Zwitterionic hydrogels from material design to wound dressing applications

Zwitterionic hydrogels, synthesized from zwitterions such as sulfobetaine, carboxybetaine, and phosphorylcholine, feature a balanced mix of positive and negative charges within the same polymer chains. They exhibit excellent antifouling properties, superior hydration, distinctive anti-polyelectrolyte behavior, tunable mechanical strength, and low immunogenicity, all of which create an environment that mimics the extracellular matrix, facilitating faster wound healing. This review examines the development and applications of zwitterionic hydrogels in wound care, highlighting their potential to enhance healing processes and reduce complications in both acute and chronic wounds. Zwitterionic hydrogels are presented with distinct functionalities such as antibacterial activity, hemostatic properties, anti-inflammatory and antioxidant effects, and adaptability to the wound environment, all contributing to improved wound healing from various perspectives. Additionally, innovative approaches enhance zwitterionic hydrogels in wound care by integrating them with various bioactive compounds, photothermal therapy, and smart materials. These enhancements enable the effective delivery of therapeutic agents directly to the wound site and facilitate responsiveness to specific wound cues, providing a comprehensive multimodal therapeutic strategy. Further, the potential challenges and future perspectives in the field are addressed, including the need for advanced material design/synthesis and the integration of machine learning to optimize hydrogel design. By exploring both current applications and forward-looking innovations, this review underscores the significance of zwitterionic hydrogels and the vast potential for their future development in revolutionizing wound care, promising not only enhanced clinical outcomes but also broad applicative potentials in medicine.