The facile fabrication of wound compatible anti-microbial nanoparticles encapsulated Collagenous Chitosan matrices for effective inhibition of poly-microbial infections and wound repairing in burn injury care: Exhaustive in vivo evaluations

Biomaterials for immunomodulation in wound healing

The substantial economic impact of non-healing wounds, scarring, and burns stemming from skin injuries is evident, resulting in a financial burden on both patients and the healthcare system. This review paper provides an overview of the skin's vital role in guarding against various environmental challenges as the body's largest protective organ and associated developments in biomaterials for wound healing. We first introduce the composition of skin tissue and the intricate processes of wound healing, with special attention to the crucial role of immunomodulation in both acute and chronic wounds. This highlights how the imbalance in the immune response, particularly in chronic wounds associated with underlying health conditions such as diabetes and immunosuppression, hinders normal healing stages. Then, this review distinguishes between traditional wound-healing strategies that create an optimal microenvironment and recent peptide-based biomaterials that modulate cellular processes and immune responses to facilitate wound closure. Additionally, we highlight the importance of considering the stages of wounds in the healing process. By integrating advanced materials engineering with an in-depth understanding of wound biology, this approach holds promise for reshaping the field of wound management and ultimately offering improved outcomes for patients with acute and chronic wounds.

Polymer-Based Functional Materials Loaded with Metal-Based Nanoparticles as Potential Scaffolds for the Management of Infected Wounds

Wound infection due to bacterial invasion at the wound site is one of the primary challenges associated with delayed wound healing. Microorganisms tend to form biofilms that protect them from harm, leading to their multidrug resistance. The alarming increase in antibiotic resistance poses a threat to wound healing. Hence, the urgent need for novel wound dressing materials capable of managing bacterial infection is crucial for expediting wound recovery. There is considerable interest in polymeric wound dressings embedded with bioactive substances, such as metal-based nanoparticles, as potential solutions for treating microbially infected wounds. Metal-based nanoparticles have been widely used for the management of infected wounds due to their broad antimicrobial efficacy. This review focuses on polymer-based and bioactive wound dressings loaded with metal-based nanoparticles like silver, gold, magnesium oxide, or zinc oxide. When compared, zinc oxide-loaded dressings exhibited higher antibacterial activity against Gram-positive strains and silver nanoparticle-loaded dressings against gram-negative strains. However, wound dressings infused with both nanoparticles displayed a synergistic effect against both strains of bacteria. Furthermore, these dressings displayed antibiofilm activity and the generation of reactive oxygen species while accelerating wound closure both in vitro and in vivo.

Electrospun Antimicrobial Drug Delivery Systems and Hydrogels Used for Wound Dressings

Wounds and chronic wounds can be caused by bacterial infections and lead to discomfort in patients. To solve this problem, scientists are working to create modern wound dressings with antibacterial additives, mainly because traditional materials cannot meet the general requirements for complex wounds and cannot promote wound healing. This demand is met by material engineering, through which we can create electrospun wound dressings. Electrospun wound dressings, as well as those based on hydrogels with incorporated antibacterial compounds, can meet these requirements. This manuscript reviews recent materials used as wound dressings, discussing their formation, application, and functionalization. The focus is on presenting dressings based on electrospun materials and hydrogels. In contrast, recent advancements in wound care have highlighted the potential of thermoresponsive hydrogels as dynamic and antibacterial wound dressings. These hydrogels contain adaptable polymers that offer targeted drug delivery and show promise in managing various wound types while addressing bacterial infections. In this way, the article is intended to serve as a compendium of knowledge for researchers, medical practitioners, and biomaterials engineers, providing up-to-date information on the state of the art, possibilities of innovative solutions, and potential challenges in the area of materials used in dressings.

Therapeutic effects of electrospun chitosan nanofibers on animal skin wounds: A systematic review and meta-analysis

Electrospun chitosan nanofibers (QSNFs) enhance the healing process by mimicking skin structure and function. The aim of this study was to analyze the therapeutic effects of QSNFs application on animal skin wounds to identify a potential direction for translational research in dermatology. The PRISMA methodology and the PICO scheme were used. A random effects model and mean difference analysis were applied for the meta-analysis. A meta-regression model was constructed, risk of bias was determined, and methodological quality assessment was performed. Of the 2370 articles collected, 54 studies were selected based on the inclusion and exclusion criteria. The wound healing area was used for building models on the 3rd, 7th, and 14th days of follow-up; the results were - 10.4% (95% CI, -18.2% to -2.6%, p = 0.001), -21.0% (95% CI, -27.3% to -14.7%, p = 0.001), and - 14.0% (95% CI, -19.1 to -8.8%, p = 0.001), respectively. Antioxidants and synthetic polymers combined with QSNFs further reduced skin wound areas (p < 0.05). The results show a more efficient reduction in wound area percentages in experimental groups than in control groups, so QSNFs could potentially be applied in translational human medicine research.

