Silver-Hydroxyapatite Nanocomposites for Infected Wound Management: Antibacterial Mechanisms, Regenerative Potential, Preclinical Evidence, and Translational Challenges

Chronic and infected wounds continue to be a huge clinical and economic burden, and research has focused on developing new biomaterials that can not only combat infection but also induce tissue regeneration. Hydroxyapatite (HAp), the main inorganic component of bone, has excellent biocompatibility and osteoconductivity, and silver nanoparticles (Ag NPs) are well known for their broad-spectrum antimicrobial activity. The integration of both of these components into a single material leads to a silver-hydroxyapatite (Ag-HAp) nanocomposite with multifunctional properties, such as the ability to inhibit microbial growth and promote cellular functions essential for tissue repair. In the present review, the recent advances in the synthesis, characterization, and biomedical application of Ag-HAp nanocomposites, especially their wound healing properties, are summarized in detail. Synthesis and characterization methods for ensuring phase purity, silver distribution, and nanostructure are included, including co-precipitation, hydrothermal, and green/biogenic approaches. The mechanism of antibacterial and pro-regenerative synergy is discussed and wound healing in vitro and in vivo have been presented. Additionally, biocompatibility and toxicity are discussed as are the challenges of translation. In summary, the literature suggests that Ag-HAp nanocomposites are promising candidate materials for next generation wound dressings, but there are still critical issues that need to be addressed, including standard synthesis methods and long-term safety data for clinical translation.