Piezocatalytic Pt@BMO-Gel Dressing for In Situ Generation of H2 and NO to Treat Infectious Inflammation Related to Incontinence

Incontinence-associated dermatitis (IAD) leads to persistent tissue damage, antibiotic-resistant infections, and neurogenic inflammation, greatly impairing patients' quality of life. Current therapies fail to simultaneously eliminate resistant bacterial biofilms, neutralize alkaline conditions, and break the cycle of ammonia (NH 3 ) regeneration. Here, a piezoelectric gas therapy strategy based on platinum-decorated bismuth molybdate load in gelatin methacrylate (GelMA) hydrogel (Pt@BMO-Gel) is introduced. Under ultrasound excitation, Pt@BMO generates high piezoelectric potential to improve charge separation, selectively adsorbs NH 3 on BMO (001) crystal facets, efficiently degrades NH 3 to normalize pH, and enables sustained release of H 2 and NO for dual antibacterial and anti-inflammatory effects. Mechanistic insights from theoretical calculations show that the Pt (111) and BMO (001) surfaces lower energy barriers for H 2 formation and N─H bond cleavage, conducive to the generation of NO and H 2 . Transcriptomic profiling reveals downregulation of key nitrogen metabolism genes (arcC/hutH) in methicillin-resistant Staphylococcus aureus (MRSA) and disruption of the (p)ppGpp-mediated stringent response, effectively eradicating bacterial persistence via metabolic reprogramming. This study establishes Pt@BMO as an efficient piezoelectric catalyst for wound therapy, presenting a novel approach in medicine that transforms harmful NH 3 into therapeutic H 2 and NO, offering a promising treatment paradigm for infected wounds, such as incontinence-associated dermatitis.