The next generation of alginate dressings: recent innovations for chronic wound healing

Chronic wounds remain a major clinical challenge with a huge associated socioeconomic burden. Therefore, multifunctional biomaterials that can simultaneously manage exudate, modulate inflammation, prevent infection and promote tissue regeneration are extremely needed. Alginate, a naturally derived and highly biocompatible polysaccharide, has long been used in the clinic for advanced wound care due to its intrinsic gel-forming ability and capacity to maintain a moist healing environment. However, commercially available products are primarily designed to absorb exudate and physically protect the wound, while offering limited support for other key therapeutic goals, including modulation of inflammation and stimulation of tissue repair and regeneration. This review highlights the most recent innovations aimed at enhancing alginate's therapeutic potential, either through physicochemical modifications of hydrogels or by expanding beyond traditional hydrogel formats into novel alginate architectures that offer improved tissue integration, tunability and controlled release of substances. The review also outlines synergistic formulations combining alginate with other biomaterials, bioactive molecules and cell-derived products to enhance its mechanical properties and antimicrobial performance, as well as to address immunomodulation and promote regeneration in chronic wounds. Together, these emerging approaches underscore alginate's versatility and potential as a multifunctional platform for next-generation chronic wound therapies.