Fish-Skin Utilized to promote Granulation tissue in Complicated Surgical Wounds: A Case Series

Introduction:Wound care is often described as an art where the clinician mediates the progression of wounds from onset to healing. Often this is disrupted by extrinsic and intrinsic factors preventing progression through the orderly healing phases. Consequently, these chronic and problematic wounds remain in the inflammatory phase.Wound progression is achieved when there is a reduction of inflammatory markers and sustainable formation of granulation tissue to fill in full-thickness wounds. Advanced products are available to compliment interventions and set closure goals in an acceptable time frame thus decreasing the potential of infections and amputations.

Methods:The purpose of this case series was to evaluate the effectiveness of a fish-skin structure to promote the proliferation of granulation tissue in managing full-thickness complicated surgical debrided patients.

Case #1 – status post extensive surgical debridement of his right lower leg with exposed bone and tendon.

Case #2 – non-healing orthopedic surgical knee with exposed bone and hardware.

Case #3 – patient with DM status post extensive surgical debridement of left thigh due to necrotizing infection.

Case #4 – status post-surgical debridement of an atypical wound with exposed ligaments/tendons.

Case #5 – Infected DFU status post-surgical debridement with exposed structures.Fish-skin graft, at a molecular level, resembles human skin maintaining similar biological properties. Its processing technique preserves glycoproteins, lipids, Omega3 fatty acids and others as they play an important role in repairing tissue.

Results:

Cases 1 – 5 achieved acceptable proliferation of granulation tissue to fill in tissue defects for these surgically debrided wounds.

Case #1, rapid progress achieving acceptable formation of granulation tissue, Case #2 healed, Cases 3-5 progressing towards closure.

Discussion:The application of a unique fish-skin structure provided a scaffold to promote the formation of granulation tissue in complicated surgical wounds. Evidence demonstrates the similarity of human and fish skin providing wounds with a unique structure to recruit human’s own cells in assisting the proliferation of granulation tissue.