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Skin substitutes for the management of hard-to-heal wounds

Gerit Mulder, Prof. Lawrence A. Lavery, William A. Marston, Harikrishna K. R. Nair, Alisha Oropallo, Naz Wahab, Marco Romanelli, Thomas E. Serena

3 December 2024

Skin substitutes—which may also be referred to under the umbrella terms ‘tissue scaffolds’ or ‘tissue-engineered products’, ‘cellular tissue products (CTPs)’, and ‘cellular, acellular and matrix-like products (CAMPs)’—have seen exponential development in recent years and become a commonplace tool within wound care. As products have been developed and the evidence base has grown, these products offer an increasingly important resource for managing complex wounds.

There is a plethora of products on the market, including those that are animal/human-derived, synthetic, or composite. These products provide useful management tools, particularly in wounds that are unresponsive to traditional wound management modalities (chronic or hard-to-heal wounds).

However, there is still confusion and a lack of awareness and guidance over best practice for product use, and how patient outcomes can be optimised through use of these advanced therapies. A lack of unbiased guidance to clarify different product categories and their use in practice was identified.

As such, a group of international experts met online on 21st June 2024 to discuss this novel product category. Their discussion forms the basis of this consensus document on the use of biological cellular and acellular matrices and tissue replacements.

This international consensus document aims to:

Provide clarity on biological matrices and dressings, and definitions of products within this category
Enable clinicians to differentiate between skin substitutes, their ability to expedite wound closure, and the rationale for their use
Provide guidance for product selection, rationale and when to use in practice
Provide practical tips on application and use in practice
Link guidance to evidence in common wound aetiologies (e.g. diabetic foot ulcers, venous leg ulcers).

While the use of different products will be influenced by a number of external factors—including availability, staff knowledge and training, cost, and the local healthcare system/setting—this consensus document aims to increase clinicians’ knowledge and awareness, helping to promote confidence in using these advanced therapies wherever available and appropriate, with the ultimate aim of improving patient outcomes.

Gerit Mulder, Chair

Download the full consensus document below

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Disclaimer: This document has been developed by Wounds International and supported by MIMEDX, MLM Biologics and Organogenesis

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Resources

Skin substitutes for the management of hard-to-heal wounds

Treatment with WOUND dressing spray based on St John’s wort oil and neem oil

Autolytic continuous debridement with a focus on biofilm management: Consensus document for the APAC region

Retrospective case series: Wounds treated with 3M™ Veraflo™ Therapy

UrgoClean Ag and UrgoStart Plus in Real Life

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