Recent Advances in Natural Polysaccharide-Based Materials for Wound Healing: Chitosan, Konjac Glucomannan and Cellulose

Wound healing is a complex and dynamic process essential for restoring the integrity of damaged skin. It requires wound dressings that actively regulate the wound microenvironment by preventing infection, maintaining moisture balance, allowing gas exchange, and managing exudate. Natural polysaccharides, such as konjac glucomannan (KGM), chitosan, and cellulose, are well suited to this role because of their biocompatibility, biodegradability, and intrinsic bioactivity. Extensive research has focused on developing polysaccharide-based wound dressings with enhanced functionality to promote healing. This review examines recent scientific research published mostly in the past five years on the development and application of chitosan, KGM and cellulose-based macromolecules for wound dressing fabrication, including hydrogels, sponges, fibers, and other forms. It explores how their structure-property-function relationships connect primary composition and inter-component interactions (e.g., hydrogen bonding, ionic complexation, covalent crosslinking) to key performance metrics (antibacterial efficacy, hemostatic activity, moisture management such as swelling and water vapor transmission rate, and mechanical robustness). The advantages and disadvantages of various methods for preparing materials of the same type using the same polysaccharide are also discussed with quantitative comparisons across studies to provide clear insights into the healing effects of different wound dressings. For relatively mature cellulose-based wound dressings, we integrate their therapeutic efficacy, functional mechanisms, clinical evidence and marketed products with typical indications. Additionally, we summarize the advantages and limitations of these polysaccharides in wound healing, while identifying future trends and challenges that should guide the rational design of polysaccharide-based wound dressings.