Review of small intestine submucosa extracellular matrix technology in multiple difficult-to-treat wound types.

The extracellular matrix (ECM) of the dermis is a critical structural component required for normal wound healing. The ECM, along with its key signaling components, provides the support structure necessary for fibroblasts, immune cells, and keratinocytes. When ECM activity is dysfunctional, the normal wound healing process is compromised, leading to slow, irregular repair, which may result in the development of chronic wounds. To replace dysfunctional ECM, several strategies have been developed to promote the development of a proper ECM or to replace the ECM entirely. One such method is the use of small intestine submucosa (SIS) to replace the nonfunctional ECM. Small intestine submucosa closely mimics the normal ECM of the human dermis despite being of porcine derivation. Small intestine submucosa wound matrix is an example of an available ECM-based biomaterial that has demonstrated improvements in wound management in the clinical setting.