Advanced Nanomaterials for Chronic Wounds: M.O.I.S.T. Concept-Driven Design Strategy.

Abstract

Clinical management of chronic wounds remains a major challenge, stemming from their complex etiology, high infection risk, and pronounced inter-patient variability. While nanomaterials offer innovative solutions to overcome the limitations of conventional therapies via tunable physicochemical and biological properties, research into their rational design for chronic wound healing remains fragmented without a systematic framework. This review summarizes recent advances in nanomaterial design guided by the M.O.I.S.T. (moisture balance, oxygen balance, infection control, supporting strategies, tissue management) framework, elaborating how nanomaterials are precisely tailored for each core dimension: structural innovation to maintain an optimal moist microenvironment; oxygen-releasing/consuming nanosystems to regulate oxygen balance; multi-mechanistic infection control via PTT/PDT/SDT, nanozymes and advanced nanostructures; targeted support for pathological microenvironments (e.g., ischemia, hyperglycemia); and enhanced tissue debridement, proliferation and remodeling. We further discuss nanomaterials' emerging role in reshaping wound microbiota to restore immune-microbial homeostasis. This work establishes a clear M.O.I.S.T. framework-nanomaterial design correlation, providing theoretical and practical guidance for personalized nanotherapies, and finally outlines cutting-edge challenges and future directions to advance clinical translation of M.O.I.S.T.-guided nanomaterials.