Wound healing is a complex biological process involving multiple stages, such as cell proliferation, angiogenesis, and tissue remodeling. Chronic wounds, due to their intricate pathology and significant management difficulties, impose a substantial burden on patients and healthcare systems. Recent advances in materials science, microelectronics, and artificial intelligence have catalyzed the development of smart dressings, offering innovative solutions for wound care. This comprehensive review summarizes the development of multifunctional smart dressings. It highlights technologies for real-time monitoring of key wound biomarkers (e.g., pH, temperature, moisture, and oxygen levels) and provides a comparative analysis of drug delivery mechanisms, spanning passive diffusion, stimulus-responsive, and actively triggered release systems. The roles of physical therapies, including thermal, ultrasound, and phototherapeutic stimulation, are also discussed. Particular emphasis is placed on electrical stimulation (ES) therapy, owing to its unique mechanistic actions and strong compatibility with smart dressing platforms. This section details ES strategies, parameter optimization, the need for adaptive parameter adjustment guided by wound microenvironment feedback, and its synergistic potential with other therapies. Finally, the review identifies key challenges regarding system integration and clinical translation, while underscoring the promising future of smart dressings in enabling automated, personalized wound management.
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