International Journal of Molecular Medical Science, 2025, Vol.15, No.5, 214-223 http://medscipublisher.com/index.php/ijmms 218 suitable for various types of wounds. In particular, synthetic hydrogels can provide a moist environment to support cell growth and can also be used for drug delivery or in combination with sensors (Liang et al., 2025). Composite dressings combine the advantages of natural polymers and synthetic polymers. For example, hydrogels made by combining collagen or chitosan with synthetic polymers not only enhance biocompatibility but also maintain good mechanical properties (Ribeiro et al., 2024). By adding nanoparticles, antibacterial components or growth factors, such materials can also acquire more functions, thereby achieving better antibacterial, anti-inflammatory and healing promotion effects. The development of high-strength and high-adaptability composite hydrogels will become an important development direction of wound care materials in the future (Wu et al., 2025). 4.3 Functional intelligent dressings The emergence of functional and intelligent dressings represents a significant advancement in the field of regenerative wound care. This dressing can respond to specific local stimuli at the wound site (such as pH value, temperature, glucose or reactive oxygen species (ROS)), thereby completing drug release, gel decomposition or other therapeutic effects (Psarrou et al., 2023). For instance, when encountering infections or abnormal metabolism, hydrogels that can detect changes in pH or glucose levels will release antibacterial components or growth factors. As for systems sensitive to temperature or light, they can initiate the processing procedure under the corresponding external signal stimulation (Mottaghitalab and Farokhi, 2024). The latest research has proposed multi-stimula-response dressings that can more precisely accommodate different stages of the same wound healing (Chen et al., 2023). These smart materials can also be integrated with biosensors to monitor the status of wounds in real time and support individualized treatment (Ribeiro et al., 2024). With the aid of advanced drug release systems, self-repair and adaptive functions, functional intelligent dressings have shown great potential in promoting the repair of chronic and complex wounds. 5 Molecular Mechanisms of Regenerated Dressings in Healing 5.1 Molecular mechanisms promoting cell adhesion, migration and proliferation Regenerative dressings accelerate tissue repair by influencing cell behavior. Chiral hydrogels and silk fibro-based dressings and other materials can simulate the structure of natural extracellular matrix (ECM), activate integrin-related signaling pathways, and thereby promote cell adhesion, migration and proliferation. For instance, dextrorotatory hydrogels can enhance the adsorption of type I collagen and activate the proliferation and migration of keratinocytes through integrins and YAP signaling, thereby accelerating the epithelialization process of chronic wounds (Figure 2) (Zhu et al., 2022). Similarly, β -single silk fibroin dressings can up-regulate the expression of integrin β1 and ECM proteins, promote fibroblast motility and granulation tissue formation, all of which are key links in the repair process. In addition to structural bionics, regenerative dressings can also regulate intracellular signal responses. For example, plasma-treated dressings can regulate adhesion kinases and cytoskeleton proteins, thereby enhancing cell motility and matrix remodeling ability. These effects can cause changes in the expression of genes and proteins related to cell adhesion, migration and proliferation, promote the coordinated work of keratinocytes and fibroblasts, and accelerate wound healing (Chou et al., 2021; Zhu et al., 2022). 5.2 Activation of angiogenesis and growth factor signaling pathways One important function of regenerative dressings is to help blood vessels grow and improve blood flow, thereby supporting tissue repair. A variety of dressings can transport or stimulate factors that promote vascular growth, such as VEGF, FGF and TGF-β. For example, hydrogels containing specific peptide or growth factor plasmids can increase the production of VEGF and stabilize its release, thereby promoting angiogenesis and accelerating healing (Lou et al., 2020; Shang et al., 2024). The initiation of pathways such as VEGF-Akt and FGFR/JAK2/STAT3 is directly related to endothelial cell migration, division and formation of tubular structures, which are key links in neovascularization development.
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