多功能水凝胶伤口敷料：材料设计、促愈合机制与临床转化

Multifunctional Hydrogel Wound Dressings: Material Design, Pro-Healing Mechanisms and Clinical Translation

摘要: 水凝胶伤口敷料具有高含水率、柔软贴合、可塑形和药物负载能力，是创面管理的重要材料平台。本文围绕“材料–结构–功能–机制–转化”主线，综述天然与合成高分子水凝胶的结构特征、改性策略及适用场景，总结动态交联、双网络增强、纳米复合、注射、喷涂、3D打印和微针等策略对敷料黏附、抗菌、抗氧化、控释及力学适配性能的调控作用。在此基础上，本文进一步从典型原创研究案例、技术优劣辨析及临床转化壁垒等角度，分析多功能水凝胶由实验室研究走向临床应用所面临的监管评价、灭菌兼容性、成本效益和临床需求匹配问题。水凝胶促进愈合的核心机制包括维持湿性微环境、模拟细胞外基质、抑制感染与炎症、递送活性因子及实现动态力学适配。未来研究应从单纯功能叠加转向需求导向设计，强化构效关系验证、标准化制备和临床转化评价，以推动水凝胶敷料实现安全、有效和可制造的精准修复。

Abstract: Hydrogel wound dressings, characterized by high water content, soft conformability, shape adaptability, and drug-loading capacity, have become an important material platform for wound management. Following the framework of “materials-structures-functions-mechanisms-translation”, this review summarizes the structural characteristics, modification strategies, and application scenarios of natural and synthetic polymer-based hydrogels, and discusses how dynamic crosslinking, double-network reinforcement, nanocomposites, injectable and sprayable systems, 3D printing, and microneedles regulate adhesion, antibacterial activity, antioxidant capacity, controlled release, and mechanical adaptation. On this basis, this review further analyzes the barriers encountered in translating multifunctional hydrogels from laboratory research to clinical application, including regulatory evaluation, sterilization compatibility, cost-effectiveness, and alignment with clinical needs, from the perspectives of representative original case studies, technical trade-offs, and clinical translation challenges. Hydrogels promote wound healing mainly by maintaining a moist microenvironment, mimicking the extracellular matrix, inhibiting infection and inflammation, delivering bioactive factors, and enabling dynamic mechanical adaptation. Future studies should shift from simple multifunctional integration toward demand-oriented design, and strengthen structure-function validation, standardized fabrication, and translational evaluation to advance hydrogel dressings toward safe, effective, and manufacturable precision wound repair.