Fabrication of Antibacterial and Antioxidant ZnO-Impregnated Amine-Functionalized Chitosan Bio-Nanocomposite Membrane for Advanced Biomedical Applications

Developing a variety of safe and effective functioning wound dressings is a never-ending objective. Due to their exceptional antibacterial activity, biocompatibility, biodegradability, and healing-promoting properties, functionalized chitosan nanocomposites have attracted considerable attention in wound dressing applications. Herein, a novel bio-nanocomposite membrane with a variety of bio-characteristics was created through the incorporation of zinc oxide nanoparticles (ZnONPs) into amine-functionalized chitosan membrane (Am-CS). The developed ZnO@Am-CS bio-nanocomposite membrane was characterized by various analysis tools. Compared to pristine Am-CS, the developed ZnO@Am-CS membrane revealed higher water uptake and adequate mechanical properties. Moreover, increasing the ZnONP content from 0.025 to 0.1% had a positive impact on antibacterial activity against Gram-positive and Gram-negative bacteria. A maximum inhibition of 89.4% was recorded against Escherichia coli, with a maximum inhibition zone of 38 ± 0.17 mm, and was achieved by the ZnO (0.1%)@Am-CS membrane compared to 72.5% and 28 ± 0.23 mm achieved by the native Am-CS membrane. Furthermore, the bio-nanocomposite membrane demonstrated acceptable antioxidant activity, with a maximum radical scavenging value of 46%. In addition, the bio-nanocomposite membrane showed better biocompatibility and reliable biodegradability, while the cytotoxicity assessment emphasized its safety towards normal cells, with the cell viability reaching 95.7%, suggesting its potential use for advanced wound dressing applications.

Fabrication of chitosan nanocomposites loaded with biosynthetic metallic nanoparticles and their therapeutic investigation

The present research demonstrates the formation of zinc oxide nanoparticles facilitated by Cissus quadrangularis (CQ-ZnONPs) and subsequent synthesis of chitosan-conjugated nanocomposites (CQ-CS/ZnONCs) along with their biological assessment. The biosynthesized nanoparticles and nanocomposites were physicochemically characterized and therapeutically assessed for their antioxidant, antibacterial, and antidiabetic potential. The formation of CQ-ZnONPs and CQ-CS/ZnONCs was preliminarily validated by the change in color and subsequently by UV-visible spectroscopic analysis. The crystalline peaks associated with the CQ-ZnONPs in CQ-CS/ZnONCs were established by XRD analysis. Morphological evaluation of CQ-ZnONPs and CQ-CS/ZnONCs was carried out through FE-SEM and HRTEM studies. The particle size of the CQ-ZnONPs and CQ-CS/ZnONCs was 243.3 nm and 176.6 nm, with a PDI of 0.188 and 0.199, respectively. Nanoparticles and nanocomposites expressed Zeta potential of -15.7 mV and -16.2 mV, respectively. The CQ-ZnONPs and CQ-CS/ZnONCs showed good radical effectiveness with various in-vitro assays. The formulated nanoparticles and nanocomposites displayed significant antibacterial activity against the selected bacterial pathogens. CQ-CS/ZnONCs presented noteworthy α-amylase and α-glucosidase inhibitory effects compared to CQ-ZnONPs with IC50 of 73.66 ± 1.21 μg/mL and 87.59 ± 1.29 μg/mL, respectively. Moreover, the synthesized CQ-CS/ZnONCs demonstrated 98.92 ± 0.39% and 99.58 ± 0.16% wound contraction (at 7 and 14 mg, respectively), significantly (p < 0.05) higher than the standard and CQ-ZnONPs. Thus, the CQ-ZnONPs and CQ-CS/ZnONCs could effectively develop promising drug delivery systems to inhibit pathogens and chronic tissue repair.

