Symptomatic Alleviation Of Painful Venous Leg Ulcers Using A Fish Skin Acellular Dermal Matrix

Background:
Pain in venous leg ulcers is frequently described by patients as significant and debilitating. Mitigating ulcer related discomfort can improve patients’ quality of life, tolerance of wound care, and mobility. Fish skin acellular dermal matrices have demonstrated efficacy in promoting wound healing; in this study we investigated whether application can also reduce patients’ subjective pain scores.
 
 

Methods:
We identified 5 patients with venous leg ulcers associated with chronic severe pain concurrently appropriate for OR debridement and application of a skin substitute graft. Prior to OR management the patients recorded baseline subjective pain scores from the prior week utilizing a written questionnaire. Fish skin acellular dermal matrix was applied at the time of debridement. Patients returned to clinic for 4 weekly follow up visits at which time they continued to record their subjective average pain scores from the previous week in addition to collecting standard quantitative wound healing data.

Results:
Patients had between 1 and 3 treated venous leg ulcers with sizes ranging from 8.75 to 126 cm2.  Subjective pain scores were recorded on a scale from 1-10. The average pain score recorded at baseline was 9.25. All patients recorded a reduction in their weekly pain score by their first follow up visit. At the end of 4 follow up visits the average pain score was 4.63, which represented an average 49% decrease in perceived pain.

Conclusions: 
Topically applied fish skin acellular dermal matrices not only serve as an effective therapy for wound healing in venous leg ulcers but in this study also demonstrated positive supplemental effects on reducing severe chronic pain frequently encountered and described by these patients. In addition to providing a barrier layer and stimulating wound closure, fish skin products are rich in Omega-3 fatty acids which may exert analgesic effects though their anti-inflammatory properties, suggesting these products might be particularly beneficial in patients with painful venous leg ulcers.

Trademarked Items (if applicable): Kerecis

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