From Concept to Clinic: Innovative Applications and Design Evolution of Microneedles in Wound Healing

Wound healing is a complex and dynamic biological process that can be disrupted by various pathological factors, including abnormal inflammatory responses, biofilm formation, impaired angiogenesis, neural dysfunction, and pathological fibrosis. Such complexities pose substantial challenges in wound management, highlighting the urgent need for advanced, adaptive, and comprehensive therapeutic strategies. Recently, microneedles (MNs) have garnered significant attention in wound healing for their remarkable ability to penetrate tissue barriers and deliver therapeutics efficiently. However, there remains a lack of comprehensive reviews that systematically bridge the gap between advanced material design and the hurdles of clinical translation. This review summarizes recent advancements in MN technology, analyzing the design evolution from passive delivery tools to bioactive, stimuli-responsive scaffolds and smart systems with integrated sensing and feedback capabilities. Additionally, we explore stage-specific therapeutic strategies across different wound types to address specific barriers such as exudate management and labile payload stability. Finally, we critically assess translational requirements - including sterility assurance, mechanical safety, and regulatory considerations for drug-device combination products - to support the development of clinically deployable MN technologies.