Biologic Scaffolds Composed of Extracellular Matrix as a Natural Material for Wound Healing

The ideal substrate/scaffold for cells, tissues, and organs is that which exists in nature; that is, the extracellular matrix (ECM). It is widely recognized that the ECM has a profound influence on cell differentiation, phenotype, and behavior. The technical limitations of reproducing all elements of the ECM, especially those which are dynamic and responsive to transitional external influences, are daunting. There currently exist many biologic scaffold materials composed of mammalian ECM. Such naturally occurring materials are the subject of this chapter. The chapter provides an overview of these materials, which are typically regulated as surgical mesh medical devices by the Food and Drug Administration (FDA). The preparation of such materials are briefly reviewed including the influence of various processing methods on clinical efficacy. It is widely accepted that passive range of motion and mechanical loading can have a positive and substantial effect on the endogenous healing response.