Theranostic platforms for skin tissue engineering: Bridging healing and real-time monitoring

Chronic wounds are a major healthcare challenge, contributing to significant morbidity and reduced quality of life while imposing a substantial economic burden on healthcare systems. Traditional wound care approaches often fail to provide real-time feedback on treatment efficacy, limiting the ability to adapt therapeutic strategies dynamically. Theranostic platforms, which can integrate both diagnostic and therapeutic functionalities, have emerged as a promising solution to bridge this gap. These advanced systems enable continuous monitoring of key wound parameters, such as temperature, pH, oxygen levels, glucose, and reactive oxygen species (ROS), while simultaneously delivering targeted therapies, including drug release, gene and cell therapies, immunomodulation, and photothermal or photodynamic treatments. By incorporating both healing and monitoring capabilities into acellular scaffolds, hydrogel-based matrices, self-healing hydrogels, and 3D-bioprinted skin substitutes, researchers aim to optimize therapeutic efficacy and improve clinical outcomes. This review explores the different platforms available for skin tissue engineering that serve as the foundation for theranostic systems, alongside the most relevant diagnostic and therapeutic strategies for enhanced wound healing, and discusses future directions and challenges in this evolving field.