Smart Bioresponsive Hydrogels for Chronic Wound Healing: Design, Therapeutic Functionalization, and Emerging Digital Health Integration

Smart bioresponsive hydrogels have emerged as a transformative solution for the management of chronic wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure sores, which are often complicated by persistent inflammation, infection, and biochemical dysregulation. Unlike traditional dressings, these advanced materials are engineered to respond to intrinsic wound stimuli such as pH, reactive oxygen species (ROS), glucose, and enzymatic activity, enabling spatially and temporally controlled drug release. This review comprehensively examines the design principles, biochemical triggers, and functionalization strategies behind stimuli responsive hydrogels. We explore diverse hydrogel classes, including single and multi-stimuli systems, and in-depth functional augmentations, such as antibacterial agents, angiogenic growth factors, and self-healing adhesion mechanisms. A major emphasis is placed on emerging integration with digital health platforms such as wearable biosensors, implantable systems, and AI driven wound analytics, which enable real time monitoring and closed loop drug delivery. Comparative analyses between academic prototypes and existing commercial products are discussed alongside translational barriers related to clinical trials, regulatory challenges, and manufacturing scalability. The review concludes by outlining a prospective roadmap for AI personalized, multifunctional all-in-one hydrogel systems that integrate biomaterials with biosensing and telemedicine capabilities. This manuscript provides a detailed and timely resource for researchers, clinicians, and bioengineers seeking to bridge the gap between hydrogel innovation and clinical impact.