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The International Journal of Lower Extremity Wounds
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The Extracellular Matrix in Wound Healing: A Closer Look at Therapeutics for Chronic Wounds

Magnus S. Agren

Department of Surgery K, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark, maa02{at}bbh.regionh.dk

Maria Werthen

Department of Biomaterials, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden, Mölnlycke Health Care AB, Göteborg, Sweden

Disappointing results with the use of exogenous recombinant growth factors in chronic wounds have redirected the focus to the extracellular matrix (ECM). Newer research has clearly changed our view on the role of the ECM in tissue repair and dismissed the dogma that the sole function of ECM is a passive physical support for cells. It is now clear that intact or fragmented ECM molecules are capable of transducing signals pivotal for cell processes in wound healing primarily via integrin interactions in concert with growth factor activation. In addition, our knowledge about ECM molecules in minute concentrations with biological activity, but devoid of significant structural influence, is increasing. This article reviews the multifaceted molecular roles of ECM in the normal wound-healing process and some molecular abnormalities in chronic wounds, and touches on potential therapies based on the developments of tissue biology.

Key Words: angiogenesis • granulation tissue formation • epithelialization • wound contraction • integrins • growth factors • amelogenin • fibronectin • hyaluronic acid

The International Journal of Lower Extremity Wounds, Vol. 6, No. 2, 82-97 (2007)
DOI: 10.1177/1534734607301394
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