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. 2023 Aug 23;23:e51.

TABLE.

SUMMARY OF ECMs COMMONLY USED IN WOUND CARE

ECM type Description Indications Competitive advantages Disadvantages
Allografts Skin tissue primarily obtained from cadavers that is procured, processed, and preserved with 2 main techniques (cryopreservation and glycerol preservation)

  • - Full-thickness wounds

  • - Partial-thickness wounds

  • - Coverage of widely meshed skin autografts

  • - Wound bed preparation for an autograft

  • - When autografts are not available

  • - Have properties of autologous skin

  • - Stimulate vascularization

  • - Pain reduction

  • - Antimicrobial properties

  • - Provide a dermal matrix and stronger scar

  • - Not always readily available

  • - Slower healing and procedure times

  • - Risk of immunogenicity

  • - Good but not great cosmesis

  • - Shelf life and preservation requirements
Bioengineered Synthetic skin tissue derived from a variety of materials (eg, engineered with a silicone membrane and nylon mesh impregnated with porcine dermal collagen; engineered from living foreskin-derived keratinocytes, fibroblasts, and bovine collagen)

  • - Full-thickness wounds

  • - Partial-thickness wounds

  • - Burns and diabetic and venous ulcers

  • - Graft reduction

  • - Surgical or trauma wounds

  • - Faster healing rates and procedure times

  • - Readily available

  • - Cosmetically superior

  • - Affordable

  • - Pain reduction

  • - Antimicrobial properties

  • - Low immunogenicity

  • - Diverse options allow for selecting matrix tailored to patient needs

  • - Can be used temporarily or permanently

  • - Indefinite shelf life and minimal preservation requirements

  • - Fails to vascularize

  • - Weaker and more fibrotic scars

  • - Too many options can complicate selection process
Xenografts Grafts obtained from multiple animal species (eg, porcine, bovine) that are used for temporary wound coverage; genetically modified to prevent acute rejection; preserved with glutaraldehyde

  • - Partial thickness burns

  • - Split-thickness skin graft donor sites

  • - Exfoliative skin conditions

  • - Debridement of infected burns and ulcer

  • - Diabetic foot ulcers

  • - Pain reduction

  • - Maintenance of ideal moisture conditions

  • - Antimicrobial properties

  • - Array of sizes available

  • - Affordable

  • - Fails to vascularize

  • - Only a temporary wound barrier

  • - Immunosuppressive therapy may be required if host has an immune reaction to the graft
Acellularized fish skin Distinct xenograft harvested from either Nile tilapia or North Atlantic cod and prepared with a light detergent that induces osmotic manipulation

  • - Partial and full thickness burns

  • - Pressure ulcers

  • - Chronic vascular ulcers (arterial and venous)

  • - Diabetic ulcers

  • - Trauma and surgical wounds

  • - Accelerated wound healing (surface area and depth)

  • - Pain reduction

  • - Cod acellularized fish skin is expensive

  • - Less-expensive tilapia acellularized fish skin has limited availability

  • - Limited evidence supporting acellularized fish skin usage