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December 20
November 22

New Products available on NHSSC

New Products available on NHSSC

From the 1st of November 2021

November 15

Curea symposium at Virtual EWMA Conference Oct 26 2021

Exudate management:
Time to rethink and change the narrative?

Professor Sebastian Probst chairs a conversation and round table debate on ‘rethinking exudate management’ with Professor Amit Gefen and Ass. Professor Bodo Erhardt Gunther.

The round table looks at the appropriate use of these technologies, the MYTH? Are super absorbents only for high exudating wounds? Airlaid structures versus SAP cores and why this delivers better outcomes.

Do you agree with Professor Amit Gefen? That Super absorbents are potentially a better choice than foams? Tell us what you think after you have watched the round table.

September 15

Wound bed Preparation in 3 simple, quick steps

Introducing Nexodyn and CleanWnd

Two effective and simple solutions to improve and support your wound bed preparation. Focused on simplifying the process, saving you time and reducing the cost of providing thorough and effective wound bed preparation.

Why choose CleanWnd and Nexodyn to help your wound bed prep?

In 3 steps and taking around 2 minutes you can achieve the following:

  1. Cleanse and irrigate
  2. Debride, disrupt biofilm and treat infection
  3. Treat the inflammatory response, kick start healing

Our wound bed prep options are about keeping it simple but using proven and evidence based processes and products to better support wound healing without adding time and resource.

A simple cost effective solution that everyone can access.

➡️  For more information on both Nexodyn and CleanWnd click here ⬅️

Nexodyn – using with chronic paediatric wounds

CleanWnd – changing practice, Chelsea

Curea – More than a superabsorbent

August 23

Real-World Data shows Endoform™ Natural achieves significantly improved wound closure for Diabetic Foot Ulcers compared to traditional collagen dressings

A retrospective analysis of real-world data published in the ‘International Wound Journal’ compared the wound closure times for diabetic foot ulcers treated with either Endoform™ Natural (1150 wounds) or collagen/ORC (1072 wounds).

We are excited to be sharing this with you, Endoform™ offers clinicians further options in the face of non healing wounds or choosing an earlier intervention. Biologics like Endoform™ are normally considered to be limited in use and cost prohibitive. 

This publication goes some way to proving that regenerative therapies and extra cellular matrices such as Endoform™ have a very key place in the treatment and closing of wounds.

Some key highlights:

  • The data was analyzed to evaluate the median time for wound closure, percentage of wounds healed at 12-,24- and 36- weeks and probability of wound closure.
  • The time to wound closure was significantly faster, between 1.9 to 5.6 weeks, in the Endoform Natural group relative to the collagen/ORC group. This represented a reduction in time to wound closure of 11.3% to 21.4%, and increased the probability of wound closure between 18% to 38%.
  • Diabetic foot ulcers are the leading cause of non-traumatic amputations in the United States and are estimated to cost the US health care system $9-13 billion per annum.[1],[2]

A new retrospective study of real-world data (‘RWD’) has shown significantly improved wound closure times for diabetic foot ulcers (‘DFU’) and much greater probability of wound closure in wounds treated with Endoform™ Natural, compared to wounds treated with a traditional collagen dressing.

Endoform Natural is manufactured and distributed by soft tissue regeneration company Aroa Biosurgery Limited (ASX:ARX, ‘AROA or the ‘Company’). This is the first large retrospective analysis comparing the healing efficacy of Endoform Natural to collagen/oxidized regenerated cellulose (‘ORC’) and is the first large clinical study comparing advanced extracellular matrix (‘ECM’) technology to an older style reconstituted collagen product.

The findings have been published this week in a study titled “Retrospective Real World Comparative Effectiveness of Ovine Forestomach Matrix and Collagen/ORC in the Management of Diabetic Foot Ulcers” published in the ‘International Wound Journal.’

➡️ The study is online at https://onlinelibrary.wiley.com/doi/10.1111/iwj.13670 ⬅️

About the study

The retrospective study employed a data set of patients treated in U.S.-based wound care centers for their DFUs where treatment included either Endoform Natural or collagen/ORC.  It used existing wound data, with minimal inclusion or exclusion criteria. As such, the study captured ‘real-world’ use of both products from 2222 qualifying DFU wounds from 1590 patients, extracted from a wider data set of over 31,880 wounds in over 25,760 patients.

