Below the Knee – August 2025 Edition

Wound Care. Limb Salvage. Foot & Ankle. Innovation, Capital & Policy.

Author

Scott Nelson
September 03, 2025

🔥 July Recap – The Heat Was Real

July delivered across the board: reimbursement shocks, deal flow, fund volatility, and a market suddenly demanding evidence over hype. Here’s what mattered most 👇

  • CMS drops the hammer: 2026 skin sub reimbursement overhaul — flat bundled payments, ASP margins gone.

  • M&A engine restarts: Arthrex, Zimmer, Mölnlycke, Venture Medical, Tiger Wound Care all on the move.

  • Poll results are in: Nearly 3,000 responses say Biologics are the most overhyped segment in wound care (49%).

  • Innovation watch: Real-time tissue monitoring is closer than anyone thinks — and it won’t come from a dressing.

💲 Finance & Fund Performance

The WoundCareFund continued its strong run through the summer, closing August at $461.30, up 7.2% for the month and 13.7% since June.

  • June saw a solid rebound, with the fund gaining 4.6% despite some mid-month volatility.

  • July was more muted, reflecting a slight pullback and rotation, with the fund rising just 1.4% for the month.

  • August reignited momentum, posting consistent weekly gains and ending the quarter on a high note.

Weekly movements highlighted some short-term swings—most notably a 3.7% dip in mid-July—but overall, the trajectory has been positive, underscoring resilient growth in wound care equities.

The summer rally reflects both strong clinical innovation signals and strategic market positioning across the portfolio, signaling confidence in the sector as we head into the fall.

Top Movers Driving Momentum:

  • InfuSystem: +69.82% — EPS up 300% YoY, EBITDA + cash flow strength.

  • Treace Medical Concepts: +29.42% — narrowed losses, launched 3 bunion systems, investor day incoming.

  • Sanara MedTech: +25.78% — 28% YoY growth, turned a profit, strategic review in play.

  • BioStem Technologies: Rollercoaster month (–42.8% → +22.5%) tied to weak earnings, then insider buys.

  • Organogenesis: +14.54% on resilience post-Q2.

💼 Q2 Earnings Roundup: Mixed Signals, Strategic Moves, and Early Positioning for 2026

Q2 earnings season delivered a mix of growth stories and cautionary tales across the wound care sector. While a few companies beat expectations and showcased momentum, others are tightening belts and rethinking strategies heading into 2026. Here’s a closer look at the headlines that matter:

Organogenesis (ORGO)

Organogenesis posted $105.5M in revenue, down 3% YoY, with management citing ongoing reimbursement pressures and pricing challenges across their advanced wound care portfolio. Despite the softness, ORGO reaffirmed guidance for the year and pointed to operational cost discipline as a hedge against headwinds. CEO Gary Gillheeney emphasized that the company is leaning into new evidence-generation initiatives and payor engagement to defend key biologics’ positioning ahead of potential CMS coverage changes in 2026. The market reaction was muted, signaling investors are waiting for a clearer growth catalyst.

MiMedx (MDXG)

MiMedx turned in solid revenue growth at $93.8M, up 8% YoY, driven by its placental biologics segment and international expansion efforts. The company’s bullish guidance reflects a renewed focus on surgical applications and diabetic foot ulcer evidence, as it seeks to differentiate amid biologics consolidation. Management highlighted double-digit procedural growth in targeted hospital networks and emphasized their belief that innovation plus clinical rigor is key to weathering regulatory scrutiny.

Integra LifeSciences (IART)

Integra’s wound and reconstructive portfolio remained a steady revenue driver, helping offset softness in other parts of the business. Integra emphasized their focus on scaling the SurgiMend® and PriMatrix® franchises in specialty care settings, with investment in digital imaging partnerships being a future growth lever. However, headwinds from hospital capital spending constraints were noted, reinforcing the defensive value of biologics and chronic wound solutions in their broader mix.

Smith+Nephew (SNN)

Smith+Nephew delivered a modest 4% YoY growth in Advanced Wound Management, driven by adoption of PICO™ single-use NPWT in outpatient settings and sustained uptake of ALLEVYN® dressings. The company spotlighted its strategy to double down on community-based wound care, where payors are pushing for more home-based healing models. Margin pressure remains a concern, but SNN’s diversified portfolio and international footprint give it relative resilience.

