Advancements in multimodal approaches for enhanced wound healing: From chemical to physical strategies

Abstract

Cutaneous injuries, especially chronic wounds are considered as one of the immense healthcare burdens for millions of patients over the worldwide. Persistent inflammation, comorbidities, impaired tissue regeneration and immunosuppression are defining characteristics, which complicate clinical management and highlight the need for innovative solutions in this critical area. However, the formation of biofilm and other polymicrobial interaction to host immunity envision resist the effectiveness of these approaches. Most modern wound care products create an optimal healing environment by removing waste tissue, preventing infections and maintaining a moist wound bed. This is often not enough to re-establish the healing process in chronic wounds. This review aims to systematically examine and understand state-of-the-art advances of physical/chemical cues and multimodal approaches to attain faster skin repair. It highlights the complexity in chronic wound healing process, while identifying limitations in current therapeutic approaches and ways to overcome via using chemical strategies (pH modulation, use of biomaterials and gas-mediated therapies and physical strategies (electrical stimulation, photothermal therapy and mechanotransduction). By clearly defining and analyzing these individual modalities, this present article highlights how their synergistic integration can regulate inflammation, promote angiogenesis, and enhance extracellular matrix remodeling. The scope further extends to discuss the translational potential of such hybrid approaches in clinical settings. Through this multidimensional framework, the review seeks to guide future research and innovation toward more effective and personalized wound healing solutions, ultimately aiming to improve healing outcomes and reduce long-term complications such as scarring.