Gang Jing,1,* Chen Hu,2,* Keyi Fang,3 Yingying Li,3 Linlin Wang1 

1Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, People’s Republic of China; 2Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China; 3School of Stomatology, Hainan Medical University, Haikou, Hainan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Linlin Wang, Hainan General Hospital, Hainan Affiliated Hospital of Hainan medical University, No. 19 Xiuhua Avenue, Haikou, Hainan, 570311, People’s Republic of China, Email wanglinlin1986@126.com

Abstract: Chronic wound infection has become a global health problem, with bacterial biofilms, which are difficult to penetrate using traditional antibiotics, considered the primary cause of recurrent infection and delayed healing in chronic wounds. In recent years, the outstanding performance of nanomaterials in controlling biofilm infections has been widely acknowledged, and these materials are regarded as highly promising for chronic wound infection management. The formation and structure of chronic wound biofilms undergo complex dynamic changes. Therefore, a deep understanding of the underlying causes of repeated wound infections and the specific antibacterial mechanisms of nanomaterials at different stages of biofilm formation is crucial for effective “chronic wound infection management”. This review first reveals the relationship between biofilms, wound chronicity, and recurrent infections. Secondly, it focuses on the four stages of chronic wound biofilm formation: (1) adhesion stage, (2) aggregation and promotion stage, (3) maturation stage, and (4) regeneration and dissemination stage. It also comprehensively summarizes the specific antibacterial mechanisms of nanomaterials. This study analyzes essential factors affecting the control of chronic wound biofilms by nanoparticles from various perspectives, such as the material itself, the local wound environment, and the systemic host response. Finally, the limitations and potential future trends in current research are discussed. In summary, nanoparticles represent a promising strategy for combating chronic wound biofilm infections, and this review provides new insights for alternative adjuvant therapies in managing bacterial biofilm infections in chronic wounds.

Keywords: bacteria, nanomaterials, mechanism, wound management