Abstract
BACKGROUND: The skin, as the largest organ of the human body, functions as a critical protective barrier against external threats such as pathogens, mechanical damage, and temperature extremes while regulating physiological homeostasis. However, acute and chronic wounds-ranging from surgical injuries to diabetic ulcers-pose significant global health and economic challenges due to their complex, often dysregulated healing processes involving intertwined cellular, molecular, and microenvironmental factors. Conventional dressings (gauze, films) face limitations in moisture regulation, mechanical compatibility, and bioactive modulation. Engineered hydrogels, with high water content, ECM-mimetic structures, and tunable properties, offer transformative solutions. While existing reviews focus on materials (natural/synthetic polymers) and fabrication (crosslinking, 3D printing), systematic analysis of innovative therapeutic applications remains underexplored. AIM OF REVIEW: This review systematically summarizes innovative hydrogel strategies spanning three key dimensions: functional (growth factor controlled release, cell/exosome delivery, coordinated regulation of inflammation and oxidative stress, angiogenesis promotion, and antibacterial defense), structural (multilayered biomimetic architectures and dynamic network designs), and technological (bioprinting and microfluidic techniques). It further explores the potential of cross-dimensional (function-structure-technology) synergy in advanced wound management. Considering current research challenges, future directions for constructing multidimensional-integrated engineered smart hydrogels are proposed, providing insights for developing intelligent wound dressings in the era of personalized precision medicine. KEY SCIENTIFIC CONCEPTS OF REVIEW: Multidimensional Hydrogel Design: Integration of functional (controlled delivery, immunomodulation, angiogenesis, antibacterial), structural (biomimetic layering, dynamic networks), and technological (bioprinting, microfluidics) strategies; Cross-Dimensional Synergy: The synergistic effect of function-structure-technology intergration in advanced wound management; Intelligent Wound Dressings: Application of smart hydrogel platforms towards personalized medicine in wound healing.