{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T11:06:25Z","timestamp":1770462385754,"version":"3.49.0"},"reference-count":23,"publisher":"Mark Allen Group","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Hard-to-heal wounds refractory to standard of care (SoC) therapy pose a major clinical and economic burden on healthcare systems. A dual-layer hydrated human amniotic membrane (HAMA) allograft, pre-hydrated with saline, is an emerging advanced therapy for complex hard-to-heal wounds. The aim of this study was to evaluate the real-world effectiveness of Membrane Wrap Hydro (BioLab Holdings, Inc., US) in achieving complete closure and relative percentage area reduction (PAR) across hard-to-heal diabetic foot ulcers (DFUs), venous leg ulcers (VLUs), pressure injuries (PIs) and open wounds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>This was a retrospective multicentre analysis of patients treated from November 2024 to July 2025 after \u226530 days of optimised SoC with &lt;50% healing. Weekly applications of HAMA were performed in outpatient clinics, nursing homes or home settings. The primary endpoint was complete wound closure (99.99\u2013100% re-epithelialisation). Secondary endpoints were: PAR (paired samples t-test); applications to closure; and time-to-healing (Kaplan\u2013Meier).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The cohort included 80 patients (83 wounds). Complete closure occurred in 46\/83 (55.4%) wounds with a median six applications (mean: 6.54\u00b13.22). Closure rates were: 53.3% (DFUs); 50.0% (VLUs); 47.1% (PIs); and 59.6% (open wounds). Mean PAR was 84.3%, with significant area reduction from baseline (p&lt;0.001; Cohen's d=0.79). Large effect sizes were observed across aetiologies (d=1.01\u20131.84). Median time-to-healing was 42 days (range: 7\u2013110).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Membrane Wrap Hydro achieved clinically meaningful closure and substantial PAR across diverse refractory hard-to-heal wounds, with outcomes in PIs and open wounds comparable or superior to DFUs and VLUs. These findings support the role of HAMA as a versatile advanced therapy in multimodal hard-to-heal wound management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.12968\/jowc.2025.0604","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T15:58:53Z","timestamp":1769270333000},"page":"150-161","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of a dual-layer pre-hydrated amniotic membrane allograft in the treatment of hard-to-heal wounds"],"prefix":"10.12968","volume":"35","author":[{"given":"Daniel","family":"Kapp","sequence":"first","affiliation":[{"name":"Palm Beach Gardens Medical Center, FL, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4201-469X","authenticated-orcid":false,"given":"Angelina","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Sygnola, Mandeville, LA, US"},{"name":"MedCentris, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T Kent","family":"Denmark","sequence":"additional","affiliation":[{"name":"Advanced Wound Therapy, OK, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Johnson","sequence":"additional","affiliation":[{"name":"Comprehensive Wound Care Services, Washington, DC, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Personic Health, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Sygnola, Mandeville, LA, US"},{"name":"MedCentris, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Morrison","sequence":"additional","affiliation":[{"name":"MedCentris, US"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12395"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12329"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.58624\/SVOAOR.2024.04.069"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12566"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12227"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.29309\/TPMJ\/2020.27.06.4240"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/2045-824X-6-10"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0093726"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.00000000000010951"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12140"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/ASW.0000000000000115"},{"key":"e_1_3_2_12_2","unstructured":"Centers for Disease Control and Prevention. Classification of diseases functioning and disability. Tenth Revision. https:\/\/tinyurl.com\/yf5cz427 (accessed 15 January 2026)"},{"key":"e_1_3_2_13_2","unstructured":"American Medical Association. Current Procedural Terminology: CPT. 2025. https:\/\/tinyurl.com\/46wnhp6b (accessed 15 January 2026)"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000222891.74489.33"},{"key":"e_1_3_2_15_2","unstructured":"Centers for Medicare and Medicaid Services. Skin substitute grafts\/cellular and tissue-based products for the treatment of diabetic foot ulcers and venous leg ulcers. https:\/\/tinyurl.com\/yuyn33ke (accessed 7 January 2026)"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.25270\/wnds\/25005"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2023.0075"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.76262"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12976"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.19809"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-021-01084-8"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.2217\/cer-2019-0142"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.57264\/cer-2025-0092"}],"container-title":["Journal of Wound Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/jowc.2025.0604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T17:25:01Z","timestamp":1770398701000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/10.12968\/jowc.2025.0604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,2]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,2]]}},"alternative-id":["10.12968\/jowc.2025.0604"],"URL":"https:\/\/doi.org\/10.12968\/jowc.2025.0604","relation":{},"ISSN":["0969-0700","2052-2916"],"issn-type":[{"value":"0969-0700","type":"print"},{"value":"2052-2916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,2]]}}}