(CR-061) Time to Wound Closure After Autograft or Placental-Derived Allografts in Venous Leg Ulcers - Post Hoc Analysis of ChronEx RCT

Asi Haviv, DMD; Robert Snyder, DPM, MBA, MSc

Introduction: Effective wound bed preparation and timely wound closure are essential in managing chronic lower-extremity ulcers. Evidence describing healing trajectories after autograft or allograft use in VLUs is limited. This post hoc analysis assessed closure incidence and timing following grafting procedures in the ChronEx RCT.

Methods: ChronEx randomized VLU patients to up to two weeks (eight daily applications) of BBD (bromelain-based debridement), placebo gel vehicle (PLC), or non-surgical standard of care (NSSOC), followed by 12 weeks with non-active dressings. Autograft or allograft use during follow-up was permitted per investigator judgement.

Complete closure was defined as 100% re-epithelialization without drainage or dressing need, confirmed at two weeks. Closure incidence and timing (mean, median, range) were summarized descriptively; no between-group statistical analyses were performed.

Results: Nine patients received autografts (ESX n=5, PLC n=3, NSSOC n=1). Mean age was 68.2 years; median wound size 5 cm²; wound age 36 weeks. All achieved complete debridement and full granulation coverage after the treatment phase. Overall, 78% reached complete closure within 12 weeks. Mean time to closure was 14 days (median 18.5; range 7–45).

Seven patients received placental-derived allografts (ESX n=2, PLC n=3, NSSOC n=2). Mean age was 71.4 years; median wound size 5.4 cm²; wound age 19 weeks. Five achieved complete debridement and granulation coverage. Overall, 43% reached closure. Mean time to closure was 27.3 days (median 21; range 21–40).

Discussion: Autografting after wound bed preparation yielded higher closure rates and faster healing (≈2–3 weeks), whereas allograft-treated wounds showed lower closure incidence and slower trajectories (≈3–6 weeks). These findings provide practical insight into expected healing timelines following grafting in VLU.