Abstract
Chronic and infected wounds continue to pose significant clinical challenges due to microbial infections, biofilm development, inflammation, and poor tissue regeneration. Traditional antibiotics medications often show low efficacy and lack stability. The demand for new therapeutic approaches is increasing due to bacterial resistance. Metal-based nanozymes have intrinsic enzyme-like catalytic activity and emerged as a promising class of antibacterial agents for wound-healing applications. The functionalization with metals such as silver (Ag), copper (Cu), iron (Fe), manganese (Mn), cerium (Ce), platinum (Pt) and gold (Au) enhances peroxidase (POD)-, oxidase (OXD)-, and catalase (CAT)-like biomimetic activities. This improvement enables efficient reactive oxygen species (ROS) production, biofilm inhibition, and microenvironment-responsive antibacterial activity. These metal-nanozymes also alter the immune response, increase angiogenesis, and promote extracellular matrix remodeling when combined with metals and also polysaccharides. This review summarizes recent advances in metal-incorporated antibacterial nanozymes including their design, catalytic mechanisms, structure-activity relationships, and integration into hydrogels, films, and fibers for wound healing. Key challenges such as biosafety, metal ion release, the inflammatory balance, and clinical translation are critically discussed. Emerging directions such as single-atom nanozymes, cascade enzyme systems, and stimuli-responsive platforms are highlighted as promising routes for next-generation wound therapeutics. Overall, this review underscores the clinical potential of metal-functionalized nanozymes for infected wound management; however, concerns regarding ion leakage and long-term safety persist emphasizing the need for controlled designs and biocompatible systems to enable safe translation.