Nanozymes in infected wound therapy: catalytic mechanisms, rational design and combination therapy

Topics of wound healing have gained increasing attention, and wound healing is a complex dynamic process involving multiple stages and cytokines interactions. The causes of wound formation include physical injury, burns, frostbite resulting in ulcers or abscesses, and chronic diseases such as diabetes. All of these factors can lead to varying degrees of tissue damage. Infectious wound-related diseases are a major public safety concern, affecting the healthy lives of millions of people. Nanozymes, as a new artificial enzyme with the advantages of low cost and good stability, can effectively mimic natural enzyme activity and regulate the wound microenvironment to achieve the alleviation of oxidative stress, lowering of blood glucose, reconstruction of blood vessels, and promotion of infected wound healing. Therapies based on nanozymes and their related strategies have been extensively tapped in wound healing. This review explores the catalytic mechanism of nanozymes for wound treatment and their design directions, which provides readers with ideas for further research on the design of rational nanozymes. In addition, we have systematically explored their synergistic therapy. The clinical potentialities and future trials of nanozymes in boosting antimicrobial wound healing are accentuated in the final part. STATEMENT OF SIGNIFICANCE: Infected wound healing remains a significant challenge in the medical field. Traditional wound treatments are confronted with issues such as antibiotic resistance and limited effectiveness in promoting tissue repair. However, nanozymes, with their unique enzyme-like catalytic activities and nanomaterial properties, have emerged as a promising alternative. Nanozymes can effectively regulate the wound microenvironment to alleviate oxidative stress and inflammation, thereby promoting the healing of infected wounds. In this article, we comprehensively and systematically summarize the latest progress in nanozyme-based wound healing therapies, as well as the strategies for improving current nanozyme-based therapeutic approaches. Moreover, we elaborate on the role of nanozymes in the treatment of infected wounds from multiple perspectives, present examples of the combination of nanozymes with various other wound healing treatment methods, and summarize nanozyme-based delivery systems.