Acellular Dermal Matrix Applications in Chronic Wound Healing
Summary
Chronic wounds, including diabetic foot ulcers, venous leg ulcers and pressure sores, represent a major global health challenge owing to impaired tissue regeneration, persistent inflammation and high risk of infection. Acellular dermal matrices (ADMs) are biologically derived scaffolds created by removing cellular components from donor skin while preserving the native extracellular matrix architecture. This process yields a biocompatible structure that supports host cell infiltration, guides angiogenesis and modulates inflammatory responses. ADMs serve as a temporary framework that permits revascularisation, encourages deposition of new extracellular matrix and reduces scar formation. These products have been applied as grafts or overlays alongside standard care—such as debridement and off-loading—to accelerate wound closure, improve tissue quality and decrease recurrence rates. Advances in manufacturing have refined decellularisation techniques, reduced immunogenic remnants and enabled sterilisation without compromising mechanical integrity. Despite this progress, challenges remain in optimising integration in poorly vascularised regions, matching mechanical properties to wound site demands and ensuring cost-effectiveness across diverse healthcare settings. Continued multidisciplinary research is focusing on composite constructs combining ADMs with growth factors, cellular therapies or advanced dressings to address these challenges and extend applications in resource-limited contexts.
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Acellular Dermal Matrix Applications in Chronic Wound Healing publication trend
The graph below shows the total number of articles in acellular dermal matrix applications in chronic wound healing across all publications each year (not limited to Nature Index journals).
Technical terms
Acellular dermal matrix (ADM): A biomaterial derived from skin in which cells are removed, leaving behind the structural extracellular matrix.
Decellularisation: The process of eliminating cellular components from a tissue or organ, typically using chemical, enzymatic or physical methods, to reduce immunogenicity.
Angiogenesis: Formation of new blood vessels from pre-existing vasculature, critical for delivering oxygen and nutrients to healing tissue.
Extracellular matrix (ECM): A complex network of proteins and polysaccharides that provides structural support and biochemical signals to cells.
Biological dressing: A wound cover composed of natural or bioengineered materials designed to promote regeneration and protect the wound environment.
References
- Chronic Diabetic Wounds and Their Treatment with Skin Substitutes. Cells (2021).
- Decellularized Scaffolds for Skin Repair and Regeneration. Applied Sciences (2020).
- Acute Cutaneous Wounds Treated with Human Decellularised Dermis Show Enhanced Angiogenesis during Healing. PLOS ONE (2015).
- Skin substitutes as treatment for chronic wounds: current and future directions. Frontiers in Medicine (2023).
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