How Transformative Are ROS Responsive Hydrogel Nanoformulations to Treat Refractory Infected Wounds

Zongjunlin Liu,1, Hongqiong Xiang,1, Ke Xian,2, Lina Cai,1, Dui Yin,1 Jianqiao Zhong1 1Department of Dermatology, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China; 2Clinical Medical College, Southwest Medical University, Luzhou, 646000, People’s Republic of ChinaThese authors contributed equally to this workCorrespondence: Jianqiao Zhong, Department of Dermatology, Affiliated Hospital of Southwest Medical University, No. 25 Tai Ping Jie, Luzhou, Sichuan, 646000, People’s Republic of China, Tel +86-15082088598, Fax +86-830-3198173, Email zjq7632@hotmail.comAbstract: Controlling infection in bacterial-infected wounds presents a formidable challenge, especially when compounded by additional high-risk factors that hinder the healing process during clinical interventions. Currently, the efficacy of standard therapeutic approaches often falls short, largely attributed to persistent local infections and inflammatory responses that impede healing cascades. In recent years, increasing reports on the management of hard-to-heal infected wounds have highlighted the potential of reactive oxygen species (ROS)-responsive hydrogels to facilitate wound recovery. The capacity of these hydrogels could be greatly enhanced by integrating them with traditional treatments, thereby addressing the complexities of healing in refractory infected wounds. Therefore, based on a thorough review of latest literatures, this paper comprehensively outlines the molecular mechanisms associated with hard-to-heal infected wounds, the role of ROS-responsive hydrogels in promoting healing, and a combined therapeutic strategy for wound control. It is designed to offer valuable insights to inform and advance future investigative efforts in this research field.Keywords: hard-to-heal infected wounds, reactive oxygen species, ROS, hydrogel, nanoformulations, combination therapy strategy