Of the 2222 qualifying wounds analyzed, 1150 wounds had been treated with Endoform Natural and 1072 treated with collagen/ORC to compare the median time for wound closure, percentage of wounds healed at 12-, 24- and 36- weeks and probability of wound closure.

Key findings

The time to wound closure for all wounds was 1.9 weeks faster in the Endoform Natural group relative to the collagen/ORC group. This represents a reduction in time to wound closure of 11.3%. The percentage of all wounds closed at 12-, 24- and 36-weeks also increased in DFUs treated with Endoform Natural compared to collagen/ORC, and differences were statistically significant at 36-weeks. Statistical analysis showed that the treatment of wounds with Endoform Natural increased the probability of wound closure by up to 21%.

The research team also undertook a sub-group analysis of the data set to look at the impact of Endoform Natural treatment on those more challenging wounds that required more visits to the wound care centers (‘WCC’) for intervention. For example, DFU that received twelve or more WCC visits closed 5.3 weeks faster, representing a 19.4% reduction in the time to wound closure. Additionally, these more challenging wounds had a 38% increase in the probability of closure having received Endoform Natural.

Significance of the findings

AROA CEO, Dr. Brian Ward said this study demonstrates the potential for improvements in patient quality of life due to the significantly reduced time to close wounds and material cost reductions using Endoform Natural compared to traditional collagen dressings.

“Recent research indicates that up to one-third of the half a billion people with diabetes worldwide will develop a DFU over the course of their lifetime[3]. This presents many real challenges in treatment and quality of life for patients, family members and clinicians, particularly as an estimated 1 in 6 patients with a DFU will go on to require an amputation,” Dr. Ward says.

DFUs are the leading cause of non-traumatic amputations in the United States[4]and there are also significant financial burdens associated with DFUs. A 2012 retrospective study of 7099 DFUs reported a mean cost to achieve closure of $3927 per DFU[5] and the overall DFU related cost and burden to the U.S. health care system alone has been estimated at $9-13 billion[6],[7].  

AROA’s Endoform Natural is an intact ECM technology for acute and chronic wounds that utilizes the Company’s proprietary AROA ECM™ technology. It is a distinctly different technology to the traditional reconstituted collagen products that have been commonly used in the management of acute and chronic wounds. These ‘older style’ technologies utilise collagen, isolated from animal tissues using relatively harsh processing, which is then reconstituted into finished wound dressings.  For example, collagen/ORC is comprised of bovine reconstituted collagen and synthetically modified cellulose. This product typically gels on contact of the wound bed, remains in place for 48-72 hours and requires frequent reapplications.

Pre-clinical studies have shown that the AROA ECM technology includes over 150 different protein components that are known to aid wound repair, stimulate blood vessel formation and attract stem cells. It acts as a bio scaffold to aid the patient’s natural wound healing process.

ECM-based products for wound care have largely remained inaccessible due to their cost. They are typically rationed and utilized as a ‘last resort’, being available only as ‘cellular or tissue-based product’ (CTP, or ‘skin substitutes’).

Endoform Natural is the first widely accessible ECM-based product available to wound care professionals, enabling increased accessibility and adoption of advanced ECM technology into clinical practice.

“This data also adds to our existing body of evidence about the effectiveness and broad application of our AROA ECM technology platform for healing complex wounds in compromised patients. It is consistent with the improved outcomes that we have seen in Tela Bio’s Ovitex BRAVO hernia study and Aroa’s previously published Myriad studies. It is encouraging that our underpinning AROA ECM technology and product portfolio is continuing to demonstrate improved healing in complex wounds and soft tissue reconstruction, often in the presence of inflammation and contamination,” Dr. Ward says.


[1] Rice, J.B., et al., Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care, 2014. 37(3): p. 651-8.

[2] Barshes, N.R., et al., The system of care for the diabetic foot: objectives, outcomes, and opportunities. Diabet Foot Ankle, 2013. 4.

[3] Armstrong, D.G., et al., Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer. J Foot Ankle Res, 2020. 13(1): p. 16.

