Microbiotherapy: an emerging adjunct for burn wound healing

Burn injuries rank among the most common types of severe trauma, typically causing damage to skin tissue. However, traditional management strategies, particularly those relying on broad-spectrum antibiotics, face the dual challenges of increased drug resistance and limited wound healing efficacy, necessitating urgent development of novel therapeutic strategies. In recent years, microbiotherapy has garnered significant attention as a potential adjuvant therapy in burn wound management. Microbiotherapy achieves antibacterial effects by competitively inhibiting pathogen adhesion and secreting metabolites. Additionally, it promotes burn wound healing through the secretion of anti-inflammatory and growth factors, as well as the restoration of immune homeostasis. This approach aligns with the field's shift toward personalized therapy, where microbial interventions can be tailored to the specific microenvironment of a patient's wound. Current microbiotherapies for burn treatment primarily focus on probiotics, bacteriophages, and microbial metabolic derivatives. These therapies can be used individually or in combination and are gradually transitioning from laboratory early-stage research to clinical application. Probiotics, the core component of microbiotherapy, exert their therapeutic effects mainly by secreting various metabolites. This review summarizes the latest advances in microbiotherapy for burn wound treatment, focusing on its mechanisms of action, in vivo studies, and potential combined applications. Furthermore, this review critically evaluates the future opportunities and translational challenges of microbiotherapy to provide a balanced perspective on its clinical viability.