Bioactive Glass Fiber Matrix for Refractory VLUs — Veterans Case Series | Medipyxis

Correlation of Reduction in Exudate, Pain and Wound Size of Refractory Wounds to Quality of Life, Emotional and Social Well‑Being: A Veteran’s Story

INTRODUCTION

Persistent non‑healing wounds can significantly impair quality of life (QoL) for veterans, contributing to anxiety, depression, reduced mobility, sleep disturbance and social isolation.[1] These wounds are often malodorous and heavily exudative, causing substantial pain, limiting daily activities, and affecting emotional well‑being as well as social participation.[1]

Veterans with combat‑related injury have a high prevalence of chronic neuropathic and post‑amputation pain, adding to functional limitations and further restricting engagement in work, family and community life.[2]

Emerging synthetic materials, such as borate‑based bioactive glass fiber matrices (BBGFM), have gained attention for their ability to support rapid granulation and epithelialization in difficult‑to‑heal wounds.[3–5]

BBGFM dressings maintain a moist, ion‑releasing microenvironment that has been associated with accelerated wound closure and reduced symptom burden (exudate, odor, infection) compared with standard care alone.[3–5]

This case series describes how reductions in exudate, pain and wound size in two veterans with refractory venous leg ulcers (VLUs) correlated with improvements in mobility, emotional state and social well‑being.

METHODS

Two veterans with a total of five chronic, heavily exudative and painful VLUs—each present for more than 8–10 months—were treated with weekly applications of a borate‑based bioactive glass fiber matrix (BBGFM). All wounds had failed multiple advanced treatment modalities before BBGFM, including other cellular/tissue‑based products and compression, and both patients were unable to tolerate debridement or compression therapy because of severe pain.

Prior to BBGFM application, both patients reported limited mobility and were largely confined to their homes due to pain, persistent exudate, malodor and feelings of embarrassment and social withdrawal.

At each weekly visit, the wounds were cleansed and BBGFM was applied directly to the wound bed and covered with appropriate secondary dressings. Wound size (length × width × depth), exudate level, odor, and self‑reported pain were documented, along with narrative comments on activity level and perceived social engagement.

RESULTS

(92% reduction of venous leg ulcer wound after 12 weeks of treatment)

Within the first two weeks of BBGFM use, both veterans experienced a rapid decrease in exudate and odor, along with complete resolution of wound‑associated pain. These early changes enabled tolerance of graduated compression therapy and increased ambulation, which patients described as key to feeling “more normal” and less socially isolated.[4,5]

After six weekly applications of BBGFM, four of the five VLUs had fully epithelialized. The fifth wound—initially measuring 10.8 × 9.0 × 0.3 cm—demonstrated approximately 60% reduction in wound area within the first few weeks of treatment, with ongoing steady reduction thereafter. The patient remained pain‑free and increasingly active, reporting return to community activities that had been avoided for months because of drainage and odor.

In the wounds that closed, rapid, healthy granulation and epithelialization were observed clinically, with high‑quality tissue and no evidence of slough or infection. These outcomes are consistent with prior reports of BBGFM in hard‑to‑heal venous and mixed‑etiology wounds in older, multimorbid populations.[3–5]

The biologic response may be partly explained by the ionic dissolution products of bioactive glass, which have been shown to stimulate fibroblasts to secrete angiogenic growth factors (e.g., VEGF, bFGF) and to promote endothelial cell proliferation and in‑vitro angiogenesis.[6]

DISCUSSION

These two veteran cases provide real‑world evidence that BBGFM can rapidly reduce exudate and pain in chronic, previously recalcitrant VLUs while promoting robust granulation and epithelialization. The ability to control drainage and odor, alongside elimination of wound pain, enabled patients to tolerate compression and increase ambulation—cornerstones of effective venous ulcer management—and to re‑engage in social activities they had avoided for months.

The clinical trajectory observed here mirrors outcomes reported in a multicenter randomized controlled trial in diabetic foot ulcers, where adding BBGFM to standard of care significantly increased the proportion of wounds healed and improved percent area reduction without additional safety concerns.[3]

Case‑based series in venous and complex refractory wounds likewise describe closure of long‑standing ulcers and substantial reductions in infection‑related complications when bioactive glass wound matrices are introduced after multiple prior treatment failures. [4,5]

Importantly, both veterans in this series reported dramatic improvements in QoL, describing better sleep, increased confidence in leaving the house, and reduced embarrassment related to drainage and odor. These observations align with broader literature documenting the heavy psychosocial burden of chronic leg ulcers—especially pain, exudate and malodor—as drivers of depression, anxiety and social isolation.[1]

While this is a small, uncontrolled series, the convergence of rapid symptom relief, wound area reduction, and QoL gains in veterans with long‑standing refractory VLUs supports further prospective study of BBGFM as an adjunctive option for complex venous wounds in military and VA populations.

Bottom line

• Symptom relief came fast. Within two weeks of introducing BBGFM, both veterans had a striking drop in exudate and odor and complete resolution of wound‑related pain, which unlocked compression therapy and increased walking.

• Healing followed symptom control. Four of five chronic VLUs fully healed after six weekly BBGFM applications; the fifth large ulcer demonstrated ~60% area reduction in the first few weeks with continued progress, echoing healing patterns seen in BBGFM RCTs and case series.[3–5]

• Quality of life moved with the wound. As drainage, odor and pain improved, both patients reported better mobility, less isolation, and greater emotional well‑being—consistent with evidence that controlling these wound symptoms is central to restoring QoL in people living with chronic leg ulcers.[1,2]

For veterans with refractory VLUs who are “stuck” because pain and exudate make standard therapies intolerable, a borate‑based bioactive glass fiber matrix is a reasonable, evidence‑supported adjunct to consider, with potential benefits that extend beyond the wound bed into emotional and social recovery.

References

1. Situm M, Kolić M, Spoljar S. QUALITY OF LIFE AND PSYCHOLOGICAL ASPECTS IN PATIENTS WITH CHRONIC LEG ULCER. Acta Med Croatica. 2016;70(1):61‑63.

2. Kumar A, Soliman N, Gan Z, et al. A systematic review of the prevalence of postamputation and chronic neuropathic pain associated with combat injury in military personnel. Pain. 2024;165(4):727‑740.

3. Armstrong DG, Orgill DP, Galiano RD, et al. A multi‑centre, single‑blinded randomised controlled clinical trial evaluating the effect of a resorbable glass fibre matrix in the treatment of diabetic foot ulcers. Int Wound J. 2021;19(4):791‑801.

4. Johnson M, Ortega E, Armstrong D. How can novel bioactive glass wound matrix optimize hard‑to‑heal venous leg ulcers in geriatric patients with multiple comorbidities? Wound Masterclass. March 2024;3:1‑7. (Cited in SAWC case‑series poster.)

5. Castillo‑Garcia E, Thuy Nguyen P. Complex refractory wounds: How to overcome treatment recalcitrance and restore the healing trajectory using innovative bioactive glass. Wound Masterclass. March 2024;3:1‑12. (Referenced in SAWC Spring bioactive glass poster.) Conference poster reference

6. Day RM. Bioactive glass stimulates the secretion of angiogenic growth factors and angiogenesis in vitro. Tissue Eng. 2005;11(5‑6):768‑777.