Harnessing Bioengineered Exosomes for Chronic Wound Repair Mechanisms, Strategies, and Applications

Abstract

Chronic wounds pose a persistent clinical challenge due to delayed healing, heightened infection risk, and the
limited efficacy of existing therapies. Exosome-based, cell-free interventions have emerged as promising options
exploiting the inherent capacity of exosomes to regulate inflammation, stimulate angiogenesis, and orchestrate
extracellular matrix transformation. The current assessment highlights new mechanisms, namely, that bioengineered
exosomes facilitate wound repair, together with a focus on their roles in immune transition, vascularization,
scar reduction, antimicrobial activity, and oxidative stress reduction. We present recent bioengineering strategies,
including heritable modification, preconditioning, the integration of biomaterials, and veneer functionalization,
which enhance exosome firmness, targeting, and curative efficacy. Preclinical research on chronic wound models,
such as diabetic ulcers and burns, is critically analyzed alongside a discussion of translational difficulties aimed
at scalability, safety, and standardization. Rising trends, including artificial intelligence-powered design and 3D
bioprinting, are exploring their potential to innovate regenerative medicine. This assessment aims to inform and
encourage future innovations in bioengineered exosomes for chronic wound repair by consolidating current signs
and analyzing discrepancies