Takeaway: Strategic Positioning Ahead of Regulatory Inflection Points

With CMS poised to shake up skin substitute reimbursement in 2026, companies are clearly signaling to investors that clinical differentiation and payor engagement are front-and-center priorities. Expect biologics leaders like MiMedx and Organogenesis to ramp up evidence campaigns, while device-focused players such as Smith+Nephew emphasize cost-effective outpatient solutions. Q2 was less about blockbuster growth and more about fortifying strategies for a shifting market.

💰 M&A and Capital Moves: Momentum Accelerates in H1 2025

The medtech deal engine roared back to life in the first half of 2025, and July only cemented the trend, with activity spanning wound care, biologics, diagnostics, and beyond.

🔹 Wound Care Consolidation Heats Up:
Arthrex made a strategic play by acquiring Vomaris Innovations, integrating bioelectric dressings into its trauma, sports medicine, and foot & ankle portfolios—signaling growing orthopedics interest in advanced wound healing. Venture Medical picked up ProgenaCare’s keratin-based wound care assets, while Tiger Wound Care added NOVO Health’s HealPACK product line, consolidating niche innovation under more nimble players. Legacy Medical, meanwhile, secured exclusive U.S. rights to market ActiGraft Pro, strengthening its regenerative wound offerings.

🔹 Big-Ticket Investments:
Mölnlycke Health Care doubled down with a €115M U.S. manufacturing expansion and a €400M financing round, alongside a strategic stake in Siren, whose diabetic sensor socks reflect the growing convergence of wearables and wound care. Zimmer Biomet closed its $1.2B acquisition of Paragon 28, further cementing its dominance in foot & ankle surgery, while LifeNet Health’s acquisition of HCM Medical added xenograft and next-gen biologics expertise to its portfolio.

🔹 Growth Capital and Platform Plays:
Conformis, now under restor3d, secured a $104M growth investment, fueling scaling efforts. These moves reflect a steady flow of capital into regenerative and surgical tech platforms that bridge orthopedics and wound care.

🔹 Diagnostics on Fire:
Diagnostics emerged as one of the most active verticals this summer. MolecuLight raised $27.5M and dropped compelling randomized clinical trial (RCT) data: fluorescence-guided debridement sped healing (49 vs. 63 days), slashed infection rates (4% vs. 22%), reduced antibiotic costs by ~40%, and shortened hospital length of stay. This validation makes diagnostics a rising battleground for both capital and clinical adoption.

🔹 Beyond Wound Care – A Medtech Feeding Frenzy:
Outside wound care, heavyweights went shopping: Stryker’s $4.9B acquisition of Inari Medical and Boston Scientific’s combined $1B+ deals for Bolt and SoniVie signal aggressive cardiovascular expansion. On the public markets, Heartflow’s $316.7M IPO staked its claim in the $504B AI-driven healthcare market, while Beta Bionics and Caris Life Sciences followed with offerings that reflect investor appetite for precision health and digital-first care models.

Takeaway: Consolidation is accelerating across the wound and limb salvage ecosystem, with diagnostics and biologics leading innovation bets. Expect Q4 to bring even larger plays as medtech capital floods back into growth sectors.

🧪 Innovation Signals

The push toward real-time tissue monitoring is gaining serious traction. Across wound care, the signal is clear: the future is moving toward instant, actionable insight at the bedside.

  • AI-powered spectral imaging is showing promise for detecting ischemia earlier than ever, giving clinicians a potential head start before tissue damage becomes irreversible.

  • Cross-pollination from orthopedics and cardiovascular sensor technology is accelerating innovation in wound care, bringing sophisticated monitoring capabilities once confined to other specialties.

  • Clinical trials are evolving—perfusion endpoints are now being tracked as predictors of healing, not just outcomes, reflecting a more proactive, precision-driven approach.

Looking ahead: a software-first, reimbursable, bedside tool that can quantify tissue viability in under five seconds is on the horizon. This isn’t just incremental improvement—if realized, it could redefine triage, shift the balance in limb salvage versus amputation decisions, and fundamentally reshape value-based risk stratification in wound care.