A light-responsive wound dressing hydrogel: Gelatin based self-healing interpenetrated network with metal-ligand interaction by ferric citrate

Interpenetrated network (IPN) hydrogels with desired mechanical properties were prepared based on gelatin. A copolymer of dimethyl aminoethyl methacrylate (DMAEMA) with 2-Acrylamido-2-methylpropane sulfonic acid (AMPS) in gelatin was chemically cross-linked with methylene bis acrylamide (MBA) to form a semi-IPN hydrogel. Also, IPN hydrogel is fabricated from the AMPS-co-DMAEMA and gelatin in the presence of ferric ions with both chemical and physical cross-linkers. According to the compression test, the metal-ligand interaction has a remarkable impact on the mechanical strength of hydrogel. Ferric ions caused a decrease in the pores size confirmed by the SEM images of hydrogels, resulting in preserving its mechanical stability during the swelling test due to a more robust structure of hydrogel. Ferric to ferrous ions reduction is observed under visible light irradiation, which results in a light-sensitive hydrogel with a higher rate of biodegradation compared to semi-IPN hydrogels. MTT assay results implied that the synthesized hydrogels are non-toxic for the L-929 cell line. Also, for more detailed investigations, histological studies are conducted as in vivo tests. With regards to the improvements of mechanical properties harnessed in IPN hydrogels by ferric ions along with the extraordinary self-healing capability, IPNs would be considered an appropriate option for tissue engineering.

Dual functional antifouling and bactericidal proteinaceous coating

Coatings with both anti-fouling and bactericidal functions are used in many fields. In this work, lysozyme (Lyso) and poly (2-Methylallyloxyethyl phosphorylcholine) (PMPC) conjugate (Lyso-PMPC) is successfully designed and synthesized for the first time. A new nanofilm (PTL-PMPC) is then obtained by phase transition of lysozyme via the reduction of disulfide bonds in Lyso-PMPC. Benefit from lysozyme amyloid-like aggregates as surface anchors, the nanofilm shows excellent stability, it remains unchanged after treatment under extreme conditions such as ultrasonic and 3 M tape peeling. Due to the presence of zwitterionic polymer (PMPC) brush, the PTL-PMPC film has excellent antifouling properties against cell, bacterium, fungi, proteins, biofluids, phosphatide, polyose, esters, and carbohydrates. Meanwhile, the PTL-PMPC film is colourless and transparent. Further, a new coating (PTL-PMPC/PHMB) is fabricated by hybridizing PTL-PMPC with poly (hexamethylene biguanide) (PHMB). This coating had excellent antibacterial properties, and the antibacterial rate against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) is more than 99.99%. In addition, the coating exhibit good hemocompatibility and low cytotoxicity.

Electrospun nanofibers with antibacterial properties for wound dressings

The antibacterial nanofibers have been proposed as an interesting material for wound healing management, since the majority of traditional wound dressings exhibit issues and complications such as infection, pain, discomfort, and poor adhesive proprieties. It allows the organism's passage through the dressing and delay the wound healing progression. Electrospun nanofibers have been intensively investigated for wound dressings in tissue engineering applications due to their distinctive features and structural similarities to the extracellular matrix including the various available methods to load the antibacterial compounds onto the nanofiber webs. To construct an effective electrospun wound dressing, various efforts have been made to design different strategies to develop advanced polymers, such as employing synthetic and/or natural materials, modifying fiber orientation, and incorporating chemicals and metallic nanoparticles (NPs) as intriguing materials for antibacterial bandages. Thus, this review summarizes the relevant recent studies on the production of electrospun antibacterial nanofibers from a wide variety of polymers used in biomedical applications for wound dressings.

Polysaccharide Electrospun Nanofibers for Wound Healing Applications

As a type of biological macromolecule, natural polysaccharides have been widely used in wound healing due to their low toxicity, good biocompatibility, degradability and reproducibility. Electrospinning is a versatile and simple technique for producing continuous nanoscale fibers from a variety of natural and synthetic polymers. The application of electrospun nanofibers as wound dressings has made great progress and they are considered one of the most effective wound dressings. This paper reviews the preparation of polysaccharide nanofibers by electrospinning and their application prospects in the field of wound healing. A variety of polysaccharide nanofibers, including chitosan, starch, alginate, and hyaluronic acid are introduced. The preparation strategy of polysaccharide electrospun nanofibers and their functions in promoting wound healing are summarized. In addition, the future prospects and challenges for the preparation of polysaccharide nanofibers by electrospinning are also discussed.

