Page 97 - JCTR-11-2

Journal of Clinical and
Translational Research Biomimetic matrix used to treat diabetic foot ulcers

A B reduction in the percent wound area. When comparing
similar wounds on patients with similar comorbidities,
the investigators found that those wounds receiving more
treatments showed a greater reduction in wound area.
Odor, drainage, inflammation, and re-epithelization were
also noticeably improved, with most wounds showing a
reduction in depth within one or two BMM applications.
In addition, no adverse effects during and after BMM
application were observed. According to Sheehan et al.,
11
a reduction in wound area of diabetic foot ulcers observed
for over 4 weeks can be used as a robust predictor for
complete healing after 12 weeks, supporting the hypothesis
C D that treatment with BMM may substantially increase the
chances of full closure.
BMM achieved an average percent wound area
reduction of 63.6% in wounds measuring 7.5 cm on
2
average after 6 weeks of treatment with one to three
applications. In comparison, a meta-analysis study on the
treatment of foot ulcers in patients with diabetes reports
that an average percent area reduction of 48% was found
in patients treated with advanced biologic products after
12 weeks, with an average wound size of 3.5 cm . BMM
2 12
achieved higher area reduction rates in larger wounds
in about half the average time compared with advanced
E F biologics.
In this study, the investigators relied on each patient’s
prior treatments to serve as their respective controls. All
eight study subjects had been previously treated with off-
loading and other advanced modalities, ranging from
living cell treatments to advanced biologic wound care
products. Many of these subjects also had prior treatments
with negative pressure wound therapy. In each case, the
patients were enrolled only after demonstrating a lack of
progress or even worsening of their wounds for at least
3 months. (The average duration of wounds among the
eight subjects was 21.5 months). Due to the small sample
size, it was not practical to evaluate half the subjects with a
Figure 2. Representative images of chronic wounds before and after placebo and half with BMM, and that is a limitation of the
treatment with BMM. Charcot midfoot ulceration on day 1 (A) and current study.
after 6 weeks (B), with two applications of BMM. Heel ulcer on day
1 (C) and 5 weeks later (D), after three treatments with BMM. Midfoot In this study, BMM, a fully synthetic matrix composed
ulcer beneath the fifth metatarsal base on day 1 (green marker is placed for of self-assembling peptides, was evaluated in a variety of
size standardization) (E) and 6 weeks after (F) one treatment with BMM. chronic, stalled diabetic wounds. The BMM used in this
Abbreviation: BMM: Biomimetic matrix.
case series is shelf-stable at room temperature, supplied
as a flowable matrix in a sterile, prefilled syringe system
compared to a standardized marker within the picture with a flexible applicator so that the material can be easily
frame to calculate the wound surface area (Figure 2D). dispensed onto and can intimately contact the wound bed,
These measurements were used to calculate changes in including the hard-to-access areas. These features allow
wound area. All measurements were taken following BMM to closely adhere to the wound surface and coat
wound debridement. any defects or irregularities, providing superior contact
After one, two, or three applications of BMM, all compared to sheets and other form factors such as powders.
wounds in this study demonstrated a measurable In addition, unlike most biological wound care products,

Volume 11 Issue 2 (2025) 91 doi: 10.36922/jctr.24.00063