Traditional Chinese medicine polysaccharides in wound repair: From bioactive therapeutics to functional delivery...

Excessive inflammatory responses, reactive oxygen species accumulation, and infectious factors collectively constitute the primary barriers to wound healing, while traditional dressings have limited functionality and struggle to meet complex healing demands. Due to their excellent biocompatibility, degradability, and rich bioactivity, traditional Chinese medicine polysaccharides (TCMPs) demonstrate a unique "dual-role" integrated value in wound repair: serving both as "pharmacodynamic substances" that directly intervene in the repair process and as "functional carriers" for constructing advanced dressings. This review systematically deconstructs the application logic and implementation pathways of TCMPs in these dual roles. Starting from the physiological processes of wound healing, it focuses on analyzing the inhibitory mechanisms of excessive inflammation on vascularization and epithelialization; then focuses on the "pharmacodynamic substances" dimension, elucidating the multi-target regulatory capabilities of TCMPs in promoting coagulation, reshaping the inflammatory microenvironment, and driving cell proliferation and migration. Shifting to the "functional carrier" dimension, this review summarizes methods and advancements in constructing polysaccharide-based hydrogel dressings via physical, chemical, and hybrid crosslinking, illustrating structure-function synergistic design using Bletilla striata, Astragalus, and Gastrodia elata polysaccharides as representative examples. Further breaking away from traditional delivery paradigms, this review proposes a design leap from physical penetration to microenvironment responsiveness, demonstrating the integration potential of TCMPs in novel dressings such as microneedles and biomimetic dressings. Finally, by discussing key bottlenecks in the clinical translation of TCMPs into wound dressings, this review provides theoretical support and strategic guidance for the functional repositioning of natural polysaccharides in innovative dressing systems.