Clinical Observations of a Novel Fish Skin Graft in Reconstruction of a Complex Full-Thickness Burn

Significant advances over the past decade have occurred in burn wound management that have improved outcomes and quality of life. Patients with larger burns are at an increased risk of nosocomial infections and sepsis due to extended times to wound closure. This unique case study describes recent developments in chronic wound care that advance the practice of burn care.

The novel fish skin graft supports the body’s own ability to regenerate by recruiting the body’s own cells. The graft is decellularized Icelandic codfish skin. Its protein composition closely resembles that of human skin, and the porous microstructure provides a scaffold for efficient ingrowth of dermal cells and capillaries. In addition, the graft is uniquely rich in the polyunsaturated omega-3 fatty acids EPA and DHA, which are known for their anti-inflammatory properties.

The patient is a 61-year-old female who sustained a full-thickness scald burn to her right thigh. The wounds in aggregate, measured 30 cm by 20 cm, extending into the deep subcutaneous tissue. She was experiencing significant pain which necessitated intravenous opioid therapy. Her past medical history was significant for polycythemia vera and required ongoing active anticoagulation with a heparin drip. Operative debridement was performed and placement of fish skin graft with negative pressure wound therapy. Two weeks later, she underwent successful split-thickness skin graft reconstruction.

Clinical observations were a subjective reduction in pain, no significant bleeding despite remaining on a heparin drip in the postoperative period, and rapid granulation of the wound bed leading to faster application of skin graft.

Conclusions: This rapid granulation and assisted closure of a deep and painful burn results in a decreased risk of wound complications, improvement in QOL, and reduction in costs.