Smart Dressings for Skin Wound Healing: A Systematic Review of Mechanisms, Materials, and Applications

Smart wound dressings have emerged as transformative platforms capable of responding to dynamic changes in the wound microenvironment. These systems enable spatiotemporally controlled drug release, pathogen neutralization, and tissue regeneration, offering significant advantages over passive or single-function dressings. Despite considerable advancements, existing reviews predominantly focus on material types or disease-specific applications, lacking a mechanism-oriented framework to evaluate stimulus-responsiveness across wound healing stages. Following PRISMA 2020 guidelines, a systematic search of PubMed, Web of Science, and Google Scholar was conducted for peer-reviewed articles published from 2020 to 2025. A total of 62 relevant studies were identified, involving wound dressings responsive to endogenous signals (e.g., pH, glucose, and enzymes) and exogenous triggers (e.g., light, electricity, and ultrasound). Smart dressings are classified by their underlying stimulus–response mechanisms, with analyses of the material structures and chemical functionalities that drive responsiveness, and strategies for integrating multiple mechanisms are highlighted. Particular emphasis is placed on the alignment of these mechanisms with wound-stage physiology to enhance therapeutic precision. This review establishes a mechanism-driven framework for categorizing smart wound dressings and outlines design principles for next-generation systems with integrated, adaptive, and closed-loop therapeutic capabilities.