Smart natural polymer-based hydrogels for chronic wound management: advances in real-time monitoring and stimuli-responsive therapy

Chronic wounds have been a significant clinical challenge, owing to their persistent inflammation, poor regeneration, and high infection risk. This necessitates advanced strategies for real-time monitoring and effective treatment, and natural polymer-based hydrogels, composed of renewable materials such as polysaccharides, proteins, and plant-based macromolecules, serve as compelling candidates for engineering multifunctional smart dressing. This review summarizes recent advances in natural polymer-based smart hydrogels with a primary focus on their applications in wound monitoring and stimuli-responsive therapy. Following a brief overview of chronic wound pathophysiology and the fundamental design principles of natural polymer hydrogels, the integration of sensing mechanisms for real-time monitoring of critical wound biomarkers (e.g., pH, enzymes, temperature, reactive oxygen species (ROS)) is summarized. Particular emphasis is placed on integrated platforms that combine sensing and treatment capabilities. The review also discusses the integration of hydrogels with wearable electronics and closed-loop feedback mechanisms in advanced hybrid systems. Finally, the remaining challenges and future perspectives regarding the development of multimodal, artificial intelligence (AI)-assisted precision wound management technologies are outlined.