Efficacy of Axolotl-derived Xenograft in Chronic Comorbidities Population: Wound Closure with up to Four Weekly Applications – a Case Series

Introduction: Chronic wounds pose a persistent healthcare challenge, often necessitating advanced therapies for effective resolution. Axo- lotl-derived xenografts, fabricated from dermal extracellular matrix and sterilized via gamma irradiation, provide a biocompatible and immunoge- nicity-free solution for wound management. This case series assesses the efficacy of these xenografts in achieving complete closure across diverse chronic wound types within four weekly applications. Methods: Seven patients (aged 50–97) with at least one chronic comor- bidity (T2DM = 4, 57%; HTN = 7, 100%; CKD = 2, 29%; CAD = 1, 14%; AFib = 3, 43%; HLD = 5, 71%) were included. Wound types treated included diabetic foot ulcers (DFUs = 14%), surgical wounds (14%), traumatic wounds (14%), pressure ulcers (14%), perianal abscesses (14%), and skin tears (14%), with sizes ranging from 0.48 cm² to 8.47 cm². Weekly xeno- graft applications were conducted, and outcomes were evaluated through wound area reduction, Bates-Jensen scores, and time to closure using automated wound apps* for precision. Previous treatments included advanced dressings, debridement, antibiotics, and compression therapy. Care was delivered in patients’ homes or assisted living facilities by ad- vanced practice providers. No adverse effects, including allergic reactions or infection, were reported or observed during treatment. Results: All wounds achieved complete closure within four weeks of treatment, demonstrating consistent efficacy. Closure times ranged from 1 to 4 weeks. A 97-year-old female with a 0.64 cm² skin tear achieved closure in 1 week, illustrating the matrix’s suitability for fragile skin. A 66-year-old male with a 3.14 cm² diabetic foot ulcer achieved closure in 4 weeks. Rapid wound area reduction and improved Bates-Jensen scores were observed within the first application. No adverse effects, including allergic reactions or infection, were reported or observed during treatment. Discussion: Axolotl-derived xenografts show promise in addressing chronic wound challenges, supporting rapid closure in wounds resistant to conventional treatments. Their biocompatibility, effectiveness, and reduced healing times suggest potential as a first-line treatment, lowering costs and aligning with advancements in extracellular matrix-based scaffolds that support tissue formation. Expanding the scope to include randomized trials and larger cohorts will validate these findings and provide comparative data against existing therapies.