{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T22:08:08Z","timestamp":1789510088562,"version":"build-2803163510"},"reference-count":45,"publisher":"Mark Allen Group","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2021,8,2]]},"abstract":"<jats:p> Skin healing defects severely impair the quality of life of millions of people and burden healthcare systems globally. The therapeutic approach to these pathologies still represents a challenge. Novel scaffolds, used as dermal substitutes, possibly represent a promising strategy in complex wound management. Integra Flowable Wound Matrix (IFWM) is composed of a lyophilised, micronised form of collagen\/chondroitin sulphate matrix, already used in regenerative medicine and endorsed in the therapy of diabetic foot lesions. In this paper, IFWM was applied to a tunnelling hard-to-heal skin lesion in order to restore tissue integrity. Although the different phases of skin wound healing are well established, the molecular mechanism underpinning IFWM-induced tissue repair are almost unknown. Here, we report, for the first time, the comparative analysis of molecular, histological and clinical observations of the healing process of a hard-to-heal tunnelling skin wound. The therapeutic success of this clinical case allowed us to recommend the use of IFWM as a tissue substitute in this rare type of hard-to-heal wound in which the high inflammatory status hampered the natural healing process. <\/jats:p>","DOI":"10.12968\/jowc.2021.30.8.644","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T13:10:14Z","timestamp":1628773814000},"page":"644-652","source":"Crossref","is-referenced-by-count":3,"title":["Hard-to-heal wound treated with Integra Flowable Wound Matrix: analysis and clinical observations"],"prefix":"10.12968","volume":"30","author":[{"given":"Marcella","family":"Cammarota","sequence":"first","affiliation":[{"name":"Department of Experimental Medicine, Section of Biotechnology, Medical Histology and Molecular Biology, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, 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