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308 Arnold and Arm | Journal of Clinical and Translational Research 2024;10(5):307-316
migration of responding cells to the wound site, hindering and combating microbial burden [5]. The microvasculature,
repair. In addition, the oxygen-deprived environment impairs composed of small blood vessels (arterioles, capillaries, and
the healing ability of the cells that do arrive [5]. As in all venules), ECM proteins that form the basement membrane and
wounds, a functioning microcirculation that provides adequate vessel structure, and inherent cells (multipotent cells, endothelial
tissue oxygenation is essential for healing. Wound healing, cells, pericytes, fibroblasts, and smooth muscle cells), serves as
microvascular ingrowth into a non-healing site, and general the foundation for granulation and remodeling during wound
tissue repair all require an effective extracellular matrix (ECM) healing [6-8]. Microvascular ECM proteins form the basic
scaffold. structure of blood vessels and provide physical scaffolding,
During normal wound healing, angiogenesis leads to tissue mechanical stability, and biochemical cues necessary for tissue
revascularization and the establishment of a functioning to form and maintain stability [9,10]. The ECM is capable of
microcirculation to deliver oxygen and nutrients required for modulating a whole host of processes, including cell migration,
proper tissue repair, along with the removal of waste metabolites attachment, differentiation, and repair [11].
Repair of damaged microvascular structure and restoration
of adequate blood flow to provide oxygen and nutrients to
the site is essential to promote healing and minimize tissue
breakdown in the newly epithelialized wound. Formation of
a new neurovascular network after tissue injury is critical
for wound resolution and maintaining tissue viability and
function. Advanced age, diabetes, and radiation treatments
are all conditions that manifest in deficient or dysfunctional
microvasculature, which can compromise the healing process,
leading to poor tissue quality and impaired healing in these
patient populations.
Processed microvascular tissue (PMVT) is a microvascular
tissue structural allograft (mVASC ; MicroVascular Tissues,
®
Figure 1. Application of processed microvascular tissue (PMVT). The Inc., USA) consisting of lyophilized and terminally sterilized
sterile, lyophilized PMVT disk can be removed from the vial, broken allogeneic microvascular tissue ECM harvested from the
into pieces if desired, and applied topically in dry form to a surface hypodermal tissue of cadaveric human donors. It is packaged
wound site. as a lyophilized disk in a sealed glass vial for single-patient

A

B

Figure 2. Progression of metatarsal diabetic foot ulcer. (A) Images demonstrating that weekly topical application of processed microvascular
tissue through week 6 rapidly healed the ulcer, leading to complete closure by week 10. (B) Graph detailing the healing rate of the closing ulcer by
area and volume.

DOI: http://doi.org/10.36922/jctr.24.00059