FGF2 in Burn Wound Healing: From Molecular Function to Clinical Application - A Systematic Review

Burn injuries trigger complex inflammatory and metabolic cascades that impair wound healing and increase morbidity. Fibroblast Growth Factor 2 (FGF2), a potent mediator of cellular proliferation, angiogenesis, and extracellular matrix remodeling, has emerged as a promising therapeutic agent in burn care. This systematic review evaluated the biological mechanisms, delivery strategies, and clinical outcomes associated with FGF2 in burn wound healing to clarify its therapeutic value and translational potential. Following PRISMA 2020 standards, a structured literature search was conducted across PubMed, EMBASE, Web of Science, Cochrane, and Google Scholar to identify studies investigating FGF2 in thermal injury. Eligible records included clinical trials, in vivo models, and in vitro experiments. Methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale, SYRCLE tool, and Oxford Levels of Evidence. Thirty-three studies (1992-2025) met inclusion criteria, encompassing randomized controlled trials, animal models, and mechanistic analyses. FGF2 accelerated repair by stimulating fibroblast proliferation, keratinocyte migration, angiogenesis, and matrix organization. Topical FGF2 formulations shortened healing time and improved scar quality in partial-thickness burns. Innovative carriers, including hydrogels, liposomes, and gene-activated matrices, enhanced bioavailability and sustained local effects. In diabetic and complex burn models, FGF2 mitigated inflammation, preserved barrier integrity, and promoted re-epithelialization. Efficacy depended on dosage and wound characteristics. Studies reported favorable safety profiles with few and mild adverse events. FGF2 demonstrates regenerative and immunomodulatory potential in burn management. Broader adoption requires harmonized regulatory evaluation, optimized delivery systems, and multicenter validation to define its role in precision-guided burn care.