From passive to active: Next-generation mechanically active dressings for wound healing

Traditional passive dressings significantly slow down the wound healing process due to their lack of mechanical adaptability that matches human tissues. In contrast, mechanically active dressings (MADs), as a form of active intervention, can accelerate wound closure through their own mechanical deformation and are considered a key direction for next-generation wound care. Despite the continuous emergence of high-performance MADs in recent years, the relationship between their structural design characteristics and stimulus-responsive capabilities remains a major challenge that urgently needs to be addressed. In this review, the fundamental design principles governing MADs' function are first elaborated, followed by a thorough examination of the biomechanical mechanisms by which they promote wound healing. Next, the connection between material design and stimulus-responsive mechanisms is examined, followed by the highlighting of recent MADs breakthroughs and an outline of current limitations. Finally, the main challenges and solutions for translating these innovations into clinical practice are explored, providing new references for creating smarter dressings of the future. STATEMENT OF SIGNIFICANCE: This review addresses a critical gap in the field of mechanically active dressings (MADs) by moving beyond traditional single-material discussions to establish a unified design framework. This framework systematically links material morphology to diverse stimuli-responsiveness, including temperature, enzymes, ions, and magnetic fields. Furthermore, the introduction of a comprehensive performance comparison table transforms the review from a passive summary into a practical decision-support tool. Most importantly, by exploring patient-specific needs and commercialization pathways, we bridge the crucial gap between fundamental research and clinical practice, providing a clear roadmap for the rational design of next-generation wound care solutions.