Multifunctional Hydrogel‐Based wound Dressings for Scar‐Free Healing: Design Principles, Therapeutic Mechanisms, and Clinical Translation Challenges

Pathological scarring imposes a substantial global healthcare burden, affecting over 100 million individuals annually with costs exceeding $20 billion. Current therapies yield suboptimal outcomes due to limited efficacy and recurrence. Hydrogel‐based wound dressings have emerged as transformative platforms due to their tunable physicochemical properties, bioactivity, and ability to modulate the wound microenvironment. This review uniquely integrates scar biology with hydrogel‐based therapeutic strategies. A phase‐specific framework that correlates hydrogel functions is provided with key scar‐influencing events, including inflammation regulation, fibroblast reprograming, extracellular matrix remodeling, and skin appendage regeneration. Moreover, cutting‐edge innovations are highlighted such as stimuli‐responsive hydrogels (pH/temperature/light), nanocomposite systems, and 3D‐printed scaffolds that enable spatiotemporal control of drug release and dynamic microenvironment modulation. Furthermore, unresolved clinical translation barriers are critically addressed, including scalability, standardization, biocompatibility, and immune response variability, proposing interdisciplinary solutions. By synthesizing recent advances and persistent limitations, this work provides a translational roadmap for developing next‐generation hydrogels to bridge the gap between benchtop innovation and clinical scar‐free tissue regeneration.