Wound Healing Society

Aims: To evaluate the real-world effectiveness of a human keratin matrix (HKM) compared with standard of care (SOC) in promoting pressure ulcer (PU) healing among patients treated in post-acute care settings. Methods: This observational comparative effectiveness study analyzed deidentified PU-level data from the LiftOff Registry, a national real-world database capturing post-acute wound care delivered in long-term acute care hospitals and skilled nursing facilities. PUs treated with HKM plus SOC were compared with those managed with SOC alone. Bayesian propensity score methods were used to reduce confounding and balance baseline demographic and clinical characteristics measured at PU identification. Healing—defined as complete epithelialization or closure—was modeled using Bayesian logistic regression with study arm and baseline PU stage as predictors. Treatment effects were summarized as posterior risk ratios (RR) with 95% highest density intervals (HDI) and posterior probabilities of benefit. Results: Before matching, the SOC cohort included 9356 patients with 14,740 PUs (33.2% healed), while the HKM cohort included 58 patients with 81 PUs (54.3% healed). After matching, 161 PUs were analyzed (81 HKM; 80 SOC); most were Stage 3 or Stage 4. HKM treatment was associated with higher modeled probabilities of healing compared with SOC alone. The posterior mean RR for healing was approximately 1.6 (95% HDI ≈ 1.0–2.1), with a posterior probability of benefit (RR > 1) of approximately 99.4%. Conclusion: In this real-world post-acute care cohort of patients with PUs, HKM use was associated with a high posterior probability of improved healing compared with SOC alone. These findings support HKM as an adjunctive therapy for complex or non-healing pressure ulcers in post-acute care settings.

Objective: To assess real-world effectiveness of Innovamatrix™, a dehydrated porcine placental extracellular matrix (PPECM), in chronic wounds refractory to 30 days of optimized standard-of-care (SOC) therapy. Methods: Multicenter retrospective analysis of 72 chronic wounds (18 diabetic foot ulcers (DFUs), 4 venous leg ulcers (VLUs), 12 pressure injuries, 38 open wounds) in 66 patients treated with sequential PPECM applications (between October 2023 and June 2025). All wounds showed <50% area reduction during SOC run-in and met Medicare Local Coverage Determination (LCD) eligibility. Primary endpoint focused on complete re-epithelialization (99.99% to 100% percent area reduction (PAR)). Secondary endpoints included PAR, applications to closure, and time-to-closure. Results: Wounds presented with a mean baseline area of 9.75 ± 15.97 cm2 and achieved a mean PAR of 85.92%. Complete closure occurred in 46/72 wounds (63.9%): 61.1% of DFUs healed, 50.0% pressure injuries healed, 76.3% open wounds healed, and 0% VLUs healed. Among healed wounds, the median number of applications to closure was 6 (mean 6.28 ± 3.58) with open wounds healing the fastest (median 4). Paired t-test showed statistically significant area reductions (t(71)=10.47, p<0.001; Cohen’s d=0.65). Etiology-specific effect sizes were moderate to large. Kaplan-Meier median time-to-closure was 43 days (95% CI 36-56). Conclusion: In complex, previously non-responsive, chronic wounds, PPECM achieved a 63.9% complete closure rate and 85.92% mean PAR. Healing outcomes in pressure injuries and open wounds were comparable or superior to DFUs. These data support broader, etiology-agnostic use of PPECM as an effective advanced therapy when combined with comprehensive SOC.

Negative pressure wound therapy (NPWT) has revolutionised the management of complex wounds via mechanisms such as microdeformation, angiogenesis and exudate control. However, its clinical effect has historically only been evaluated by qualitative and visual parameters. This study integrates near-infrared spectroscopy (NIRS) as a biofeedback tool to quantify physiological response to NPWT in real time. This study aimed to quantitatively demonstrate the physiological and structural changes induced by an NPWT system in patients with complex wounds, measured using NIRS. A prospective real-world observational study was conducted with a cohort of 23 patients with 33 wounds. Structural and physiological parameters were documented before and after NPWT treatment. Random-intercept mixed-effect statistical models and pre-post comparison tests were used to assess clinical and physiological significance. The data showed a progressive reduction in wound area and volume, accompanied by an increase in tissue oxygen saturation and a sustained decrease in deoxygenated haemoglobin. These findings, objectively quantified through NIRS as a real-time biofeedback tool, highlight the improvement in oxygenation and wound-bed perfusion and support the hypothesis of tissue biomodulation induced by NPWT. The integration of NIRS redefines the clinical role of NPWT, allowing therapy to be customised based on specific physiological data. This combination represents a new frontier in precision wound medicine. The results of this study provide a foundation for a new generation of clinical decisions in advanced wound management.

