The gut-skin axis in wound healing: a bibliometric analysis of intestinal flora and chronic wounds (2005-2025)

The delayed healing of chronic wounds is a major challenge in clinical treatment, with complex pathogenesis involving multisystem dysfunction. In recent years, the role of intestinal flora imbalance in the impairment of chronic wound healing has received increasing attention. Given the physiological similarities and pathological correlations between the skin and the intestine, some scholars have proposed the concept of the "skin-gut axis" and believe that there is a close connection between the skin microbiota, skin condition, and intestinal flora. However, systematic analysis of research trends remains limited. This bibliometric study comprehensively evaluates the research status in the fields of chronic refractory wounds and intestinal microbiota from 2005 to 2025.

We used CiteSpace, VOSviewer, and Bibliometrix software to analyze 553 English articles from the Web of Science Core Collection. Bibliometric assessments included publication trends, collaborative networks, geographical distribution, journal impact, and keyword clustering.

A total of 553 papers were included. The number of publications in this field increased markedly from 2020 to 2025, with 2025 being the most productive year. The leading contributing countries were the United States and China; key institutions included the University of Pennsylvania and the University of Copenhagen. Elizabeth A. Grice was the most impactful author. Keyword analysis identified high-frequency terms: wound healing, biofilm, chronic wound, bacteria, and microbiota. Timeline visualization of keywords revealed emerging research hotspots, including diabetic foot ulcer and in situ detection.

To the best of our knowledge, this study represents the first bibliometric analysis in the field of chronic wounds and intestinal microbiota. Core research foci include disease-associated microbiota characteristics, probiotic therapy, microecological intervention, and the distal gut-target organ axis. Future research should prioritize microbe-targeted therapy, regulation of the immune-barrier metabolic network, and integrative medicine combining traditional Chinese and Western medicine.

https://www.crd.york.ac.uk/PROSPERO/ID=CRD420261362660, identifier CRD420261362660.