[4] Boulton, A. J. M., D. G. Armstrong, R. S. Kirsner, C. E. Attinger, L. A. Lavery, B. A. Lipsky, J. L. Mills, Sr. and J. S. Steinberg (2018). Diagnosis and Management of Diabetic Foot Complications. Diagnosis and Management of Diabetic Foot Complications. Arlington (VA).

[5] Fife, C.E. and M.J. Carter, Wound Care Outcomes and Associated Cost Among Patients Treated in US Outpatient Wound Centers: Data From the US Wound Registry. Wounds, 2012. 24(1): p. 10-7.

[6] Rice, J.B., et al., Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care, 2014. 37(3): p. 651-8.

[7] Barshes, N.R., et al., The system of care for the diabetic foot: objectives, outcomes, and opportunities. Diabet Foot Ankle, 2013. 4.

August 23

Complex Limb Salvage with Placental-Based Allografts: A Pilot Study

A recent publication in the Surgical Science publication looks at the use of dHCAM

Commercially available human placental amnion/chorion tis-sue allografts have been successfully used as protective treatment barriers for wounds and diabetic ulcers. Burn and traumatic limb injuries with exposed bone or tendon generally require surgical flaps or amputations for healing. The purpose of this study was to determine if dehydrated human amnion/ chorion membrane allografts (dHACM) with decellularized human collagen matrix (dHCM) could be used to salvage injured human extremities.


Treatment with hu-man placental-derived allografts provided a protective covering that enabled the healing cascade to generate granulation tissue formation in extremity wounds with exposed tendon and/or bone. In select limb salvage cases, dHACM/dHCM treatment may be a promising alternative to amputations, tissue rearrangements, free tissue flaps or other techniques for resolution of extremity wounds with bone and tendon exposure. 

Thornburg, D.A., Kowal-Vern, A., Tettelbach, W.H., Foster, K.N. and Matthews, M.R. (2021) Complex Limb Salvage with Placental-Based Allo-grafts: A Pilot Study. Surgical Science , 12, 76-94.

Click here to go to Surgical Science for the article

Or download the pdf here

EpiFix evidence overview

For more information on EpiFix please get in touch using the contact form on our website and we will be on hand to help in anyway we can.

EpiFix offer a unique opportunity to support wound healing and other a treatment option when your standard pathways are not working, here are some case study examples of EpiFix in use (note: these are not cases related to the above mentioned study):

Achilles heel case study

DFU case study

⬇️ A patient story – Tracey’s journey with a leg ulcer and how EpiFix helped resolve a 17 year old wound ⬇️
Patient story with Tracey
August 23

How US Medicare demonstrates clear reductions in amputations, emergency visits, readmissions regards the use of skin substitutes

Observed impact of skin substitutes in lower extremity diabetic ulcers: lessons from the Medicare Database (2015–2018)

New study shows advanced treatment for management of LEDUs (lower extremity diabetic ulcers) among Medicare beneficiaries is associated with significant reductions in major and minor amputation, emergency department (ED) use, and hospital readmissions vs. LEDUs managed without advanced therapies.

MiMedx announced publication of its peer-reviewed study in the Journal of Wound Care (JWC), addressing the observed impact of Advanced Treatment (AT) using all high-cost skin substitute products in lower extremity diabetic ulcers (LEDUs) based on data from Medicare spanning October 1, 2015 through to October 2, 2018. The study assessed outcome in patients receiving advanced therapies with all high-cost skin substitute products, as designated by the Centres for Medicare and Medicaid Services (CMS), for LEDUs versus No Advanced Treatment (NAT), and found that advanced therapies used could lead to a 42% reduction in major and minor amputations and all related costs, compared to no advanced therapies. Further, the study highlights preferable outcomes when advanced therapies follows parameters for use (FPFU), underscoring the importance of early treatment with regular intervals and well-defined treatment guidelines.

“The data derived from this study are important for a number of reasons,” noted Dr. David G. Armstrong, Professor of Surgery and Director of the Southwestern Academic Limb Salvage Alliance (SALSA) at the Keck School of Medicine of the University of Southern California. “Most notably, it is the first, to our knowledge, to broadly evaluate the parameters for use and associated observed impact of these advanced treatments in the wound care space. The substantial reduction, not only in amputation, but also in hospital readmission rates and visits to the emergency room suggests that our patients may be able to live more hospital-free and activity-rich days when we focus on getting to wound closure.”


