Decellularized small intestine for burn wound treatment: a tissue engineering paradigm shift?

Burn injuries are a major global health concern, estimated to cause 11 million injuries and 180,000 fatalities annually (1). The morbidity of burn injuries extends beyond the physical trauma, resulting in microorganism invasion, infection, and sepsis (1). Moreover, burn scars can compromise the quality of life, affecting joint mobility, functionality, and daily activities (2,3). Conventional dressings and autografts face limitations in healing, requiring the emergence of novel strategies (4). Xerographic tissue, after the adequate decellularization processing to cope with the low immunogenicity requirements, represents a unique avenue for developing advanced wound dressings. Porcine small intestine is characterized by its composition of fibroblast growth factors, transforming growth factor-beta, vascular endothelial growth factor, and structural and functional proteins. These components play pivotal roles in wound healing, regulating cell division, migration, and differentiation (5). To fully preserve these important bioactive molecules while ensuring its cost-effectiveness is an essential task, that can only be achieved by adequately designing tissue specific decellularization processes. This work proposes an advanced decellularization pipeline to obtain a safe and highly preserved porcine small intestine decellularized ECM, using combinatorial approaches and advanced technologies to achieve optimal tissue functionality as a wound dressing.