Effective wound healing hinges on a precisely orchestrated tissue remodeling process that restores both structural integrity and functionality. This review delineates the molecular mechanisms by which chitosan-based hydrogels revolutionize wound repair. Derived from natural chitin, chitosan uniquely combines robust antimicrobial, hemostatic, and biodegradable properties with the capacity to modulate critical intracellular signaling cascades-including transforming growth factor-β, mitogen-activated protein kinase, and PI3K/AKT. These dynamic interactions drive fibroblast proliferation, stimulate the strategic transition from type III to type I collagen deposition, and finely tune extracellular matrix reorganization, thereby mitigating excessive fibrosis and minimizing scar formation. Notwithstanding its considerable therapeutic promise, clinical translation of chitosan-based hydrogels is tempered by challenges in mechanical stability and controlled degradation. We propose that advanced material engineering-encompassing precision cross-linking, nanoparticle integration, and synergistic stem cell-based strategies-could surmount these limitations. This comprehensive synthesis of current molecular insights sets the stage for next-generation regenerative biomaterials, positioning chitosan-based hydrogels as a paradigm-shifting platform for achieving superior healing outcomes in complex clinical scenarios.
Keywords: chitosan-based hydrogels; extracellular matrix; regenerative medicine; tissue remodeling; wound healing.