Application of Panax notoginseng Saponins in Skin Wound Repair: Mechanisms and Research Progress

Skin wound repair involves four stages: haemostasis, inflammation, proliferation and remodelling. Refractory wounds feature prolonged healing cycles, severe scar hyperplasia and limited clinical therapeutic strategies. Panax notoginseng saponins (PNS), primarily the ginsenosides Rg1 and Rb1 monomers, display high safety and multitarget regulatory properties across the entire wound repair cycle. PNS modulates the inflammatory microenvironment and induces M2-type polarization of macrophages by inhibiting NF-κB, MAPK and other signalling pathways; activates the PI3K/AKT pathway to promote the proliferation and migration of keratinocytes and fibroblasts, and maintains the physiological ratio of collagen type I/III; and upregulates angiogenic factors, including VEGF and bFGF, improving local blood circulation to enhance angiogenesis. Meanwhile, it regulates collagen metabolism, blocks the TGF-β1/Smad2/3 scar-related pathway, and counteracts oxidative stress, thereby accelerating wound healing while inhibiting scar formation. In recent years, PNS has shown promising potential in acute trauma, diabetic foot ulcers, burns and scar repair. PLGA/chitosan nanocarriers, hydrogels, electrospun fibrous membranes and smart responsive delivery systems have effectively addressed limitations of traditional dosage forms, including low bioavailability, poor skin permeability and uneven drug release. Nevertheless, research gaps remains: unclear targets of core monomers r; ambiguous pathway interactions among monomers; and poorly understood crosstalk between signalling pathways; studies on the impacts of extraction processes on pharmacodynamic effects are lacking; and high-level clinical evidence is inadequate. Thus, PNS possesses substantial potential for treating refractory wounds because of its multi-component synergy and full-cycle regulation. Future research should focus on in-depth exploration of molecular mechanisms, standardization of extraction processes, optimization of smart delivery systems and implementation of high-quality clinical studies to promote the translation of active ingredients from traditional Chinese medicine into modern precision therapies.