The use of an acellular matrix derived from human dermis for the treatment of full-thickness skin wounds Elena Bondioli . Valeria Purpura . Catuscia Orlandi . Andrea Carboni . Paola Minghetti . Giovanna Cenacchi . Giovanni De Luca . Daniela Capirossi . Evandro Nigrisoli . Davide Melandri Received: 8 November 2018 / Accepted: 8 February 2019 Ó Springer Nature B.V. 2019 Abstract Full-thickness skin wounds occur in many different clinical cases and the use of biological acellular dermal matrices (ADMs) to reconstruct the damaged area is increasing in the field of plastic and reconstructive surgery. In particular, the ability of ADMs to maintain the structural properties of extra- cellular matrix as well as to provide a suitable envi- ronment for cell growth makes their use suitable for the improvement of wound healing and the reduction of side effects deriving from contracture and scar tissue formation. In this study, we describe the clinical use of a recently developed human dermal matrix (HDM) in combination with graft skin as an alterna- tive reconstructive solution for the treatment of full- thickness skin wounds. The HDM was applied in combination with autologous graft skin on three different clinical cases in which full-thickness skin wounds occurred. The clinical outcomes were evalu- ated in the patients during their follow-up. Histological as well as ultra-structural analysis were also performed on skin biopsy of the clinical case 3 one year after the treatment with HDM. The use of HDM stimulates the wound healing process in all clinical cases of full-thickness skin wounds here described with a functional and aesthetic rescue of the damaged area. Histological and ultra-structural analysis show a regenerative healing of the wound area with well-organized/oriented connective tissue in which cellular infiltration as well as blood vessels are evident. Our results support the clinical use of HDM as a permanent dermal replacement for the treatment of full-thickness skin wounds. Keywords Dermal matrices Á Skin wounds Á Wound healing Introduction Several clinical conditions are characterized by full- thickness skin wounds in which the dermal and epidermal layers result as totally destroyed. In these conditions, unlike the epidermis, the dermal layer is unable to regenerate and it is finally replaced by scar tissue lacking of properties required for functional and aesthetic rescue. The conventional surgical treatments with autograft or allograft skin are able to provide a life-saving skin replacement on the damaged area. On the other hand, a further injury at the donor site of the E. Bondioli Á V. Purpura (&) Á C. Orlandi Á A. Carboni Á P. Minghetti Á D. Melandri Burns Centre and Emilia Romagna Regional Skin Bank, ‘‘Bufalini’’ Hospital, AUSL Romagna, Cesena, Italy e-mail: valeria.purpura@auslromagna.it G. Cenacchi Biomedical and Neuromotor Sciences Department, University of Bologna, Bologna, Italy G. De Luca Á D. Capirossi Á E. Nigrisoli Department of Human Pathology, ‘‘Bufalini’’ Hospital, AUSL Romagna, Cesena, Italy 123 Cell Tissue Bank https://doi.org/10.1007/s10561-019-09755-w