Best practice for wound repair and regeneration use of cellular, acellular and matrix-like products (CAMPs)

Abstract

Since the introduction of biomaterial products for wound healing in the early 1970s, understanding of their effects has increased, and a plethora of these products has been developed. These products have been classified according to their cellularity (cellular vs acellular), source (autograft vs allograft vs xenograft) and material (natural vs synthetic). This led the expert panel for this consensus document to adopt the following definition for them: ‘A broad category of biomaterials, synthetic materials or biosynthetic matrices that support repair or regeneration of injured tissues through various mechanisms of action’. This was shortened to cellular, acellular and matrix‑like products (CAMPs). While CAMPs differ in composition, they provide human tissue that has been injured, either as a result of a disease, trauma or surgery, with the following benefits: • Structural support for soft tissue through the stimulation of angiogenesis and matrix production, as well as coverage of deep structures • Migration of epithelial cells • Enhancement of surgical closure • Improvement of functional outcomes • Improvement in cosmetic appearance. The success of any CAMP application depends on an appropriate and thorough patient evaluation, treatment of all underlying disorders, adequate wound bed preparation and comprehensive patient and caregiver education. This consensus document identifies impediments to their use in the current medical environment and suggests possible solutions for this. The panel recognises that, although the literature supports the use of CAMPs in the treatment of hard‑to‑heal wounds, burns, surgical wounds and some skin disorders, more good‑quality research is needed to provide robust evidence on their benefits and to determine their efficacy and cost‑effectiveness. This level of evidence is critical to obtain universal acceptance and availability of the products.