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In the randomized multicenter study, 26 subjects with diabetes, neuropathy, and foot ulceration were treated with standard local wound care and application of either a living skin equivalent [LSE] (Dermagraft (R), Advanced BioHealing, La Jolla, Calif) or extracellular matrix [ECM] collagen wound dressing (OASIS Wound Matrix, Healthpoint, Fort Worth, Tex.) Subjects were analyzed to conform that the wounds, demographics, and health characteristics of subjects in each group were equivalent. Depending on the randomization subjects received up to 3 applications of LSE or 8 applications of ECM. Subjects received this treatment in conjunction with standard saline dressings for a maximum of 12 weeks, and were observed for 20 weeks. No statistically significant differences were found in the size, distribution, or characteristics of the wounds evaluated in each group. There was no statistically significant difference in the time to closure or the rate of closure between the two groups. Similarly, no significant adverse events were reported in either group. The results of this study show comparable healing rates with use of either material. Further, it was hypothesized that both collagen and cellular components are necessary, and it is suggested that various conditions may make one or the other material more desirable.