Hyaluronic Acid-Based Biomaterials for Soft Tissue Repair and Wound Healing: Clinical Evidence and Emerging Applications

Hyaluronic acid (HA) is a glycosaminoglycan that is found within the body and has both structural and signaling functions in the extracellular matrix. HA is biocompatible and biodegradable; it has a high water content and binds directly to certain cell-surface proteins. Due to these characteristics, it is considered a promising component for the design of biomaterials for regenerative wound healing. This review covers the most recent findings on the use of HA-based biomaterials in soft tissue repair, while also incorporating earlier, foundational studies relevant to the field, focusing on HA's characteristics, cellular interactions, design, and preclinical and clinical results. The physicochemical characteristics of HA and their influence on cellular responses and tissue regeneration are discussed to show how material properties can be adjusted for specific therapeutic purposes. There have been great advances in chemically modified composite scaffolds and HA matrices, which offer better mechanical stability and controlled degradation. At the same time, new delivery systems have been built using HA, from nanoparticles to gene delivery platforms and growth factors, and these have given the material an active role as a therapeutic agent rather than just a passive one. This narrative review covers the clinical evidence for the effectiveness of commercial products for acute and diabetic wounds, as well as burns and chronic wounds, and discusses where their use is indicated. In the end, the current limitations of the research and future applications and directions are discussed.