Advances in Wound Closure Technologies: A Comprehensive Multi-Decadal Review

Wound closure remains a cornerstone of surgical excellence and emergency medical intervention. Over the past several decades, the field has evolved from rudimentary mechanical approximation techniques to highly engineered, biomimetic, and intelligent theragnostic systems. This comprehensive review article details the historical trajectory, material science, biomechanical principles, and clinical outcomes of modern wound closure devices. We analyze traditional macro-mechanical benchmarks such as monofilament and multifilament sutures, mechanical staples, and hemostatic clips, alongside advanced non-invasive options including micro-anchor matrices and pressure-sensitive zip devices. Furthermore, we dissect the chemical kinetics and biological interactions of topical cyanoacrylate adhesives, fibrin glues, and catechol-functionalized hydrogels. Finally, we explore the cutting-edge frontier of smart closures equipped with flexible bioelectronics for real-time physiological monitoring and controlled drug-eluting capabilities. By assessing tensile strength, infection mitigation, cosmetic outcomes, and health economics, this review provides clinical practitioners and biomedical engineers with a unified framework for matching optimal closure modalities to specific anatomical and physiological demands. [1]