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Bioactive Glass Matrix for Recalcitrant Trauma Wounds

November 26, 2025•4 min read

Boron-Based Bioactive Glass Fiber Matrix for Recalcitrant Trauma & Amputation Wounds

TL;DR (Key Findings)

Three lower-extremity wounds (post-ORIF dehiscence, transmetatarsal amputation, and midfoot amputation) achieved full closure after serial applications of a boron-based bioactive glass fiber matrix (BBGFM) integrated into multimodal wound care—debridement, infection control, and moisture/biofilm management—consistent with findings from the pivotal Mirragen RCT and follow-on reviews (Armstrong et al., Int Wound J. 2021 PMCID PMC9013587 ; Ren et al., Front Bioeng Biotechnol 2025 PMCID PMC11751205).

Case Highlights

Post-ORIF ankle dehiscence: 18 cm³ wound healed completely over ≈ 8.5 months after BBGFM was added to SOC (Armstrong RCT 2021).
Post-TMA wound: 100 % closure in 12 weeks after 7 applications (weekly–biweekly cadence consistent with trial protocol and case series usage patterns (Homaeigohar 2022)).
Post-midfoot amputation: Full epithelialization after 10 applications over 21 weeks (also seen in borate-glass clinical reports (Buck et al., Adv Skin Wound Care 2020)).

All three cases demonstrated robust granulation and epithelial advancement, in line with mechanistic evidence showing borate glass ions stimulate angiogenesis and fibroblast activity (Kargozar 2019 PMCID PMC6447657) and (Ege 2022 ACS ABM review).

Why This Matters

Trauma and amputation wounds often stall despite standard care due to bioburden and repeated surgery. This case series adds to emerging evidence that borate bioactive glass matrices can restart healing when SOC plateaus (Armstrong 2025 clinical report) and (HMP Global infected-hardware case).

Cases at a glance

Case 1: 45‑y/o female, dehisced surgical wound after hardware removal (post‑ORIF ankle)

Wound & History: Early Pseudomonas and S. aureus; staged grafting with human placental tissue + collagen dermal layer

Prior Issues/Care: Serial BBGFM after infection control & debridement

Outcome: From 18 cm³ with negative trajectory → full closure ~8.5 months.

Case 2: 60‑y/o male, post‑transmetatarsal amputation (TMA)

Wound & History: Non‑healing bed with eschar/slough; managed initially with topical antiseptic/cleanser

Prior Issues/Care: Seven BBGFM applications

Outcome: 100% closure at 12 weeks.

Case 3: 62‑y/o male, chronic necrotic post‑midfoot amputation wound

Wound & History: Stalled after five xenograft skin substitutes + collagen‑alginate dressings

Prior Issues/Care: Ten BBGFM applications over 21 weeks

Outcome: Contracted, granulated, and fully epithelialized (peak 4.9 cm³).

Clinical theme: In each case, progress accelerated only after BBGFM was layered into a multimodal plan (sharp debridement, infection control, absorbent/antimicrobial dressings).

Practical Takeaways for Wound Programs

Start with fundamentals then escalate. Standard bed prep and antimicrobial dressings preceded BBGFM use in all patients (StatPearls NPWT review 2023).
Plan for serial applications. Weekly-to-biweekly cadence mirrors clinical-trial protocols and ongoing DFU studies (ClinicalTrials.gov NCT06403605).
Watch for early “go/no-go” signals. Granulation and edge advancement within weeks suggest continuing therapy (Buck 2020).
Keep the strategy multimodal. Integration with debridement and infection control aligns with RCT SOC framework (Armstrong 2021).

Outcomes and Limitations

Trajectory reversal: All wounds contracted and granulated after BBGFM introduction (Armstrong 2021).
Time to closure: 8.5 months (post-ORIF) | 12 weeks (TMA) | 21 weeks (midfoot).
Quality of tissue: Described as “robust granulation and epithelialization,” consistent with bioactive-glass healing mechanisms (Ren 2025).
Study size (n = 3) → uncontrolled; authors recommend prospective trials to define comparative effectiveness and application cadence (ongoing NCT03398538).

Bottom Line

Recalcitrant trauma and amputation wounds often resist closure even after best-practice wound care and prior advanced matrices. This three-patient series reinforces growing evidence that a boron-based bioactive glass fiber matrix (BBGFM) can help restart stalled healing by stimulating granulation and epithelial advancement within a multimodal framework.

Serial use—typically weekly to biweekly applications following debridement and infection control—produced measurable improvements in wound trajectory and tissue quality, echoing outcomes seen in randomized and real-world studies. While these results are early and uncontrolled, they align with broader clinical data showing that bioactive glass dressings enhance angiogenesis, fibroblast activity, and microbial balance—creating conditions for sustainable closure.

For clinicians managing complex lower-extremity wounds, BBGFM represents a promising adjunctive option to deploy when progress plateaus, integrated with foundational wound care and objective progress tracking.

Citations

·Armstrong DG, et al. Resorbable glass microfiber matrix vs SOC in chronic wounds (RCT). Int Wound J. 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC9013587/ PMC

·PubMed record for the RCT. https://pubmed.ncbi.nlm.nih.gov/34418302/ PubMed

·Ren Z, et al. Bioactive Glasses: Advancing Skin Tissue Repair. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC11751205/ PMC

·Homaeigohar S, et al. Bioactive glass-based fibrous wound dressings. 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9519693/ PMC

·Kargozar S, et al. Using Bioactive Glasses in the Management of Burns. 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6447657/ PMC

·Armstrong DG, et al. A borate-based bioactive glass advances wound healing (clinical report). 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12475973/ PMC

·Buck DW, et al. Bioactive glass fiber matrix case series (chronic wounds). 2020. https://journals.lww.com/aswcjournal/fulltext/2020/08000/innovative_bioactive_glass_fiber_technology.11.aspx Lippincott Journals

·HMP case write-up: Bioactive glass on infected wounds/exposed hardware. https://www.hmpgloballearningnetwork.com/node/324724 ScienceDirect

·ClinicalTrials.gov – Bioresorbable glass fiber matrix in DFUs (NCT03398538, NCT06403605). https://clinicaltrials.gov/study/NCT03398538 ; https://www.clinicaltrials.gov/study/NCT06403605 ClinicalTrials+1

·CenterWatch – Mirragen DFU Study (real-world). https://www.centerwatch.com/clinical-trials/listings/NCT06598241/mirragen-diabetic-foot-ulcer-study CenterWatch

·Drago L, et al. Recent Evidence on Bioactive Glass Antimicrobial Properties. 2018. https://www.mdpi.com/1996-1944/11/2/326 MDPI

·Wilkinson HN, et al. Antimicrobial efficacy against P. aeruginosa & S. aureus in biofilm model. 2018. https://europepmc.org/article/pmc/pmc6037725 Europe PMC

·StatPearls. Negative Pressure Wound Therapy. 2023. https://www.ncbi.nlm.nih.gov/books/NBK576388/ NCBI

· Wounds International SWD consensus (NPWT in dehiscence). https://woundsinternational.com/consensus-documents/surgical-wound-dehiscence-swd-international-consensus-statement-on-assessment-diagnosis-and-management/ Wounds International

·BlueCross NC policy—objective granulation/contracture for continued NPWT.https://www.bluecrossnc.com/providers/policies-guidelines-codes/commercial/home-health-dme/updates/topical-negative-pressure-therapy-for-wounds