Recent advances on biomedical applications of pectin-containing biomaterials

There is a growing demand for biomaterials developing with novel properties for biomedical applications hence, hydrogels with 3D crosslinked polymeric structures obtained from natural polymers have been deeply inspected in this field. Pectin a unique biopolymer found in the cell walls of fruits and vegetables is extensively used in the pharmaceutical, food, and textile industries due to its ability to form a thick gel-like solution. Considering biocompatibility, biodegradability, easy gelling capability, and facile manipulation of pectin-based biomaterials; they have been thoroughly investigated for various potential biomedical applications including drug delivery, wound healing, tissue engineering, creation of implantable devices, and skin-care products.

An Overview on the Recent Advances in the Treatment of Infected Wounds: Antibacterial Wound Dressings

A wound can be surgical, cuts from an operation or due to accident and trauma. The infected wound, as a result of bacteria growth within the damaged skin, interrupts the natural wound healing process and significantly impacts the quality of life. Wound dressing is an important segment of the skincare industry with its economic burden estimated at $ 20.4 billion (in 2021) in the global market. The results of recent clinical trials suggest that the use of modern dressings can be the easiest, most accessible, and most cost-effective way to treat chronic wounds and, hence, holds significant promise. With the sheer number of dressings in the market, the selection of correct dressing is confusing for clinicians and healthcare workers. The aim of this research was to review widely used types of antibacterial wound dressings, as well as emerging products, for their efficiency and mode of action. In this review, we focus on introducing antibiotics and antibacterial nanoparticles as two important and clinically widely used categories of antibacterial agents. The perspectives and challenges for paving the way for future research in this field are also discussed. This article is protected by copyright. All rights reserved.

Electrospun Antibacterial Nanomaterials for Wound Dressings Applications

Chronic wounds are caused by bacterial infections and create major healthcare discomforts; to overcome this issue, wound dressings with antibacterial properties are to be utilized. The requirements of antibacterial wound dressings cannot be fulfilled by traditional wound dressing materials. Hence, to improve and accelerate the process of wound healing, an antibacterial wound dressing is to be designed. Electrospun nanofibers offer a promising solution to the management of wound healing, and numerous options are available to load antibacterial compounds onto the nanofiber webs. This review gives us an overview of some recent advances of electrospun antibacterial nanomaterials used in wound dressings. First, we provide a brief overview of the electrospinning process of nanofibers in wound healing and later discuss electrospun fibers that have incorporated various antimicrobial agents to be used in wound dressings. In addition, we highlight the latest research and patents related to electrospun nanofibers in wound dressing. This review also aims to concentrate on the importance of nanofibers for wound dressing applications and discuss functionalized antibacterial nanofibers in wound dressing.

Nanotechnology for Targeted Detection and Removal of Bacteria: Opportunities and Challenges

The emergence of nanotechnology has created unprecedented hopes for addressing several unmet industrial and clinical issues, including the growing threat so-termed "antibiotic resistance" in medicine. Over the last decade, nanotechnologies have demonstrated promising applications in the identification, discrimination, and removal of a wide range of pathogens. Here, recent insights into the field of bacterial nanotechnology are examined that can substantially improve the fundamental understanding of nanoparticle and bacteria interactions. A wide range of developed nanotechnology-based approaches for bacterial detection and removal together with biofilm eradication are summarized. The challenging effects of nanotechnologies on beneficial bacteria in the human body and environment and the mechanisms of bacterial resistance to nanotherapeutics are also reviewed.

Zinc Oxide Nanoparticles Exhibit Favorable Properties to Promote Tissue Integration of Biomaterials

Due to the demographic change, medicine faces a growing demand for tissue engineering solutions and implants. Often, satisfying tissue regeneration is difficult to achieve especially when co-morbidities hamper the healing process. As a novel strategy, we propose the incorporation of zinc oxide nanoparticles (ZnO NPs) into biomaterials to improve tissue regeneration. Due to their wide range of biocompatibility and their antibacterial properties, ZnO NPs are already discussed for different medical applications. As there are versatile possibilities of modifying their form, size, and function, they are becoming increasingly attractive for tissue engineering. In our study, in addition to antibacterial effects of ZnO NPs, we show for the first time that ZnO NPs can foster the metabolic activity of fibroblasts as well as endothelial cells, both cell types being crucial for successful implant integration. With the gelatin sponge method performed on the chicken embryo’s chorioallantoic membrane (CAM), we furthermore confirmed the high biocompatibility of ZnO NPs. In summary, we found ZnO NPs to have very favorable properties for the modification of biomaterials. Here, incorporation of ZnO NPs could help to guide the tissue reaction and promote complication-free healing.

