Endoform™ – Extracellular Matrix (ECM) for superficial and mid-depth wounds

– derived from ovine forestomach. Can replace lost or damaged ECM and help provide a physiological wound environment.

When is Endoform often relevant?

Chronic wounds (e.g. venous leg ulcers, diabetic foot ulcers)
Pressure ulcers / decubitus
Postoperative or traumatic wounds with delayed healing
Superficial and mid-depth defects that may benefit from an acellular ECM and additional growth factors
As a “booster” with vacuum therapy
Burns

Treating patients with chronic wounds? – Request detailed product information now.

What can Endoform provide?

May support the formation of granulation tissue by replacing the patient’s own ECM
May provide a physiological healing environment
May promote wound angiogenesis, supporting blood flow
May be combined with standard therapies (e.g. compression, vacuum therapy)

Interested in how Endoform™ could be integrated into your wound care?

Potential benefits at a glance

May help regulate wound proteases
May contribute to improved healing by replacing lost/damaged ECM
May enhance angiogenesis to improve wound perfusion, necessary for cell migration
Easy to use and integrate into existing treatment concepts
Same CAMPS category as fish skin (e.g. Kerecis)
May act as a “booster” when combined with vacuum therapy
Documented use in clinical publications

Interested in a trial or training?

What is the clinical evidence?

The use of Endoform is safe
A sufficient number of publications and case reports exist, with more than 7 million applications worldwide
Proven practicality – when used as part of treatment concepts, numerous positive outcomes have been documented
Further information: https://aroa.com/aroa-ecm/

Learn more about the scientific basis.

User Guide – Extracellular Matrix (ECM)¹

1. Analyze and measure the wound precisely (if necessary, repeat after debridement/moist phase)

Preferably measure in three dimensions (length × width × depth).
Additionally: BakterienScan and wound temperature (ideally with cv.MESH™ by CureVision® www.hofmann-medical.ch/en-curevision).
Assess general condition, wound edges, and wound bed.
Exercise special caution with open structures such as vessels, tendons, or bone. Remove fibrin coatings, necrotic tissue, and biofilm—manually (curette, scalpel, cannula) or surgically.
Exercise particular caution around open structures such as blood vessels, tendons, or bones [C]. [D] shows granulation tissue
⚠️ In case of prior ECM treatment: do not remove product/product remnants.
→ Distinguish between fibrin coating and product remnants.

2. Consistent moist phase

3. Select and prepare skin substitute (ECM) (provided the wound is judged ready)

Endoform™: for superficial and moderately deep wounds, including exposed structures (tendons, vessels, bone).
Myriad Matrix™: for deep wounds and large soft-tissue defects, also with exposed structures.
ProHeal®: alternative collagen matrix, also suitable for readiness check.
Application: Briefly press ECM onto the wound edge → mark wound edges. Then, if necessary, cut precisely to wound size with sterile scissors. Remnants may be used as fragments to fill irregularities or wound pockets. ⚠️ Do not insert too much material!
[B] Blood

4. Moisten, apply ECM, and protect the wound edge

With NaCl 0.9 % or Ringer’s solution.
Endoform™ or ProHeal®: moisten and insert—or apply dry and moisten in the wound.
Ensure good contact with the wound bed. → With heavy exudation or adequate bleeding, moistening can be omitted
Endoform™: May be applied in multiple layers or reapplied if necessary. ⚠️ Warning: multiple layers can create shear forces that adversely affect “cellular ingrowth.” In such cases, consider Myriad Matrix™.
Myriad Matrix™: Always soak outside the wound in NaCl 0.9 % or Ringer’s solution for 8–10 minutes. Ideally suture or staple Myriad Matrix™ to the wound bed/edges.
Wound-edge protection, e.g., Zinc Cream. Adjust wound-edge protection to the secondary dressing as needed.

5. Fixation & selection of secondary dressing (depending on exudate level)

Secure the product extensively with a suitable silicone spacer mesh to avoid accidental removal during secondary dressing change. 👉 If necessary, additionally secure the spacer mesh with Steri-Strips.
Little to none: hydrogel for continuous hydration or product reactivation; alternatively a light dressing (e.g., foam dressing).
Moderate–heavy: superabsorber.
Heavy: NPWT (Negative Pressure Wound Therapy)
NPWT and ECM (Endoform/Myriad) complement each other optimally. ECM does not constitute a pressure limitation.
We recommend delaying the change of the NPWT for as long as possible.
ProHeal®: an alternative collagen matrix, also suitable for readiness checks.

6. Complementary measures (depending on indication)

Pressure relief (for pressure ulcers, diabetic foot). Compression (for venous ulcers).
Important for the follow-up provider (documentation):
Particular caution is required during dressing changes.
ECM must not be accidentally removed with the secondary dressing.
ECM remnants must not be removed.
It has proven effective that Spitex (home-care service) leaves the spacer mesh in place and that it is changed only by a specialized wound-care expert.

7. Dressing change

It is normal for Endoform™ remnants to be visible during dressing change. They must not be mistaken for fibrin and must not be removed. If necessary, apply additional Endoform™. If the wound is too dry, Endoform™ can be moistened with hydrogel.

¹ According to the user guides of the respective manufacturers and the extended wound-care concepts of HOFMANN MEDICAL.

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Endoform™ – Extracellular Matrix (ECM) for superficial and mid-depth wounds

When is Endoform often relevant?

What can Endoform provide?

Potential benefits at a glance

What is the clinical evidence?