Sarah Fakher, David Westenberg
Chronic wound infections pose significant healthcare challenges due to persistent biofilms, antibiotic resistance, and impaired healing pathways. These wounds are characterised by prolonged inflammation, microbial colonisation, and disrupted tissue regeneration, leading to substantial morbidity and healthcare costs. This article reviews current knowledge on chronic wound types, their pathophysiology, and the mechanisms underlying biofilm formation to examine the latest advancements in antimicrobial-based strategies aimed at addressing these challenges. It highlights how diverse materials and technologies have been engineered to improve infection management, enhance tissue regeneration, and overcome the limitations of traditional treatments as well as advances that leverage innovations such as nanotechnology, advanced drug delivery systems, and bioactive components. Furthermore, the review explores how biomaterials can be tailored to interact with the wound microenvironment, mitigating infection risks while accelerating healing. By analysing the strengths and limitations of these emerging strategies, the review provides insights into the future of chronic wound care by integrating infection biology, biofilm dynamics, diagnostic challenges, and biomaterial-based interventions into a unified framework, highlighting the need for interdisciplinary and strategically layered treatment approaches.