Healing outcomes after placental membrane-based skin substitute allografts in multiple wound types in routine care: a retrospective case series from a prospective observational wound registry.
Tettelbach W, Schottenstein J, et al. • Wounds : a compendium of clinical research and practice • 2026
In a retrospective case series from a prospective wound registry, placental membrane-based allografts achieved complete closure by 12 weeks in 38.6% of index wounds, with a median time to closure of 28 days among healed wounds, providing 'pragmatic benchmarks for CAMP-treated wounds' in a real-world, mixed-etiology cohort.
Key Findings
Results
Complete wound closure by 12 weeks occurred in 38.6% of index wounds and 36.7% of all wounds in this real-world cohort.
17 of 44 index wounds achieved closure by 12 weeks (38.6%; 95% CI, 24.4%–54.5%)
22 of 60 total wounds achieved closure by 12 weeks (36.7%; 95% CI, 24.6%–50.1%)
The cohort included 44 patients with 60 CAMP-treated wounds total
75.0% of index wounds were lower extremity diabetic ulcers (LEDUs)
Median baseline wound duration was 91 days, indicating these were chronic, hard-to-heal wounds
Results
Among wounds that healed, the median time to closure was 28 days.
This endpoint applied to wounds that achieved complete closure within the 12-week observation window
The study population had substantial comorbidity burden, making this timeframe notable for the population studied
This finding is drawn from both index and all-wound analyses
Results
More than half of wounds achieved at least 50% area reduction by 4 weeks.
52.3% of index wounds achieved at least 50% area reduction at 4 weeks
56.7% of all wounds achieved at least 50% area reduction at 4 weeks
At least 50% area reduction at 4 weeks was a pre-specified secondary endpoint
Results
Among wounds that remained open at 12 weeks, median percentage area reduction (PAR) was approximately 50%.
Median PAR at 12 weeks was 48.8% for index wounds still open at that timepoint
Median PAR at 12 weeks was 50.8% for all wounds still open at that timepoint
PAR at 12 weeks among open wounds was a pre-specified secondary endpoint
Results
In a complete-case subset analysis excluding wounds without ascertainable 12-week status, 84.6% of wounds closed, though the authors cautioned this figure should be interpreted carefully.
22 of 26 wounds in the complete-case subset achieved closure (84.6%; 95% CI, 65.1%–95.6%)
Authors explicitly noted this result must be 'interpreted cautiously because wounds without ascertainable 12-week status were excluded'
The discrepancy between the complete-case rate (84.6%) and the primary intent-to-treat-like rate (38.6%) reflects the impact of missing follow-up data
This highlights the potential for ascertainment bias in retrospective wound care data
Methods
The study population represented a high-comorbidity, chronic wound cohort drawn from routine clinical practice.
75.0% of index wounds were lower extremity diabetic ulcers (LEDUs)
Median baseline wound duration was 91 days, indicating wounds were long-standing prior to treatment
The cohort had 'substantial comorbidity burden' per authors' characterization
Data were drawn from a prospective observational wound registry, reflecting real-world rather than controlled trial conditions
Eligible patients required at least 1 application of a placental-derived CAMP and at least 1 follow-up visit
Background
Real-world data on cellular, acellular, and matrix-like products (CAMPs) remain limited, particularly in mixed-etiology wound cohorts.
The authors identified this gap as the primary motivation for the study
The study used a retrospective case series design drawing on a prospective observational wound registry
One index wound per patient was selected for primary analyses, while secondary summaries covered all wounds
Authors concluded findings 'support the need for larger, standardized comparative studies'
What This Means
This research examined how well placental membrane-based wound coverings (a type of biological skin substitute derived from placental tissue) worked in real-world clinical settings for patients with difficult-to-heal wounds. The study looked at 44 patients with 60 treated wounds, most of whom had diabetic foot or leg ulcers that had already been open for about three months on average. Using data from an ongoing wound-tracking registry, the researchers found that about 39% of wounds fully closed within 12 weeks, and among those that did heal, it took a median of just 28 days. More than half of the wounds shrank by at least 50% within the first four weeks of treatment.
An important nuance in the findings is that a subset analysis—looking only at patients who had confirmed 12-week follow-up data—showed a much higher closure rate of about 85%. However, the authors themselves cautioned that this higher number is misleading because it excludes patients who were lost to follow-up, which can artificially inflate success rates. This kind of gap between 'complete case' and 'all patient' results is a known challenge in real-world wound care research and underscores why careful interpretation is needed.
This research suggests that placental membrane-based skin substitutes may support healing in complex, long-standing wounds in patients with multiple health conditions, providing useful real-world benchmarks that are often absent from strictly controlled clinical trials. Because the study was relatively small and observational rather than randomized, the authors emphasized that larger, more standardized studies comparing this treatment against other options are needed to better understand its effectiveness.
Tettelbach W, Schottenstein J, Eltahir M, Cala M, Perez J, Jaafar F, et al.. (2026). Healing outcomes after placental membrane-based skin substitute allografts in multiple wound types in routine care: a retrospective case series from a prospective observational wound registry.. Wounds : a compendium of clinical research and practice. https://doi.org/10.25270/wnds/25138