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The ultra-fine micronized human acellular dermal matrix (UFM-hADM; \u223c70 \u03bcm) is designed to remain suspendable and pass through narrow-gauge injection, enabling uniform distribution along irregular wound margins and undermined tissue planes where sheet-type matrices may have limited contact and conformability. Here, we evaluated perilesional injection of an UFM-hADM (\u223c70 \u03bcm) as an injectable ECM scaffold in a murine cyclic ischemia\u2013reperfusion pressure-ulcer model. Compared to saline, UFM-hADM accelerated early wound closure and improved quality of healing at Day 7, with enhanced re-epithelialization and dermal regeneration accompanied by increased collagen deposition. Mechanistically, UFM-hADM shifted the wound milieu toward a pro-healing program by attenuating pro-inflammatory cytokines (TNF-\u03b1 and IL-6) while increasing IL-10, promoting neovascularization and vascular maturation (upregulated VEGF, increased CD31 and \u03b1-SMA), and restoring balanced ECM remodeling (elevated COL1A1 and COL3A1 with suppression of MMP1 and MMP3). These coordinated molecular changes opposed inflammatory, protease-rich transcriptional signatures identified in human pressure ulcers through public transcriptomic reanalysis. In addition, exploratory observational use of Ministry of Food and Drug Safety (MFDS)-approved UFM-hADM for pressure ulcers, undertaken with patient consent as part of routine clinician-directed care, suggested acceptable tolerability and a favorable healing course during follow-up. Collectively, these findings provide mechanistic support for the adjunctive clinical use of UFM-hADM as a minimally invasive, human-derived injectable ECM adjunct that may facilitate pressure-ulcer healing through coordinated modulation of immune, vascular, and matrix responses.<\/jats:p>","DOI":"10.1177\/22808000261460977","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T19:57:20Z","timestamp":1781726240000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultra-fine micronized human dermal matrix reprograms the chronic pressure-ulcer microenvironment to accelerate healing"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2369-2745","authenticated-orcid":false,"given":"Hao","family":"Jin","sequence":"first","affiliation":[{"name":"Chungbuk National University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binna","family":"Shin","sequence":"additional","affiliation":[{"name":"Hulux"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daseul","family":"Kim","sequence":"additional","affiliation":[{"name":"Hulux"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeji","family":"Seo","sequence":"additional","affiliation":[{"name":"Hulux"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjin","family":"Lee","sequence":"additional","affiliation":[{"name":"Hulux"},{"name":"Live Cell Instrument"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Myoeng","family":"Lee","sequence":"additional","affiliation":[{"name":"Chungbuk National University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103546"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2019.28.11.702"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.70064"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.12.069"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2018.09.010"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2010.03.007"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1067-1927.2005.130213.x"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-475x.2000.00068.x"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/08941930490472046"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3009337"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2015.0635"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0022034509359125"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-475X.1999.00442.x"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrm3904"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2020.00636"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines8050101"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2011.00748.x"},{"issue":"1","key":"e_1_3_7_19_2","first-page":"S1","article-title":"Wound bed preparation: a systematic approach to wound management","volume":"11","author":"Schultz GS","year":"2003","unstructured":"Schultz GS, Sibbald RG, Falanga V, et al. 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