Optimization Strategies of Polymeric Hydrogels and Decellularized Extracellular Matrices for Diabetic Chronic Wound Healing

ABSTRACT The treatment of chronic wounds in diabetes represents a significant challenge in the biomedical field. This review summarizes the application of three categories of biomaterials in this area: natural polymeric materials (gelatin, alginates, hyaluronic acid, chitosan), synthetic polymeric materials (polyvinyl alcohol, polydopamine), and decellularized matrices (dECM). It elucidates the characteristics, biological functions targeting chronic diabetic wounds, optimization strategies, current challenges, and future research directions for each material category. Specific optimization approaches include chemical modification and active substance loading for natural polymers, composite formation and functional regulation for synthetic polymers, and the preparation and application of dECM. It also highlights current limitations such as low mechanical strength, suboptimal degradation rates, and insufficient long‐term safety data. Future directions include smart responsive dressings, integration with novel therapeutic approaches, and personalized dECM design.