Zijian Dai, Zixian Zhang, Zahan Rabita, Yingmin Yan, Dequn Wu, Jie Zhu
Chronic wounds remain a major clinical challenge nowadays due to persistent inflammation, impaired regeneration, and high infection risk. Conventional dressings offer limited functionality and lack real-time feedback, driving the need for smart dressing systems that integrate diagnosis with on-demand therapy. This review summarizes the recent advances in smart wound dressings for chronic wound management. Following a brief overview of wound healing pathophysiology and key influencing factors, smart dressings are categorized according to their core functions, including exudate management, real-time monitoring of microenvironmental biomarkers (e.g., pH and temperature), broad-spectrum antibacterial therapy and inflammation regulation, and their strategies are discussed. This review also introduces multiple stimuli-responsive drug delivery systems triggered by pH, enzymes, temperature, and glucose, with particular emphasis on integrated "diagnosis-therapy" platforms that enable closed-loop wound management. Finally, the current challenges and future perspectives for clinical translation are discussed, highlighting the need for multimodal, personalized, and cost-effective smart dressing systems.