The Interplay of Biofilms, Microbiota, and Immune Dynamics in Cutaneous versus Oral Wound Healing: A Systematic Review

The stark contrast in healing outcomes between chronic cutaneous wounds and rapidly regenerating oral mucosal wounds offers a critical framework for understanding tissue repair. Chronic wounds, such as diabetic foot ulcers, are trapped in a state of persistent inflammation and biofilm driven infection, leading to impaired healing. In contrast, oral wounds exhibit accelerated, scar free regeneration. This systematic review synthesizes evidence from ۲۰۱۵-۲۰۲۵ to delineate the mechanisms underlying this disparity, focusing on the interplay between immune regulation, the wound microbiota, and bacterial biofilm formation. Analysis reveals that superior oral healing is mediated by a unique immune microenvironment favoring a swift transition to pro regenerative responses, the influence of saliva derived bioactive factors, and fibroblasts with reduced fibrotic potential. Conversely, in chronic skin wounds, dysbiosis and resilient polymicrobial biofilms perpetuate inflammation and impede progression through healing phases. Emerging therapeutic strategies, including microbiota modulation, biofilm-targeting approaches (e.g., quorum sensing inhibitors, phage therapy), and immunomodulation, are evaluated for their potential to redirect chronic wounds toward a healing trajectory inspired by oral mucosal biology. The review concludes that leveraging insights from the oral healing paradigm is essential for developing next-generation, personalized therapies to overcome the challenge of chronic non-healing wounds.

کلیدواژه ها:

Wound Healing ، Biofilm ، Microbiota ، Chronic Wound ، Oral Mucosa ، Regenerative Therapy