{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T17:31:58Z","timestamp":1786383118663,"version":"build-2736575974"},"reference-count":41,"publisher":"Mark Allen Group","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2026,8,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study compared rates of non-traumatic lower limb amputations (\u2018amputations\u2019) among Medicare beneficiaries with diabetic foot ulcers (DFUs) who initiated purified native type 1 collagen matrix plus polyhexamethylene biguanide (PHMB) antimicrobial (PCMP) versus those beneficiaries who did not receive PCMP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>In this retrospective matched cohort study, two groups of beneficiaries with DFUs were retrospectively identified from 100% Medicare Fee-for-Service Standard Analytic Files (Quarter 1 2015\u2013Quarter 3 2023)\u2014those receiving PCMP within six months of DFU diagnosis (index date=first PCMP claim) and those who did not receive PCMP. Beneficiaries were matched 1:1. Using Wilcoxon signed-rank tests, six-month post-index amputation rates were compared. Stratified analysis evaluated amputation rates among beneficiaries initiating PCMP within 45, 60 or 90 days of DFU diagnosis, with follow-up applications every 7\u201314 days for one month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Before matching, beneficiaries receiving PCMP (n=10,939) had greater disease severity, as indicated by longer duration of active ulceration and higher amputation rates in the six months pre-index date than those beneficiaries who never received PCMP (n=657,233). After matching, baseline characteristics were well balanced (n=10,862). During follow-up, beneficiaries receiving PCMP had lower six-month amputation rates than those in the matched non-PCMP cohort (9.9% versus 12.2%, respectively; p&lt;0.001). Beneficiaries with earlier initiation of PCMP within 45, 60 or 90 days of diagnosis had lower six-month amputation rates (4.0%, 4.1% and 4.8%, respectively) compared with non-PCMP recipients (8.4%; all p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PCMP was disproportionately used in the management of beneficiaries with more complex DFUs\/wound care needs. After adjusting for baseline differences, PCMP use was associated with lower rates of lower limb amputations, particularly with earlier initiation within 90 days of DFU diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.12968\/jowc.2026.0291","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T15:25:35Z","timestamp":1784561135000},"page":"621-628","source":"Crossref","is-referenced-by-count":0,"title":["Lower limb amputation rates among Medicare beneficiaries with diabetic foot ulcers managed with and without native collagen matrix plus PHMB antimicrobial"],"prefix":"10.12968","volume":"35","author":[{"given":"Urvi","family":"Desai","sequence":"first","affiliation":[{"name":"Analysis Group, Inc., Boston, MA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Bradford","family":"Rice","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, MA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Kongara","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, MA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S","family":"Kirsner","sequence":"additional","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Hospital and Clinics Wound Center, University of Miami Miller School of Medicine, Miami, FL, US"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5130","reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12963-018-0166-4"},{"key":"e_1_3_3_2_2","unstructured":"Centers for Disease Control and Prevention. 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