Abstract: BACKGROUND: Dysfunction of neutrophils in the microenvironment of refractory wounds and their abnormal interactions with other immune cells and repair cells have become a central research focus for understanding the pathophysiology of chronic wounds and developing novel intervention strategies.
OBJECTIVE: To investigate the current research status, hotspots, frontiers, and development trends regarding neutrophils in the field of hard-to-heal wound repair.
METHODS: Relevant literature regarding neutrophils in the repair of hard-to-heal wounds published between 2004 and 2024 was retrieved from the Web of Science Core Collection database. Bibliometric visualization analysis methods were employed for analysis and visualization, revealing the research landscape, major hotspots, and frontier trends from dimensions including publication volume, countries/regions, institutions, authors, journals, references, and keywords.
RESULTS AND CONCLUSION: A total of 1 062 relevant articles concerning neutrophils in hard-to-heal wound repair were included. The annual publication output in this field showed a significant growth trend, accelerating markedly after 2014. Publications exceeded 100 in 2023, indicating increasing academic attention. The United States led globally with 378 publications, boasting an extensive international collaboration network. China ranked second with 189 publications, demonstrating strong research vitality; however, there remains potential for enhancing international collaboration and citations per paper. Shanghai Jiao Tong University (China) was the most prolific institution, while the University of Illinois and Harvard University (USA) emerged as central hubs for citation frequency. Journal analysis identified Wound Repair and Regeneration as the core journal leading in both publication volume and citation count. Research hotspots focus on inflammation, angiogenesis, and diabetic foot ulcers, among others. Keyword clustering timeline and burst analyses revealed that neutrophil extracellular trap formation and neutrophil-macrophage interactions represent frontier research trends. These results indicate that a clear developmental trajectory has emerged in this field, spanning from clinical problems to molecular mechanisms, and further towards immunomodulatory intervention strategies. In the future, precise regulation of neutrophil functions holds promise for opening new avenues in the treatment of hard-to-heal wounds.

Key words: neutrophils, hard-to-heal wounds, wound repair, neutrophil extracellular traps, bibliometrics, visual analysis