Chronic wounds and implanted medical devices remain highly vulnerable to biofilm-associated infections, which resist conventional antibiotics and immune clearance. Synthetic antimicrobial peptides (AMPs) have emerged as promising alternatives, offering tunable sequences, short lengths for cost-effective synthesis, and functional modifications that enhance stability and antibiofilm potency. Hydrogels provide an optimal delivery matrix by enabling localized AMP release, maintaining a moist wound environment, and supporting stimuli-responsive or sustained therapeutic action. This review highlights recent advances in peptide engineering strategies—including rational sequence design, chemical modifications, and self-assembling nanostructures—alongside hydrogel integration approaches ranging from physical entrapment to covalent tethering and infection-triggered release systems. Mechanistic insights into antibiofilm activity are discussed, supported by in vitro, ex vivo, and in vivo evaluation models. Beyond antimicrobial efficacy, multifunctional AMP–hydrogel systems can deliver complementary benefits such as hemostasis, anti-inflammation, or enzymatic biofilm dispersal, further accelerating tissue repair. Despite significant progress, translational challenges remain, including peptide stability, manufacturing costs, regulatory hurdles, and host safety. Future directions point toward AI-driven peptide design, programmable hydrogels, and point-of-care integration to realize safe, effective, and multifunctional AMP–hydrogel therapies for chronic wound management and biofilm eradication.
Rahela et al. (Thu,) studied this question.