Targeting Biofilms in Chronic Wounds: Emerging Strategies with Antimicrobial Nanocomposites

Chronic wounds present a significant challenge to healthcare systems globally, affecting approximately 1% of the population and severely impacting their quality of life. Biofilm development occurs in approximately 90% of chronic wounds, contributing to an increased prevalence of polymicrobial infections. Currently, there is a large quantity of antimicrobial topical treatments, dressings, and advanced therapies. However, many of them are hindered by the complex biofilm environment, antibiotic resistance, and/or host tissue toxicity. Furthermore, conventional treatments such as debridement, systemic/local antibiotics, and negative-pressure therapy are often ineffective at eradicating biofilms and fostering optimal healing conditions. Nanomedicine approaches have shown promising potential to address the limitations of current treatments. In this review, we discuss the pathophysiology of chronic wounds, the role of biofilms, microenvironmental changes, current treatments and their limitations, and nanocomposite-based strategies to eradicate biofilms and resolve chronic wounds.