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Due to pathophysiological complexity and underlying patient comorbidities, conducting randomised controlled trials to evaluate the comparative efficacy of advanced treatment modalities is difficult, as many patients would likely be excluded. This retrospective, pragmatic, real\u2010world evidence (RWE) study compared the healing outcomes of VLUs treated with either ovine forestomach matrix (OFM) (<jats:italic>n<\/jats:italic>\u2009=\u2009312) or collagen\/oxidised regenerated cellulose (ORC) (<jats:italic>n<\/jats:italic>\u2009=\u2009239) in outpatient wound care centres. Unlike restrictive randomised controlled trials, minimal inclusion and exclusion criteria were applied to create two treatment cohorts that reflected the general VLU population. The incidence (%) of closure was greater in OFM\u2010treated VLUs at 12, 24 and 36\u2009weeks, and this difference was significant at 24 and 36\u2009weeks compared to collagen\/ORC. Median time to wound closure was significantly faster (<jats:italic>p<\/jats:italic>\u2009=\u20090.045) in the OFM cohort (11.1\u2009\u00b1\u20090.6\u2009weeks) compared to the collagen\/ORC group (12.3\u2009\u00b1\u20091.0\u2009weeks). Cox proportional hazards analysis demonstrated that OFM\u2010treated VLUs had a significantly greater probability of healing (up to ~40%). This RWE comparative efficacy study further substantiates the clinical benefit of OFM in the treatment of chronic wounds, such as VLU, in a real\u2010world patient cohort.<\/jats:p>","DOI":"10.1111\/iwj.70368","type":"journal-article","created":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T05:35:22Z","timestamp":1745040922000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical Efficacy of Ovine Forestomach Matrix and Collagen\/Oxidised Regenerated Cellulose for the Treatment of Venous Leg Ulcers: A Retrospective Comparative Real\u2010World Evidence Study"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0954-3004","authenticated-orcid":false,"given":"Rebecca","family":"Aburn","sequence":"first","affiliation":[{"name":"Healthcare New Zealand  Richmond New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6446-7142","authenticated-orcid":false,"given":"Abigail E.","family":"Chaffin","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"MedCentris Wound Healing Institute  Hammond Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6563-8775","authenticated-orcid":false,"given":"Brandon A.","family":"Bosque","sequence":"additional","affiliation":[{"name":"Aroa Biosurgery Limited  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Frampton","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine (Christchurch) Otago University  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2616-0411","authenticated-orcid":false,"given":"Sandi G.","family":"Dempsey","sequence":"additional","affiliation":[{"name":"Aroa Biosurgery Limited  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2868-5881","authenticated-orcid":false,"given":"D. Adam","family":"Young","sequence":"additional","affiliation":[{"name":"Aroa Biosurgery Limited  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9855-018X","authenticated-orcid":false,"given":"Barnaby C. H.","family":"May","sequence":"additional","affiliation":[{"name":"Aroa Biosurgery Limited  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3706-9178","authenticated-orcid":false,"given":"Gregory A.","family":"Bohn","sequence":"additional","affiliation":[{"name":"The American Professional Wound Care Association (APWCA) American Board of Wound Healing  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1368-0426","authenticated-orcid":false,"given":"M. Mark","family":"Melin","sequence":"additional","affiliation":[{"name":"Gonda Vascular Center Wound Clinic, Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"1902","article-title":"Venous Leg Ulcers","volume":"2016","author":"Nelson E. 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