{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T18:02:32Z","timestamp":1763748152016,"version":"3.40.5"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Wound Repair Regeneration"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Data collected from standardized clinical practices can be valuable in evaluating the real\u2010world therapeutic benefit of skin substitutes in the treatment of venous leg ulcers (VLU). Utilizing such a dataset, this study aimed to validate the effectiveness of a bioactive human split\u2010thickness skin allograft for the treatment of VLU in the real\u2010world setting and to understand how certain variables impacted healing rates. From a pool of 1474 VLU treated with allograft, 862 ulcers in 742 patients were selected from a large wound EMR database and analyzed. All patients received standard wound care prior to allograft application. Impact of ulcer duration, number of applications, ulcer size, and time to application were analyzed. The VLU, on average, were of 189\u2009days duration with a mean ulcer size of 19.3\u2009cm<jats:sup>2<\/jats:sup>. During treatment, 70.7% of wounds healed, with an average time to closure of 15\u2009weeks (SD = 14.1\u2009weeks). The percentage of VLU less than one\u2010year duration that healed was significantly higher (72.3%) than the percentage of VLU with duration of greater than 1\u2009years (51.5%) (<jats:styled-content>\n<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> = 18.17<\/jats:styled-content>; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Ulcers less than 10 <jats:styled-content>cm<jats:sup>2<\/jats:sup><\/jats:styled-content> in size were more likely to heal (73.9%) than those larger than 10 <jats:styled-content>cm<jats:sup>2<\/jats:sup><\/jats:styled-content> (67.9%) (<jats:styled-content>\n<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> = 8.65,<\/jats:styled-content>\n<jats:italic>P<\/jats:italic> = .03). VLU receiving allograft within 90\u2009days of initial presentation are 1.4 times more likely to heal vs those receiving their first BSA application after 90\u2009days of standard of care (95% CI: [1.05, 1.86], <jats:italic>P<\/jats:italic> = .02). Allograft used in wound clinics healed a majority of refractory VLU, even in large ulcers of long duration, which are more difficult to heal. Smaller wound, size, and shorter wound duration were associated with greater likelihood of healing. VLUs treated earlier with allograft had better healing outcomes. Clinicians may consider more aggressive and timely treatment with allograft for refractory VLU.<\/jats:p>","DOI":"10.1111\/wrr.12818","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T22:06:22Z","timestamp":1589925982000},"page":"547-552","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A <scp>real\u2010world<\/scp> experience with the bioactive human split thickness skin allograft for venous leg ulcers"],"prefix":"10.1111","volume":"28","author":[{"given":"Robert S.","family":"Kirsner","sequence":"first","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology &amp; Cutaneous Surgery University of Miami Miller School of Medicine  Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Margolis","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Department of Biostatistics &amp; Epidemiology University of Pennsylvania  Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0144-5541","authenticated-orcid":false,"given":"Arti","family":"Masturzo","sequence":"additional","affiliation":[{"name":"Misonix  Farmingdale New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Bakewell","sequence":"additional","affiliation":[{"name":"NLP Logix  Jacksonville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(01)00255-1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2014.903258"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615243"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000489991.32684.9e"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2018.02.006"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1938640010387417"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000305486.06358.e0"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","unstructured":"BarbulA GellyH MasturzoA.Real world matched\u2010cohort study analyzing the health economic impact of living cell tissue products in the treatment of chronic wounds: a retrospective analysis of medicare claims data Adv skin wound care.2019;45:512\u2010519.https:\/\/doi.org\/10.1097\/01.","DOI":"10.1097\/01"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2010.164"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2019.1091"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1067-1927.2004.012207.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(94)70134-2"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkh513"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18040789"},{"key":"e_1_2_7_16_1","first-page":"1","article-title":"Cryopreserved human skin allografts promote angiogenesis and dermal regeneration in a murine model","author":"Henn D","year":"2020","journal-title":"Int Wound J"}],"container-title":["Wound Repair and Regeneration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fwrr.12818","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/wrr.12818","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/wrr.12818","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/wrr.12818","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T15:33:38Z","timestamp":1693582418000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/wrr.12818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,19]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/wrr.12818"],"URL":"https:\/\/doi.org\/10.1111\/wrr.12818","archive":["Portico"],"relation":{},"ISSN":["1067-1927","1524-475X"],"issn-type":[{"type":"print","value":"1067-1927"},{"type":"electronic","value":"1524-475X"}],"subject":[],"published":{"date-parts":[[2020,5,19]]},"assertion":[{"value":"2020-02-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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