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The extracellular matrix (ECM) plays and important role in the wound healing process. It acts as a scaffold within the wound, providing a framework to which cells can attach, proliferate and synthesise growth factors and extracellular matrix components.
When the extracellular matrix malfunctions, as happens in the case of chronic wounds, there's nothing for the cells to attach to. In hard-to-heal wounds, a malfunctioning extracellular matrix compromises tissue remodelling and re-epitheliaslisation.
In other words, it delays healing.
Schultz et al. 2003
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