The takeaway: wound care is on the verge of a diagnostic revolution, and the first movers in real-time tissue monitoring stand to reshape both patient outcomes and the economics of care.

📢 Market & Company Updates

  • Orpyx® Launches Sensory Insoles: Debuted its next-gen remote patient monitoring insole platform, combining continuous plantar pressure, temperature, and activity monitoring to reduce diabetic foot ulcer (DFU) recurrence.

  • Coloplast Strategic Restructure: Splitting into Chronic Care (ostomy, continence, wound) and Acute Care (surgical & advanced wound) to streamline go-to-market execution and accelerate growth in wound care.

  • Adia Med Expands U.S. Footprint: Scaling wound care services and announcing a strategic partnership with Venture Medical to bundle reimbursement-optimized wound products for outpatient and ASC settings.

  • PolarityBio Pushes Toward BLA Filing: Announced progress on regenerative wound-healing biologic, targeting FDA BLA submission by mid-2026.

  • Imbed Bio Dual-Action Matrix Launch: Introduced a synthetic wound matrix with silver for bioburden management and lidocaine for pain relief—a first-of-its-kind combo in advanced wound dressings.

  • MiMedx Earnings Strength: Posted strong Q2 revenue growth, driven by expansion of placental allograft products and increased hospital adoption; reaffirmed guidance for H2.

  • Sanara MedTech Momentum: Highlighted expanding ProgenaMatrix® utilization and strong commercial traction in hospital and long-term care markets, alongside continued SaaS development through Precision Healing.

  • Organogenesis Market Positioning: Signaled steady growth in PuraPly® portfolio and ongoing product innovation pipeline ahead of fall conference season.

  • Reapplix/3M Integration Update: 3M shared positive adoption trends for LeucoPatch in chronic wound care, with ongoing integration into its Acelity portfolio.

  • Medline Deepens AI + Imaging Partnerships: Announced new initiatives to embed AI wound measurement tools into distribution and supply platforms.

  • Wound Diagnostics Convergence: MolecuLight and Kent Imaging were both spotlighted in clinical studies and strategic partnership rumors, reinforcing diagnostic role as a growth catalyst.

🎤 What’s Next

  • #SAWCFall is coming in hot — Expect the annual powerhouse event to double down on cellular- and tissue-based products (CTPs), reimbursement battles, and next-gen imaging. AI-enhanced diagnostics, fluorescence, and multispectral imaging are no longer novelties — they’re moving toward clinical standardization. Early buzz suggests new data on bacterial load imaging, regenerative matrices, and a few stealth-stage launches designed to shake up standard wound care workflows.

  • H2 2025 Deal Flow — The second half of this year looks primed for M&A acceleration:

    • Mölnlycke’s appetite for innovation is well-telegraphed — expect potential moves into biologics or imaging.

    • MolecuLight feels acquisition-ready with its expanding footprint and new distributor alignment, they are also hiring for key leadership sales roles, so we’ll see?

    • Expect convergence in diagnostics, AI platforms, and digital wound imaging to draw larger strategics into early acquisitions, setting the stage for market consolidation in 2026.

  • Capital Flows and Investment Trends: Venture funding is gravitating toward hybrid platforms that bridge point-of-care hardware and SaaS analytics, creating clinical decision support loops that could redefine standard of care. This shift will push investors to look beyond one-dimensional product plays and reward ecosystems that combine device, data, and reimbursement strategy.

  • Clinical and Regulatory Outlook: Keep a close eye on FDA’s evolving stance on AI/ML in diagnostics. Guidance expected later this year could accelerate time-to-market for wound imaging and predictive healing tools. For CTP players, CMS’s ongoing reimbursement recalibration is likely to create headwinds for underperforming SKUs, but also opportunity for high-value biologics.

  • The Bottom Line:
    We’re entering an inflection point where digital-first wound care models and regenerative innovation aren’t just buzzwords — they’re emerging as the dominant growth drivers. If you’re a medtech or biotech leader, H2 2025 is the time to double down on ecosystem plays and data-backed clinical differentiation before the market gets crowded.

That’s July in the books. August brings SAWC, more earnings, likely more fireworks and a brand new Innovation In Wound Market Map!

If you’re at SAWC, let’s connect!

-scott