Following standard care, nonhealing lower extremity (LE) ulcers were managed with a bacterial cellulose (BC) wound dressing, Dermafill™, (AMD/Ritmed, Tonawanda, NY), derived from Acetobacter xylinum. The time to 75% reduction in wound size was compared in 11 chronic wounds before and after the application of BC. The mean period of observation before the application of BC was 315 days; (95% CI: 239-392 days). With the application of BC to these chronic wounds, the mean time to 75% epithelization was reduced to 81 days (95% CI: 50-111 days) with a median of 79 days. The rate of wound closure with BC was significantly faster than with standard care (P < 0.001). When applied to nonhealing LE ulcers, a BC wound dressing shortens the time to wound closure over standard care.