Background: The incidence of chronic wounds in developed countries ranges from 1–2%. In order to improve patient\\\'s quality of life and maintain their physical and mental well-being, chronic wounds need to be well treated. Chronic wounds can be treated with debridement, ultrasound, hyperbaric oxygen therapy, negative pressure wound therapy, electromagnetic therapy, hydrogel dressings, and skin grafts. The tunable functional properties of hydrogel dressings, such as biodegradability, adhesiveness, antimicrobial, anti-inflammatory, and pre-angiogenic bioactivities, could be a promising option for chronic wound healing. This review aims to summarize the types of chronic wounds, phases of the healing process, and key approaches to treatment. Methods: Eleven databases (Embase, Scopus, Google Scholar, PubMed, Cochrane Library, Magiran, UpToDate, SID, Medline, Elsevier, and Lilacs) were searched for published articles on Immunomodulatory effects of hydrogels in treating chronic wound healing from January 2002 to July 2022. Seventeen affiliated articles with complete abstracts were included in this study. All data were extracted from interrelated papers and analyzed with R version 4.2.1 artificial intelligence software. Results: Hydrogel-based dressings can easily be modified compared to other chronic wound treatment strategies. Using hydrogel dressings can speed wound contraction and healing by loading cells, antiviral, antibacterial, and antifungal agents, biomolecules, and growth factors due to their flexible, tunable properties. Hydrogel dressings can be developed depending on the size, severity, and location of the wound. Because these dressings induce in situ and cytocompatible chemical crosslinking, they can also be easily applied to irregular or deep wounds. Conclusion: Several advantages can be derived from hydrogel-based dressings, such as their ability to bind and adhere to the surface, their vascularization ability, antimicrobial properties, antioxidant activities, and anti-inflammatory properties.

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