Oxygen-Releasing Exosome Hydrogels for Hypoxic Wounds: A Combined Approach to Enhance Healing in Chronic Ulcers

Chronic wounds, such as diabetic ulcers and pressure sores, are notoriously difficult to treat due to persistent hypoxia, inflammation, and impaired tissue regeneration. Current therapies, such as oxygen therapy and conventional wound dressings, often fail to achieve adequate healing, especially in hypoxic environments. This review highlights an innovative approach that combines oxygen-releasing hydrogels with exosome-based therapies to enhance wound healing. Oxygen-releasing hydrogels sustain localised oxygen delivery, essential for promoting cellular functions such as metabolism, angiogenesis, and collagen synthesis. Simultaneously, exosomes, derived from sources like mesenchymal stem cells, offer bioactive molecules including proteins, RNAs, and growth factors that help modulate inflammation, stimulate cell proliferation, and accelerate tissue regeneration. This dual-action therapy simultaneously addresses oxygen deficiency and the need for regenerative signalling in chronic wounds. Preclinical studies demonstrate that combining these technologies can enhance wound healing by reducing inflammation, increasing vascularization, and promoting faster re-epithelialization. Although the results are promising, further research is needed to optimise the co-delivery of oxygen and exosomes for long-term therapeutic efficacy. This narrative review explores the potential of oxygen-releasing exosome hydrogels as a transformative strategy for treating chronic wounds, with significant implications for improving patient outcomes.