Skin is a very important organ that covers the body surface and directly contacts with the external environment, which plays a key role of protection and perception of stimuli, etc. [1]. Although human skin can repair itself for its restoration of structure and function, the process is still slow and difficult. For large, open or chronic wounds, wound care is crucial for preventing infection, reducing pain and avoiding scarring [2]. Currently, in developed countries, approximately 1–2 % of the population suffers from chronic wounds [3]. Meanwhile, chronic wounds such as diabetic ulcers, vascular ulcers, pressure ulcers, take a long time to heal and cause immense pain to patients due to disease, aging, or improper treatment, affecting their daily lives, and even leading to death in severe cases [4]. According to statistics, the global wound care products market is growing rapidly and is expected to reach $18.7 billion by 2027 [5]. At present, skin wound treatment is still a hot and challenging issue for clinical and scientific research. The skin can be divided into the epidermis layer, which is in direct contact with the outside world, and the dermis layer, which is inside. The epidermal layer is mainly consisted of the keratinocyte layer and germinal layer, which has the functions of preventing the outflow of tissue fluid, resisting friction, and resisting infection. Therefore, the completion of the epidermal layer is crucial for the treatment of wound tissue [6]. The dermis is divided into a papillary layer and a reticular layer, which contains structures such as capillaries, nerve endings and lymphatic vessels, which are also important for wound cell growth and proliferation [[7], [8], [9]].

Wound is a type of skin defect caused by damage to the body, such as physical or chemical factors, which is manifested as the destruction of the structure and function of the tissues [10,11]. Wound healing involves the regulation of a variety of cells and factors, and belongs to tissue regeneration, which is a very complex biological process. The main goal of wound management is to enable rapid wound healing. Therefore, preventing wound infection, shortening the inflammatory response, promoting cell proliferation or migration, and promoting angiogenesis are all effective in shortening the time to wound healing. Many different types of drugs have been developed that can be used at different wound stages, such as antimicrobial, anti-inflammatory, and pro-vascularizing drugs. However, it is difficult to achieve rapid wound healing with drugs alone. A reason for this is that drugs are subject to a number of efficacy problems caused by dosage, half-life, and drug resistance. Another important reason is that the speed of wound healing is also affected by the environment of the wound surface. The study found that the dry shell that forms on the wound surface during healing obstructs the migration of epidermal cells. When the wound is kept moist, epidermal cells can migrate more quickly through the wound exudate [12]. In addition, wound exudate contains higher levels of fibroblast growth factor (FGF), epidermal growth factor (EGF), and platelet-derived growth factor (PDGF) than non-moist environments, which can stimulate cell proliferation and promote tissue repair. Forming a barrier to protect the wound is an important function of wound dressings, which prevents infection, provides a favorable microenvironment, promotes skin cell regeneration, and actively promotes wound healing. Therefore an ideal skin wound dressing needs to fulfill the following requirements: (1) Excellent histocompatibility, not causing cellular toxicity or tissue inflammation; (2) A certain degree of breathability and moisture retention, which maintains a clean wound as well as a moist microenvironment, preferably with a certain degree of absorption of wound exudate as well; (3) Possess appropriate mechanical strength to ensure its integrity during use and not be damaged with normal activities, thus avoiding material breakage leading to external bacterial invasion; (4) In the face of different application scenarios, it is desirable to purposefully design the surface microstructure and biochemical properties of materials to confer functions such as promoting cell adhesion, proliferation and differentiation [13]. Researchers have developed many wound dressings to promote wound healing, such as semi-permeable membranes, semi-permeable foams, gel sponges, and hydrogels [14]. Among them, hydrogels have become one of the most widely studied candidates for wound dressings due to the material's favorable biosafety and its three-dimensional porous structure similar to that of extracellular matrix. Hydrogels are one of the most popular wound dressings and have been extensively studied in recent years due to their structure and function. Hydrogels have a porous three-dimensional mesh structure, similar to ECM. This structure makes the hydrogel have excellent water absorption and water locking ability, and provides a good growth environment for cells. The mechanical properties of the adhesive can be optimized by adjusting the chemical composition and crosslinking strategies to make it stable on the macro level and dynamic on the micro level. This property allows hydrogels to better simulate the dynamic properties of natural ECM. Allowing it to provide a scaffold for cell attachment and migration. Promote cell proliferation and differentiation. In addition, the three-dimensional structure of hydrogels allows them to promote wound recovery by introducing active substances or functional materials [15,16].

In addition, physiotherapy, also known as nonpharmacological therapy, is a commonly used treatment method in research, and in recent years, an increasing amount of physiotherapy has been applied in wound repair due to its high efficiency and low degree of irritation. Studies have shown that physiotherapy can have a positive impact on wound healing to the extent that it enhances blood circulation, achieves a reduction in inflammation and promotes cell proliferation [17].

There are numerous reviews available on the use of hydrogel dressings for promoting wound healing. Meanwhile, as the efficacy of physiotherapy in promoting wound healing has become increasingly recognized, reviews on physiotherapy have also emerged. As research continues to advance, researchers have found that combining hydrogel dressings with specific capabilities and physiotherapy can synergistically promote wound healing. This combination of therapies helps to capitalize on the advantages of both therapies in avoiding wound infection, protecting the wound microenvironment and shortening the time to wound closure. However, reviews describing the combination of these two therapies and their application in wound healing have not been found. This paper reviews the use of combination therapies in wound healing. First, the role of different types of therapies in wound healing and their characteristics are described, and next we summarize the role of hydrogel dressings combined with different types of physiotherapy in promoting wound healing. We hope to provide unique insights into the future treatment of wounds by focusing on recent strategies that use combination therapies to accelerate wound recovery. Finally, we discuss the prospects and challenges of combination therapies for the advancement of wound treatment.