{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:34:36Z","timestamp":1753878876006,"version":"3.41.2"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Diabetic foot ulcers (DFUs) are a severe complication for diabetic patients, significantly impacting patient quality of life and healthcare system efficiency. Traditional standard of care (SOC) treatments are inadequate for many patients, necessitating the use of advanced wound care products, such as human placental membranes. We studied a real\u2010world population of large, hard\u2010to\u2010heal and complicated wounds, otherwise under\u2010studied in the wound care literature. To this end, we conducted a retrospective cohort analysis to compare the effectiveness of a human placental amnion\/chorion membrane product using retention\u2010based processing (RE\u2010AC) and SOC in managing chronic DFUs. During the study period of September 2021 through April 2024, we collected retrospective observational data from electronic health records of 21 patients treated with RE\u2010AC at three outpatient wound care centres. Additionally, 21 control SOC patients were matched from a wound registry using Coarsened Exact Matching. Patients were categorized into two cohorts based on whether they received RE\u2010AC or SOC. Key metrics included wound size progression and wound closure. The analysis employed Bayesian regression and Hurdle Gamma Analysis of Covariance models. Despite their rather large size (average of 13.8\u2009cm<jats:sup>2<\/jats:sup>), our results indicated that RE\u2010AC achieved almost a 10% higher expected wound closure rate compared to SOC at 12\u2009weeks (8.53% [credible interval: 5.60%\u201310.7%]). Further, for wounds that did not close, RE\u2010AC resulted in a 93.6% (credible interval: 147.7%\u201341.6) improvement in expected Percent Area Reduction over the SOC group at 12\u2009weeks. We noted that on average, SOC wounds stalled or grew larger. In terms of a risk ratio comparing the study group with SOC, we found a 52% benefit in the RE\u2010AC group (RR\u2009=\u20091.52). The findings suggest that even with larger DFUs, R\u2010AC is superior to SOC for wound closure and expected Percent Area Reduction by 12\u2009weeks. This benefit likely leads to reduced treatment costs, optimized resource utilization and improved outcomes in the DFU patient population; ultimately resulting in improved patient care.<\/jats:p>","DOI":"10.1111\/iwj.70096","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T02:45:33Z","timestamp":1728960333000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retention processed placental membrane versus standard of care in treating diabetic foot ulcers"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9095-303X","authenticated-orcid":false,"given":"Robert G.","family":"Frykberg","sequence":"first","affiliation":[{"name":"Open Wound Research  Puyallup Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zwelithini","family":"Tunyiswa","sequence":"additional","affiliation":[{"name":"Open Wound Research  Puyallup Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy W.","family":"Weston","sequence":"additional","affiliation":[{"name":"Biostem Technologies  Pompano Beach Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"volume-title":"IDF Diabetes Atlas","year":"2017","key":"e_1_2_9_2_1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0043"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.10578"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9061780"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00383-2"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1428"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0536"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0200"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100716688073"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.11.025"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2176"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(07)60001-5"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.10.003"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.13133"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3657"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-1836"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.6.1879"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2015.0635"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2023.32.Sup4b.S1"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12329"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12976"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001095"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12227"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12395"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.794"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.2217\/cer-2021-0069"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj-cs.1516"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-1-6"},{"volume-title":"Case Study Comparing Bayesian and Frequentist Approaches for Multiple Treatment Comparisons","year":"2013","author":"Carlin BP","key":"e_1_2_9_31_1"},{"volume-title":"Guidance for the Use of Bayesian Statistics in Medical Device Clinical Trials. 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