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. 2026 Oct 16;14:1976532. doi: 10.3389/fbioe.2026.1976532

FIGURE 5.

Illustration showing how EVs-loaded hydrogel promotes wound healing by providing a moist environment, mechanical protection, antibacterial action, oxygen supply, and microenvironment modulation, enabling sustained EVs release that regulates inflammation, promotes angiogenesis, activates fibroblasts, remodels ECM, and enhances cell proliferation and migration for effective transition from inflammatory to remodeling phases.

Biological mechanisms by which hydrogel-EV systems promote wound healing. Hydrogel-mediated EV delivery can regulate multiple interconnected processes involved in wound repair, including inflammatory modulation, angiogenesis, extracellular matrix (ECM) remodeling, and cell proliferation and migration. EV cargos can influence macrophage polarization and inflammatory cytokine production, promote endothelial-cell migration and neovascularization, regulate fibroblast activity and collagen deposition/remodeling, and enhance keratinocyte proliferation and re-epithelialization. EVs, extracellular vesicles; ECM, extracellular matrix; ROS, reactive oxygen species; VEGF, vascular endothelial growth factor; PDGF, platelet-derived growth factor.