pH/ROS-responsive smart hydrogels for infection control and immune microenvironment modulation in chronic wound healing

Chronic wounds are characterized by persistent infection, excessive oxidative stress, and dysregulated inflammation, which together hinder tissue repair and promote non-healing states. In this context, pH/ROS-responsive hydrogels have emerged as promising smart wound-dressing platforms because they can exploit local acidic and oxidative cues for site-specific structural change, controlled cargo release, and microenvironment-adaptive therapy. This review summarizes the pathological basis for pH/ROS-responsive intervention and discusses recent advances in hydrogel design for infection control, ROS scavenging, and immune microenvironment modulation. We further highlight key translational challenges, including manufacturing complexity, degradation-product safety, storage stability, and the limitations of current preclinical models. Overall, pH/ROS-responsive hydrogels represent a promising strategy for chronic wound management, but future progress will depend on achieving a better balance between multifunctional performance and translational practicality.