Inclusion Criteria  Subjects are male or female, 18 years of age or older. Pressure ulcer/injury present for greater than 4 weeks (documented in the medical record). Subject has clinical documentation of no visible wound improvement in the post four weeks of standard of care. Objectively, less than 20% healing in the past four weeks from the first treatment visit. Study ulcer is a minimum of 2.0 cm2 and a maximum of 50 cm2 at first treatment visit. The subject is able and willing to follow the protocol requirements. Subject has signed informed consent.  Exclusion Criteria  Subject has major uncontrolled medical disorder such as serious cardiovascular, renal, liver or pulmonary disease, lupus, palliative care or sickle cell anemia. Subject currently being treated for an active malignant disease or subjects with history of malignancy within the wound. The Subject has other concurrent conditions that, in the opinion of the Investigator, may compromise subject safety. Concurrent participation in another clinical trial that involves an investigational drug or device that would interfere with this study. Subject is pregnant or breast feeding. Subjects with a history of more than two weeks treatment with immunosuppressants (including systemic corticosteroids >10mg daily dose), cytotoxic chemotherapy, or application of topical steroids to the ulcer surface within one month prior to first Screening Visit, or who receive such medications during the screening period, or who are anticipated to require such medications during the course of the study. Index ulcer has been previously treated with tissue engineered materials (e.g. Apligraf® or Dermagraft®) or other scaffold materials (e.g. Oasis, Matristem) within the l 30 days preceding the first treatment visit. Affected extremity requiring hyperbaric oxygen during the trial or within 2 weeks of treatment visit 1. Known HbA1C >12%. Mini-nutritional assessment Malnutrition Indication score <17.