Zinc Oxide Nanoparticles for Skin Burn Wound Healing: A Comprehensive Review of Multifunctional Nanotherapeutic and Sensor-Integrated Platforms

Burns injuries present critical health and care challenges and remain one of the leading causes of preventable morbidity globally. The pathophysiology of burns injuries combines barrier disruption, dysregulated inflammation and biofilm-driven polymicrobial infection. Zinc oxide nanoparticles (ZnO NP) offer unique, multi-functional capabilities of broad-spectrum antimicrobial, pro-regenerative zinc (II) ion sources and an intrinsic transducer that is piezoelectric, photoresponsive and pH-responsive. This paper presents a comprehensive review of ZnO NP for the treatment of skin burns injuries with a focus on its multifunctional nanotherapeutic and sensor-integrated platforms. A structured literature search of PubMed, Scopus, Web of Science, Embase and IEEE Xplore covering the period 2015 to 2025 was conducted to identify and consolidate relevant pre-clinical and clinical evidence on ZnO-based and sensor-integrated burn wound platforms. From the survey across hydrogels, electrospun nanofibers, films, sprays, and three-dimensional bio-printed constructs, it is established that ZnO formulations achieve 60–95% wound closure by day 14 versus 30–55% for untreated controls, with 3–7 log10 colony-forming-unit reductions and minimum inhibitory concentrations of 8–256 micrograms per millilitre against multidrug-resistant pathogens. Wound healing is driven by sustained Zn2+ release, reactive-oxygen-species-mediated bactericidal action, matrix-metalloproteinase-9 modulation, vascular-endothelial-growth-factor and hypoxia-inducible-factor-1-alpha angiogenesis, and nuclear-factor-kappa-B suppressed inflammation. Emerging closed-loop sensor-integrated dressings deliver real-time wound pH, temperature, and matrix-metalloproteinase-9 readout coupled to near-field-communication actuated on-demand zinc release. Clinical translation is affected by several factors such as dose-dependent cytotoxicity associated with excessive ROS generation or dissolution, limited standardisation of green-synthesis methodologies, batch-to-batch variability in nanoparticle physicochemical properties and limited clinical trial data. ZnO-based theranostic platforms hold practical clinical translation potentials provided reproducible GMP-scale synthesis, long-term biocompatibility validation and comprehensive regulatory classification is systematically addressed.