Probiotic and Postbiotic Delivery Systems for the Management of Chronic Wounds: A Review of Emerging Strategies

Several human studies show positive signals, while research methods and sample sizes continue to develop.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Chronic wounds, particularly diabetic foot ulcers (DFUs) and burn wounds (BWs), impact millions of individuals globally and generate substantial healthcare costs, highlighting the urgent need for more effective therapies aimed at controlling infections. Currently, there is growing evidence of beneficial effects of selected bacterial strains, including Lactobacillus plantarum , Lactobacillus reuteri , Lactobacillus rhamnosus , Lactobacillus paracasei , Bifidobacterium longum , and Escherichia coli , as well as fungi from the genus Saccharomyces spp. Each of these species exerts a distinct influence on the wound microenvironment. This review compiles evidence from PubMed-indexed studies published between 2016 and 2026 regarding the application of external dressings and other topically administered formulations containing probiotic or postbiotic preparations in the management of DFUs and BWs. Probiotic strains facilitate wound healing through various mechanisms, including the secretion of antimicrobial metabolites (such as organic acids, hydrogen peroxide, and bacteriocins), inhibition of biofilm formation by pathogens like Staphylococcus aureus and Pseudomonas aeruginosa , immunomodulation, local acidification, and stimulation of growth factors and components of the extracellular matrix. Various methods for delivering microorganisms with probiotic properties are being evaluated.

Evidence level

Several human studies show positive signals, while research methods and sample sizes continue to develop.

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