To evaluate large propensity-matched cohorts to assess outcomes in patients receiving advanced treatment (AT) with skin substitutes for lower extremity diabetic ulcers (LEDUs) versus no
AT (NAT) for the management of LEDUs.


There were 9,738,760 patients with a diagnosis of diabetes, of whom 909,813 had a LEDU. In propensity-matched Group 1 (12,676 episodes per cohort), AT patients had statistically fewer minor amputations (p=0.0367), major amputations (p<0.0001), ED visits (p<0.0001), and readmissions (p<0.0001) compared with NAT patients. In propensity-matched Group 2 (1131 episodes per cohort), AT FPFU patients had fewer minor amputations (p=0.002) than those in the AT not FPFU group.


AT for the management of LEDUs was associated with significant reductions in major and minor amputation, ED use, and hospital readmission compared with LEDUs managed with NAT. Clinics should implement AT in accordance with the highlighted parameters for use to improve outcomes and reduce costs.


Timothy R. Wright, MIMEDX Chief Executive Officer, commented, “As a company dedicated to advancing scientific and health economic research that informs and improves patient care and outcomes, we see these analyses as providing crucial validation that advanced treatment can reduce the suffering and expenses caused by chronic LEDUs. Future research must build upon these findings and inform better treatment guidelines and reimbursement policies, so that together, we raise the standard of care for patients with LEDUs.”

What does this look like for the UK?

How could this impact on the UK and the use of Advanced therapies for wound healing? The debate needs to open further and more consideration for the adoption of these technologies that have a clear place in closing wounds. The use of these therapies in the UK is evolving slowly, It would be useful to raise the debate further amongst UK wound specialists and look to examples such as TIMERS: hard to heal wounds as examples of how these technologies can be adapted here in the UK to great effect. 

June 8

Regen Medical Gains Investors In People Accreditation

We are delighted to announce that Investors in People has awarded the Joint Operations Family (Joint Operations (UK) LLP, Regen Medical Ltd & Joint Operations (Spine) Ltd) ‘We invest in people, standard accreditation’.

This one-year accreditation means that our principles and practices around supporting people are all in place and everyone understands how to use them to make work better.

We were particularly proud of a section in the post-assessment report that stated, “The interviews revealed a group of positive, enthusiastic people who love working for Joint Operations and can see a future in an organisation where they feel supported, proud of the work they do and part of a close-knit work ‘family’. They are excited about the future and take pride in the positive impact that the Joint Operations Family has on the provision of medical devices, human tissue and innovative solutions to Health services across the UK.”

Paul Devoy, CEO of Investors in People, said: “We’d like to congratulate Joint Operations. Being accredited with We invest in people is a remarkable effort for any organisation and places the Joint Operations Family in fine company with a host of organisations that understand the value of people.

Beckie Holmes, Group HR & Project Manager at the Joint Operations Family commented “This is such a positive achievement. To be recognised as a cohesive and supportive team by Investors in People, particularly during such unprecedented times is truly something to be celebrated by everyone across the businesses.”  Managing Director, Richard Forster added “Achieving Investors in People accreditation is a tremendous validation of what happens when a dedicated group of people come together with a shared sense of values and purpose.”

Investors in People believes that the success of an organisation begins and ends with people. If we make work better for everyone, we make work better for every organisation. And if we do that… we make society stronger, healthier and happier.

Take a look at the Regen Medical business and find out more about who we are here:

About Investors in People
Most of us will spend around 80,000 hours at work in our lifetimes.
For something that takes up that much of our time, we think people deserve to get more out of it than just a regular pay cheque. 
That’s why we’ve already helped more than 11 million people across 75 countries to make work better. 

And you know what, we’re just getting started…

How are we doing that?

We’re a community interest company, which means we put our purpose before our profits. That means everything we do and every direction we take is done to make work better.

Organisations that meet the We invest in our people framework are proud to display their accreditation to the world.

Because they understand that it’s people that make work better.

