This multi-centre observational pilot study explored the use of whole blood clot (WBC) therapy on hard-to-heal wounds where the phases of wound healing have been interrupted or stalled. Primary data from 29 patients were gathered from 10 pilot sites in South Africa and Israel. Prior to the application of WBC as an advanced technology, several other advanced wound care technologies, devices and wound care products were used in 48% of patients for more than 12 months, without achieving wound closure. An average of 65% reduction in wound size was achieved in 4 weeks in this pilot study, illustrating safety and efficacy for WBC application in hard-to-heal wounds.