled micro-electrostimulation at the wound bed. Emerging smart dressings that combine sensing, data connectivity and on-demand actuation illustrate the convergence of biomaterials, drug delivery and bioelectronics toward integrated, intelligent wound care platforms.

Keywords:Wound dressing; Hydrogel; Hydrocolloid; Extracellular matrix; Decellularized matrix; Drugloaded dressing; Negative pressure wound therapy; Electrical stimulation; Smart dressing; Chronic wound

Abbreviations: ECM: Extracellular Matrix; DECM: Decellularized Extracellular Matrix; NPWT: Negative Pressure Wound Therapy; ES: Electrical Stimulation; ROS: Reactive Oxygen Species; DFU: Diabetic Foot Ulcer; NP: Nanoparticle