Electrospun Nanosystems Based on PHBV and ZnO for Ecological Food Packaging

The electrospun nanosystems containing poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and 1 wt% Fe doped ZnO nanoparticles (NPs) (with the content of dopant in the range of 0–1 wt% Fe) deposited onto polylactic acid (PLA) film were prepared for food packaging application. They were investigated by scanning electron microscopy (SEM), energy dispersive X-ray (EDX), Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), antimicrobial analysis, and X-ray photoelectron spectrometry (XPS) techniques. Migration studies conducted in acetic acid 3% (wt/wt) and ethanol 10% (v/v) food simulants as well as by the use of treated ashes with 3% HNO₃ solution reveal that the migration of Zn and Fe falls into the specific limits imposed by the legislation in force. Results indicated that the PLA/PHBV/ZnO:Fex electrospun nanosystems exhibit excellent antibacterial activity against the Pseudomonas aeruginosa (ATCC-27853) due to the generation of a larger amount of perhydroxyl (˙OOH) radicals as assessed using electron paramagnetic resonance (EPR) spectroscopy coupled with a spin trapping method.

Intelligent Nanoparticle-Based Dressings for Bacterial Wound Infections

Conventional wound dressing materials containing free antibiotics for bacterial wound infections are presented with several limitations, that is, lack of controlled and triggered release capabilities, and may often not be adequate to address the complex bacteria microenvironment of such infections. Additionally, the improper usage of antibiotics may also result in the emergence of drug resistant strains. While delivery systems (i.e., nanoparticles) that encapsulate antibiotics may potentially overcome some of these limitations, their therapeutic outcomes are still less than desirable. For example, premature drug release or unintended drug activation may occur, which would greatly reduce treatment efficacy. To address this, responsive nanoparticle-based antimicrobial therapies could be a promising strategy. Such nanoparticles can be functionalized to react to a single stimulus or multi stimulus within the bacteria microenvironment and subsequently elicit a therapeutic response. Such "intelligent" nanoparticles can be designed to respond to the microenvironment, that is, an acidic pH, the presence of specific enzymes, bacterial toxins, etc. or to an external stimulus, for example, light, thermal, etc. These responsive nanoparticles can be further incorporated into wound dressings to better promote wound healing. This review summarizes and highlights the recent progress on such intelligent nanoparticle-based dressings as potential wound dressings for bacteria-infected wounds, along with the current challenges and prospects for these technologies to be successfully translated into the clinic.

Carboxymethyl chitosan hydrogel formulations enhance the healing process in experimental partial-thickness (second-degree) burn wound healing

PURPOSE

This study aimed to elaborate a hydrogel constituted by carboxymethyl chitosan (CMC), hyaluronic acid (HA) and silver (Ag) and to evaluate its healing effect on partial-thickness burn wounds experimentally induced in rats.

METHODS

CMC was obtained by chitosan reacting with monochloroacetic acid. The carboxymethylation was confirmed by Fourier-transform infrared spectroscopy and hydrogen nuclear magnetic resonance (NMR). Scanning electron microscopy was used to determine the morphologicalcharacteristics of chitosan and CMC. After the experimental burn wound induction, the animals (n = 126) were treated with different CMC formulations, had their occlusive dressings changed daily and were followed through 7, 14 and 30 days. Morphometric, macroscopic and microscopic aspects and collagen quantification were evaluated.

RESULTS

Significative wound contraction, granulation tissue formation, inflammatory infiltration and collagen fibers deposit throughout different phases of the healing process were observed in the CMC hydrogels treated groups.

CONCLUSIONS

The results showed that, in the initial phase of the healing process, the most adequate product was the CMC/HA/Ag association, while in the other phases the CMC/HA association was the best one to promote the healing of burn wounds.

