Chronic wounds: Current status, available strategies and emerging therapeutic solutions

In the past decades, adequate and well-planned management of chronic wounds has reached an elevated importance to improve human's quality of life and extend life expectancy. The need for more complex and biomimetic strategies has fueled the exploration of numerous emerging technologies. However, the development of new therapies requires an extensive knowledge of the wound healing process and the key players involved in it. In that sense, this review seeks to bring researchers an updated description of the wound healing process, combining the traditionally-told phase progression with the presence and function of diverse stem cells and other involved mediators. Furthermore, the present work discusses a wide variety of strategies for accelerating wound healing; from systemic or local dressing-free therapies, to cell-free dressings including films, biopolymeric porous scaffolds, electrospun nanofiber meshes and hydrogels. Finally, emerging therapy solutions derived from the development of 3D bioprinting and CRISPR/Cas9 technology or the application of extracellular vesicles in healing chronic wounds are also discussed. [Display omitted] •A well-planned care of chronic wounds is fundamental for human's quality of life.•Dressing therapies allow a controlled spatiotemporal delivery of biologicals.•Bioinspired dressings act as a temporary template for correct tissue remodeling.•3D-bioprinting helps the development of more complex and personalized dressings.•Extracellular vesicles are leading the new wave of cell-free wound healing therapies.