CLINICAL SERIES ON THE USE OF ACELLULAR FISH SKIN SUBSTITUTES TO SPEED HEALING IN TRAUMA WOUNDS

INTRODUCTION: Acellular fish skin matrix is a new skin substitute that is an alternative for repairing chronic and non-healing wounds of all etiologies. Wound healing occurs in four stages, hemostasis, inflammation, proliferation, and remodeling. Most chronic wounds stall in the inflammation stage. For years, bovine, porcine, and recently human amniotic skin substitutes have been used for chronic or stalled wounds. Mammalian skin substitutes must be harshly cleansed and treated to prevent infection transmission. This process removes important healing components like lipids, glycans, elastins, and collagen.¹ The Acellular fish skin substitute are treated gently and leave the Omega 3 fatty acids which decrease inflammation, have antiviral and antibacterial properties.¹ The Acellular fish-skin matrix has no potential for autoimmune response, or prion diseases. It also poses no cultural or religious issues like those that are faced with bovine, porcine, or amniotic skin substitutes.² Fish skin and human skin are very similar. Both have an epidermis, dermis, and a hypodermis.²   Acellular fish skin substitutes have been shown to have faster healing of full thickness wounds than porcine skin replacements.¹ In addition, studies show a decrease in pain for many patients after the skin substitute has been placed.² METHOD: Three cases are presented to demonstrate treatment of traumatic wounds with acellular fish skin graft. All patients in this case series suffered with a trauma wound of the lower extremity. Previous treatments included multilayer compression therapy, collagen, or amniotic grafts. The wounds were debrided and treated with acellular fish skin matrix. They were seen in an outpatient basis. Weekly wound measurements, photos, debridement and graft application were performed. RESULTS: The three patients experienced complete wound healing without any adverse complications. All patients also reported a substantial decrease in pain with use of acellular fish skin matrix.