The use of acellular fish skin grafts in burns and complex trauma wounds: a systematic review of clinical data

Abstract

Aim: In the field of burns and soft tissue reconstruction, skin substitutes have been successfully used for various indications. They allow for conservative treatment as well as temporal coverage through the improvement of wound bed conditions, pathogen control and the formation of new tissue. Fish skin grafts (FSGs) have gained rising attention as a new tool in the skin substitute market. This systematic review aims to provide an update on clinical studies investigating the effects of FSG on healing for the following indications: donor sites of split-thickness skin grafts, superficial and deep partial-thickness burns, full-thickness burns, combat wounds, and other acute wounds.

Methods: A systematic review of the peer-reviewed literature available as of January 2024 was conducted to examine the effects of FSG on wound healing of burn and complex trauma wounds, using the databases PubMed and Web of Science. Only clinical studies published in English were included.

Results: In total, 11 clinical studies were considered eligible and therefore included in the present review. According to the available data, the main advantages of the two commonly used types of FSGs (Kerecis® Omega3 Wound Matrix and Nile tilapia) are an acceleration of re-epithelialization time, a reduction in pain intensity and infection rates, as well as a reduction in the number of required dressing changes.

Conclusion: FSGs represent a safe and promising product for the management of donor sites, partial-thickness and full-thickness burns, as well as complex trauma wounds. However, there is a paucity of high-quality clinical evidence, especially randomized controlled trials. More research is needed to fully understand the product’s potential for wound healing and to create a more meaningful treatment algorithm.

Keywords

Fish skin graft / Omega-3 Wound Matrix / xenograft / skin substitutes / burns / trauma / combat injuries

References

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