Exosome as emerging therapeutic platform for wound healing: Current status, advancement and future crosstalk

Wound healing, particularly in chronic wounds, remains a significant clinical challenge due to delayed recovery and limited efficacy of conventional treatments. Exosomes, which are nanosized extracellular vesicles released by cells, are promising mediators of intercellular communication and repair processes. They regulate angiogenesis, collagen synthesis, inflammation, and scar formation, thereby accelerating tissue repair. Recent evidence highlights that stem cell-derived exosomes can serve as a cell-free therapeutic alternative with superior efficacy and lower tumorigenic risk compared to stem cell transplantation because of their regenerative secretome. This review critically summarizes the current applications of exosomes in wound healing, including their role as natural drug carriers, interactions with biomaterials for sustained release, and modulation of molecular pathways across different healing phases. Furthermore, we discuss advances in engineered exosomes, recent clinical and preclinical results, and persisting challenges such as standardization, large-scale production, and safety considerations. By consolidating existing knowledge and future directions, this study underscores the potential of exosomes as a next-generation therapeutic platform to improve wound repair.