Biomaterial-Based Strategies for Infection Control in Chronic Wounds

Chronic wounds, including diabetic foot ulcers, pressure ulcers, and venous leg ulcers, remain a global healthcare burden due to persistent inflammation, impaired tissue repair, and high susceptibility to infection. The rise of antibiotic-resistant pathogens and the prevalence of biofilms in these wounds have limited the effectiveness of conventional therapies, highlighting the need for advanced strategies that simultaneously control infection and promote healing. Biomaterial-based approaches have emerged as promising solutions, offering multifunctional platforms that combine antimicrobial activity with regenerative support. Natural and synthetic polymers, antimicrobial peptide-loaded scaffolds, metal oxide nanoparticles, bacteriophages-loaded biomaterials and hybrid composites have demonstrated the ability to disrupt biofilms, deliver targeted therapeutics, and create environments favorable for cell proliferation and tissue repair. Recent innovations emphasize “smart” biomaterials that respond to wound-specific stimuli, controlled-release systems for sustained drug delivery, and bioinspired materials that mimic native tissue architecture. The integration of electrospinning, 3D bioprinting, and surface functionalization has further advanced the design of next-generation wound dressings. This comprehensive review explores how biomaterials combat infection in chronic wounds, evaluates their clinical translation, and discusses barriers such as cytotoxicity, scalability, and regulatory challenges. Finally, it outlines future directions for personalized, biomaterial-based wound care that supports antimicrobial stewardship and improved patient outcomes.