Natural and synthetic polymers in burn wound healing
Sepehr Zamani, Arian Ehterami, Ahmad Vaez, Mahdi Naeiji, Hasan Maghsoodifar, Seyed Amir Hossein Sadeghi Douki, Maryam Molaee Eshgh abad, Zohreh Arabpour, Nafiseh Baheiraei, Arash Farahani, Ali R. Djalilian, Majid Salehi
Abstract
Burn wound management presents significant therapeutic challenges due to the pathophysiological complexity of injured tissues, which disrupts healing and heightens risks of infection, dehydration, and scarring. This review systematically analyzes the efficacy of hydrogel- and non-hydrogel-based dressings in acute and sub-acute burn care. Hydrogels with a water content of more than 90% present an environment for healing by way of autolytic debridement, angiogenesis, fibroblast proliferation, and pain relief-they are extremely helpful in partial-thickness burns owing to their cooling and non-adherence characteristics. Additionally, hydrogels can deliver bioactive agents (e.g. antimicrobials) and manage moderate exudate, enhancing their utility in infected wounds. In contrast, non-hydrogel dressings-including foam, nanofiber, and film-based systems-are tailored for heavily exudative or deep burns (e.g. full-thickness injuries). Foam dressings combine high absorbency with mechanical protection, while electrospun nanofibers mimic the extracellular matrix to accelerate cell migration. Key determinants for polymer selection include hydrophilicity, adhesion properties, wound depth, exudate volume, and microbial load. Natural polymers like chitosan and alginate enhance biocompatibility and antimicrobial activity, whereas synthetic variants (e.g. polyurethane) provide mechanical stability. Composite systems integrate these advantages but face scalability limitations. Emerging innovations, such as pH-responsive and sensor-integrated smart dressings, alongside biomimetic designs, promise advancements in personalized burn care. This review examines the types of polymeric wound dressings and their strengths and weaknesses, addresses current limitations, and leverages technological advances to develop appropriate dressing solutions that can transform burn management paradigms.