April 26

The JWC Masterclass on skin substitutes – Now on demand

The debate on Skin Substitutes

There is no doubt that there is further debate to be had on wound care versus wound healing

The use of skin substitutes including ECMs (extracellular matrix) offers up some bigger questions and begs for further debate, this webinar offers an exceptional look at the best practice of using these devices but also raises the question of:

When should we be using these? Or, as suggested by Professor Steven Jeffery during the webinar; when would you not use skin substitutes? The webinar raises the debate on whether it is better to use such devices earlier in order to get wounds closed quicker.

For the UK wound care community it offers a real chance to rebalance some of the challenges we are facing with non-healing wounds, a chance to tip the scales from manufacturer led care pathways that encourage the use of products that are fundamentally designed for wound management and not wound healing.

The panel offer a number of interesting comments on the marketplace and some suggestions on the status quo in ‘wound management’ (you can listen to this at 23.30 minutes in on the webinar). 

The use of these skin substitutes and ECMs have been proven all over the globe to make a significant impact on healing rates and the cost of care. They provide real opportunities to support the great work being carried out by clinicians to help patients and provide another option on the wound healing care pathway.

“One thing’s for sure. If we keep doing what we’re doing, we’re going to keep getting what we’re getting. One definition of insanity is to keep doing the same thing and expect different results.” – Stephen Covey

The discussion throughout this webinar is supported by the ongoing conversation around the consensus paper on hard to heal wounds? Implementing TIMERS: the race against hard-to-heal wounds. This document lays out a clear and realistic method to utilise and further implement skin substitute/ECM in a clear and practical way.

To see how EpiFix fits in with this principle and pathway click here. The EpiFix blog runs through implementing TIMERS and the use of EpiFix to help support further options for you and the patient on the wound healing journey.

About This Webinar

Skin substitutes (SS) can be a vital adjunct to standard of care for achieving wound closure in acute and chronic wounds. However, the variety of SS categories available and their very high unit cost, often complicated by reimbursement requirements, can make selection challenging, as the physician needs to be able to determine which SS will be both clinically effective and cost-effective for individual patient needs.

In this online masterclass, a select group of KOL physicians will debate how to make good SS selection decisions and then quiz manufacturers/suppliers as to when and why they should use their products.

The masterclass will comprise two parts. The first will be a discussion among key opinion leaders identifying the main challenges relating to the selection of a clinically effective and cost-effective skin substitute (SS) and how they deal with this in their practice. The second part will be a Q&A section, in which the KOLs will ask various manufacturers/suppliers of SSs how they can get the best use out of their product.

⬇️   Click on the image to watch the webinar  ⬇️


How can we help? We are primarily focused on better wound bed preparation and therapies focused on wound closure, across burns and acute/chronic wounds. This also includes specific areas such a DFUs and VLUs.

Our products span across both specific skin substitutes and ECMs:


April 13

Acceptance evaluation of an impregnated cleansing and debridement cloth – CleanWnd – Karen Staines

Background: Effective debridement is an essential component of the treatment of complex wounds (Frykberg and Banks, 2015). Removal of devitalised tissue is necessary for wound healing progression to occur (Atkin, 2016). Aims: This article will describe a product evaluation of the impregnated mechanical debridement cloth CleanWnd, with aim of evaluating efficacy, ease of use, reduction in pain level, ease of handling, reduction in time taken to complete wound debridement and the condition of the surrounding skin. Methods: The objectives were evaluated by nurses after a single use of CleanWnd in two separate cohorts of 10 and 11 participants. The experience of using CleanWnd cloths was compared subjectively with the nurse’s standard methods of debridement. Results: Overall, the debridement objective was achieved in the great majority of cases and pain levels reduced. Conclusion: All of the nurses using CleanWnd considered it clinically acceptable and easy to use. The outcome of the evaluation demonstrated the clinical acceptability of CleanWnd cloths for debriding wounds.

CONCLUSION All of the nurses using CleanWnd considered it clinically acceptable and easy to use. The debridement objective was achieved in the great majority of cases and pain levels reduced. CleanWnd will be a useful addition to the health professional’s options for wound management. Its ease of use will support consistent and effective debridement, enabling wound bed preparation and periwound skin toiletry.

For more information on Cleanwnd and ordering please click here – For education support click here


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