Therapeutic Potential of Microbial Exopolysaccharides in Skin Wound Healing: A Systematic Review and Meta-Analysis of In Vivo Experimental Studies in Rat Models

Background/Objectives: Microbial exopolysaccharides (EPS) are complex biopolymers that mimic the native extracellular matrix and have emerged as promising biomaterials for tissue regeneration. Methods: This study aimed to evaluate the therapeutic potential of microbial EPS in the healing of cutaneous wounds through a systematic review and meta-analysis of in vivo experimental studies in rat models. Conducted in accordance with the PRISMA guidelines, a search of the Scopus, Embase, and ScienceDirect databases identified 2496 records. After rigorous screening, 17 rat studies were included in the quantitative synthesis, comprising 181 animals and 398 wounds (199 treated with EPS and 199 controls). Results: Treatment with EPS promoted a mean healing rate of 90.46% (range: 9.1% to 100%) on day 14, reflecting the heterogeneity of the included studies. The meta-analysis revealed an overall mean difference of 21.15% (95% CI: 17.89 to 24.42; p < 0.0001) in favor of EPS compared with the control group. Conclusions: These findings support the potential for translating EPS-based therapies from rodent models to human wounds, although the substantial heterogeneity of the evidence and the absence of clinical data indicate that controlled clinical trials remain essential to validate their application in humans.