Chronic wounds exert a rising global health burden. The lack of effective intervention is an outcome created by four core pathophysiological barriers, viz., biofilm persistence, oxidative stress, impaired angiogenesis, and dysregulated inflammation/extracellular matrix (ECM) remodeling. To overcome the interventional hurdles, nanomaterial-based delivery systems including electrospun nanofibers, hydrogels, and nanoparticles offer intelligent, multi-targeted solutions through controlled release and intrinsic bioactivity. This review is structured around recent advances (2020–2025) around these barriers and critically evaluates how each platform counters specific deficits. Briefly, nanofibers mimic ECM to restore remodeling, hydrogels scavenge ROS and enable on-demand release, nanoparticles penetrate biofilms while upregulating VEGF and hybrid systems achieve synergistic outcomes (e.g., 55 % faster diabetic wound closure). Furthermore, translational challenges involving toxicity, scalability, and regulation are discussed along with strategies for clinical acceleration. We conclude with a roadmap for AI-guided, closed-loop, dressings that potentially (and dynamically) address the lowering of all four barriers, and pave the way for precision wound care.
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