Africa is the world’s second-largest continent, with 54 nations and 1,000 unique ethnic groups speaking more than 1,000 languages. The current African population of 1.5 billion is anticipated to increase to 2.4 billion by 2050. Africa’s population accounts for 18.3% of the world population. The largest expansion will occur in sub-Saharan Africa (SSA), which includes 46 of Africa’s 54 countries, the majority of which are classified as low-income countries (Abbas and Boulton, 2022; Abbas and Gangji, 2025). The most recent edition of the International Diabetes Federation (IDF) Atlas 2025, predicts that diabetes will affect approximately 588.7 million people in 2024, increasing to 852.5 million by 2050 (IDF, 2025). Diabetes prevalence rates are predicted to increase primarily in Africa (IDF, 2025). Diabetes has become an epidemic in many recently industrialised and lower-middle-income countries, and it is expected to become a serious health problem in developing nations (Abbas and Boulton, 2022; Abbas and Gangji, 2025; IDF, 2025). In 2024, it was projected that 24.6 million people in SSA had diabetes; by 2050, this figure is expected to rise by 59.5 million, a 142% increase (IDF, 2025). SSA countries are at various stages of epidemiological transition, dealing with a wide range of illnesses. The African continent is growing rapidly, with increased prosperity as a result of urbanisation. Resultantly, lifestyle alterations, demographic transition to an older population and raised risk factors, such as obesity and physical inactivity, are linked to the rising incidence of diabetes (Abbas and Boulton, 2022; Abbas and Gangji, 2025; IDF, 2025). Diabetic foot ulcers (DFUs) are associated with the highest morbidity and death rate of any complications, particularly severe and horrific ones (Abbas and Boulton, 2022; Abbas and Gangji, 2025). Effective management and prevention strategies are crucial in addressing the growing burden of DFUs. By focusing on aspects such as enhancing public awareness, improving access to healthcare services and promoting lifestyle changes, the risk factors associated with diabetes can be mitigated. DFU has resulted in significant impairment, a decrease in life expectancy and expensive healthcare costs for the SSA region, which already has limited resources (Abbas and Boulton, 2022; Abbas and Gangji, 2025; Dhatariya et al, 2025). According to one estimate, diabetes is thought to be the cause of 40-60% of all non-traumatic lower-limb amputations globally (Abbas and Boulton, 2022; Abbas and Gangji, 2025; Dhatariya et al, 2025). Approximately 19-34% of people with diabetes will develop a foot ulcer at some time in their lives (Abbas and Boulton, 2022; Abbas and Gangji, 2025).

This report details a face-to-face educational event hosted by the Urgo Foundation, which brought clinicians together to learn from wound care experts in addressing the challenges faced when discussing, recommending, and applying therapeutic graduated compression. Education and networking opportunities sought to increase both confidence and capability.

Cutaneous wounds, resulting from skin integrity loss, pose a significant burden globally. Acute wounds, affecting all humans, are expected to heal. Chronic wounds—skin ulcers that fail to reduce by 50% in a timely manner—affect over 2.5% of the general population. In Europe, chronic wound care costs 2–4% of total healthcare expenditure. Wound care involves a multidisciplinary approach, connecting various specialists and healthcare professionals. Recognizing the absence of wound healing curricula in many European countries, the European Union of Medical Specialists (UEMS) collaborates with professional organizations such as the European Wound Management Association (EWMA) and the European Association of Fellows in Wound Healing (EAFWH) to address this gap. Aligned with the wound healing teaching curricula of MJC-WH UEMS, this book serves as a valuable resource for colleagues interested in chronic wound management. It covers various aspects of chronic wounds, offering solutions from wound healing experts. The chapters provide a succinct overview of general pathology, referencing the European Training Requirements (ETR). Clinical case presentations highlight practical aspects, emphasizing the multidisciplinary nature of wound care. As Europe’s population ages, healthcare providers must consider chronic wounds within the broader context of patients’ overall health. The collaborative effort of authors from different European countries underscores the importance of patient quality of life in wound care decisions.

The Wound Care Association UK (WCAUK) is committed to supporting both the accurate and consistent delivery and reporting of pressure ulcers/injuries based on the best available research and evidence. It is known that strategic and clinical guidance to support the delivery of evidence-based care does have a significant impact. Recent proposals to change pressure ulcer categorisation led the WCAUK to undertake a questionnaire survey of its members. This article outlines the importance of evidence-based guidance on the categorisation and assessment of pressure ulcer, highlighted by the responses to published changes to pressure ulcer categorisation for nurses in England, and presents the results of the survey. The article concludes that, although the discipline of tissue viability is constantly developing, the changes must be based on evidence, and clinicians must be supported strategically and practically to implement any proposed changes. Since publication of the new guidance the document has become the subject of further discussion, following concerns raised by tissue viability nurse specialists with strategic responsibility for change, as well as generalists who are expected to implement the changes.