Smart Biomaterials in Wound Healing: Advances, Challenges, and Future Directions in Intelligent Dressing Design

Chronic wounds (such as diabetic foot ulcers and pressure ulcers) affect millions of patients worldwide. These non-healing wounds pose major clinical challenges due to persistent inflammation, high infection risk, and impaired tissue regeneration, and incur a substantial healthcare burden, with global wound care costs reaching tens of billions of dollars annually. This unmet need has spurred the development of intelligent wound dressings-advanced bioengineered systems that go beyond conventional passive wound coverings by actively monitoring the wound microenvironment and responding dynamically to promote tissue repair. This review comprehensively examines a broad range of smart wound dressing technologies, including pH-sensitive, temperature-responsive, moisture-responsive, pressure-sensing, electroactive, biosensor-integrated, shape-memory, and controlled drug-releasing systems. We also discuss critical challenges in translating these innovations to clinical practice, such as ensuring biocompatibility and long-term stability in the harsh wound environment, manufacturing scalability and cost-effectiveness, patient comfort and adherence, and navigating regulatory hurdles. By emphasizing recent bioengineering advances and clinical potential, we underscore that intelligent wound dressings represent a paradigm shift in chronic wound management-enabling continuous, personalized therapy with the potential to significantly improve healing outcomes, reduce complications, and improve patient quality of life.