Table 3.

Clinical evidence for ADMs in wound care and ulcers.

Authors	Product name(s), Material	Usage, Population	Summary findings
Case series and case reports
Pontell et al. (2018)	Integra™, BADM	Lower-extremity wound reconstruction 8 patients: 4 with all components and 4 with only RSAF and STSG	RSAF and immediate STSG group time of healing was 141.2 days on average and 2 required reoperation ADM, STSG, NPWT and RSAF group time of healing was 104.5 days and 1 patient required reoperation (reduction in about 36.7 days, or 25%) All patients achieved complete wound closure
Retrospective studies
Paredes et al. (2017)	PriMatrix®, FBADM	Chronic, large venous leg ulcers 33 patients, 40 total wounds Excluded: Those with non- CEAP class 6 wounds	45% of wounds had been open for ≥12 months Wound sizes are in the range of 0.24–131.35 cm2, mean = 21.1 ± 27.4 cm2 4 weeks after treatment: 23.5% median area of reduction for all wounds Average VLU closure rate of 1.96 cm2/week after 4 weeks Those that required reapplication of FBADM (14/40 wounds): ≥40% reduction in wound size after 4 weeks
Prospective studies
Cazzell et al. (2019)	DermACELL®, HADM	VLUs 28 patients: 18 utilising D-ADM and 10 without	Average reduction in percent wound area of 59.6% at 24 weeks in the D-ADM group vs. 8.1% at 24 weeks Substantial wound area reduction was seen in wounds present for <1 year in the D-ADM arm (74.1%) compared with conventional care (2.0%) 1 application of D-ADM had a substantial increase in the healing rate over the control (44.4% vs. 33.3%, respectively) after 24 weeks D-ADM wounds remained closed at higher rate than non-D-ADM
Kavros et al. (2014)	PriMatrix®, FBADM	DFUs 46 patients completed (out of 55) Mean age: 61 ± 14 years Mean BMI: 28.9 ± 4.3 BMI of 38 or less Those with comorbidities were excluded	76% of the completed treatment population achieved complete wound closure by week 12 post-operation, with a mean time of 53.1 ± 21.9 days to close 57.1% used only 1 round PriMatrix, and 22.9% required 2 23 ± 13.5 days on average in between each application For those that did not completely heal, wound reduction area by 12 weeks was 71.4% ± 27.0%

ADM, acellular dermal matrix; BADM, bovine acellular dermal matrix; CEAP, clinical aetiology anatomy pathophysiology; DFU, diabetic foot ulcer; FBADM, fetal bovine acellular dermal matrix; HADM, human acellular dermal matrix; NPWT, negative pressure wound therapy; RSAF, reverse sural adipofascial flap; STSG, split-thickness skin graft; TBSA, total body surface area; VLU, venous leg ulcer.