Recent Advances in Bioactive Hydrogel Composites for Wound Healing: Mechanisms, Materials and Clinical Prospects

Wound healing is a complex and dynamic biological process that can be significantly impaired by infection, chronic inflammation, and underlying systemic conditions such as diabetes and vascular disorders. Conventional wound dressings primarily provide physical protection and often fail to actively support tissue regeneration or regulate the wound microenvironment, leading to delayed healing and increased complications. In this context, bioactive hydrogel composites have emerged as promising advanced wound care materials due to their ability to mimic the extracellular matrix, maintain a moist environment, and deliver therapeutic agents in a controlled manner. This review summarizes recent advances in the design and application of bioactive hydrogel composites for wound healing and tissue regeneration. Emphasis is placed on the classification of hydrogels based on natural, synthetic, composite, and hybrid polymers, as well as their unique physicochemical and biological properties. The mechanisms by which these hydrogels promote healing-such as enhanced cell adhesion, proliferation, migration, angiogenesis, and modulation of inflammation-are discussed in detail. In addition, advances in fabrication strategies, including physical and chemical crosslinking, injectable systems, stimuli-responsive hydrogels, and 3D-printable bioinks, are highlighted. Key in vitro and in vivo evaluation parameters relevant to wound healing applications are also reviewed. Finally, current clinical prospects, translational challenges, and future directions-including personalized and theranostic hydrogel systems are outlined. Overall, bioactive hydrogel composites represent versatile and multifunctional platforms with significant potential to overcome the limitations of conventional wound care and improve clinical outcomes.