Next-generation wound care: a scoping review on probiotic, prebiotic, synbiotic, and postbiotic cutaneous formulations

Background/Objectives: Chronic wounds represent a significant socioeconomic burden, affecting 1–2% of the global population. Wound healing is a complex process involving inflammation, cell proliferation, and tissue remodeling, but factors such as infections, diabetes, aging, and poor nutrition can impair recovery, leading to chronic wounds. Given these challenges, researchers have explored topical probiotics, synbiotics, and postbiotics as alternative strategies. Strains like Lactobacillus and Bifidobacterium contribute to skin restoration by producing antimicrobial, anti-inflammatory, and immunomodulatory compounds, offering a novel approach to cutaneous restoration. Our study aims to address the potential effects of topical probiotic, synbiotic, and postbiotic formulations for wound healing applications by means of a broad scoping review and evidence-gap mapping. Methods: A systematic literature search of preclinical studies (in vitro and in vivo) was performed in PubMed, Scopus, and Web of Science (January 2025), yielding 3052 articles after duplicates removal, of which 44 met the inclusion criteria. Results: These studies were published between 1986 and 2024, mostly by China (27.3%) and Iran (25.0%). Probiotics were frequently evaluated among the studies included (47.7%) (with Lactobacillus plantarum being the most assessed strain), followed by postbiotics (36.4%) (with predominant use of cell-free supernatants) and synbiotics (15.9%) (especially fructooligosaccharides). Dosage forms included gels (44.4%), films (15.6%), and ointments (13.3%). Conclusions: Most studies indicate that probiotics, synbiotics, and postbiotics have antimicrobial and anti-inflammatory properties, while promoting angiogenesis, tissue regeneration, and skin barrier restoration. The use of different delivery systems may additionally enhance therapeutic outcomes by accelerating wound closure, reducing bacterial load, and modulating immune response. However, methodological limitations in animal studies highlight the need for greater experimental rigor. Further robust clinical trials are essential to confirm efficacy and safety before clinical application of these formulations.

Description

This research was funded by CNPq and the fellowship was received by Raul Edison Luna Lazo (grant #176655/2023-9). This study is part of the National Institute of Science and Technology in 3D printing and Advanced Materials Applied to Human and Veterinary Health—INCT_3D-Saúde, funded by CNPq, Brazil (Grant #406436/2022-3).

Keywords

Burned skin Cutaneous administration Dermatological formulations Excisional skin Scar formation Tissue repair

URI

http://hdl.handle.net/10400.21/21904

Citation

Machado P, Ribeiro FN, Giublin FW, Mieres NG, Tonin FS, Pontarolo R, et al. Next-generation wound care: a scoping review on probiotic, prebiotic, synbiotic, and postbiotic cutaneous formulations. Pharmaceuticals (Basel). 2025;18(5):704.