Electrospinning Proteins for Wound Healing Purposes: Opportunities and Challenges

With the growth of the aging population worldwide, chronic wounds represent an increasing burden to healthcare systems. Wound healing is complex and not only affected by the patient's physiological conditions, but also by bacterial infections and inflammation, which delay wound closure and re-epithelialization. In recent years, there has been a growing interest for electrospun polymeric wound dressings with fiber diameters in the nano- and micrometer range. Such wound dressings display a number of properties, which support and accelerate wound healing. For instance, they provide physical and mechanical protection, exhibit a high surface area, allow gas exchange, are cytocompatible and biodegradable, resemble the structure of the native extracellular matrix, and deliver antibacterial agents locally into the wound. This review paper gives an overview on cytocompatible and biodegradable fibrous wound dressings obtained by electrospinning proteins and peptides of animal and plant origin in recent years. Focus is placed on the requirements for the fabrication of such drug delivery systems by electrospinning as well as their wound healing properties and therapeutic potential. Moreover, the incorporation of antimicrobial agents into the fibers or their attachment onto the fiber surface as well as their antimicrobial activity are discussed.

Sustainable Rabbit Skin Glue to Produce Bioactive Nanofibers for Nonactive Wound Dressings

This paper assessed the collagen glue (Col) from rabbit skin for use as a raw material in combination with different water-based dispersants of antimicrobial agents such as ZnO NPs, TiO₂ NPs doped with nitrogen and Ag NPs (TiO₂-N-Ag NPs), and chitosan (CS) for the production of biocompatible and antimicrobial nanofibers. The electrospun nanofibers were investigated by scanning electron microscopy (SEM), attenuated total reflectance in conjunction with Fourier-transform infrared spectroscopy (ATR-FT-IR) analyses and antioxidant activity. The biocompatibility of electrospun nanofibers was investigated on cell lines of mouse fibroblast NCTC (clone L929) using MTT test assays. Antimicrobial activity was performed against Escherichia coli and Staphylococcus aureus bacteria and Candida albicans pathogenic fungus. Electrospun antimicrobial nanofibers based on collagen glue achieved reduction in the number of viable microorganisms against both fungi and bacteria and exhibited multiple inhibitory actions of fungal and bacterial strains. The electrospun nanofibers showed average dimension sizes in the range of 30–160 nm. The results indicated that both Col/TiO₂-N-Ag NPs and Col/CS formulations are suitable for cell proliferation and may be useful for producing of nonactive wound dressings.

ZnO Nanomaterials: Current Advancements in Antibacterial Mechanisms and Applications

The prevalence of various diseases caused by bacteria has been increasing, and some traditional antibiotics have been reported to have varying degrees of resistance. ZnO nanomaterials (ZnO-NMs), due to their excellent broad-spectrum antibacterial properties, lasting antibacterial effects, and excellent biocompatibility, have quickly become the research focus of new antibacterial agents. While the narrow light response range of ZnO-NMs has limited the antibacterial performance to some extent and modifying it by various means to improve its response under visible light, such as doping metal/non-metal atoms, depositing noble metals and coupling carbon materials, which is a new research hotspot. Herein, the current mainstream claims about the antibacterial mechanisms and applications of ZnO-NMs are reviewed.

Iron and zinc ions, potent weapons against multidrug-resistant bacteria

Drug-resistant bacteria are becoming an increasingly widespread problem in the clinical setting. The current pipeline of antibiotics cannot provide satisfactory options for clinicians, which brought increasing attention to the development and application of non-traditional antimicrobial substances as alternatives. Metal ions, such as iron and zinc ions, have been widely applied to inhibit pathogens through different mechanisms, including synergistic action with different metabolic enzymes, regulation of efflux pumps, and inhibition of biofilm formation. Compared with traditional metal oxide nanoparticles, iron oxide nanoparticles (IONPs) and zinc oxide nanoparticles (ZnO-NPs) display stronger bactericidal effect because of their smaller ion particle sizes and higher surface energies. The combined utilization of metal NPs (nanoparticles) and antibiotics paves a new way to enhance antimicrobial efficacy and reduce the incidence of drug resistance. In this review, we summarize the physiological roles and bactericidal mechanisms of iron and zinc ions, present the recent progress in the research on the joint use of metal NPs with different antibiotics, and highlight the promising prospects of metal NPs as antimicrobial agents for tackling multidrug-resistant bacteria.