ROS-responsive drug delivery systems for chronic wound healing: advances, challenges, and translational perspectives

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Chronic wounds pose a substantial global health burden, due to the high incidence and recurrence rates, and associated morbidity. Excessive and sustained production of reactive oxygen species (ROS) is a hallmark of the chronic wound microenvironment, ultimately stalling the repair process. The pathological accumulation of ROS in chronic wounds has motivated the development of ROS-responsive drug delivery systems (DDS), which show considerable potential in improving wound healing outcomes. In this review, we provide a comprehensive overview of the advances in ROS-responsive DDS for chronic wound healing, summarizing the design principles, material chemistry, and underlying ROS-triggered functional mechanisms. Key translational challenges are discussed, including material biocompatibility, stability in protease- and ROS-rich wound exudates, manufacturing scalability, and regulatory considerations. Finally, we outline future perspectives, emphasizing the integration of multi-responsive functionalities, real-time ROS monitoring, and advanced biomaterial engineering to accelerate clinical translation. By aligning therapeutic release with the dynamic redox status of chronic wounds, ROS-responsive DDS holds considerable potential to redefine precision therapy for wound management.

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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