Clinical Experience of Omega 3 Fish Graft in Full Thickness Wounds

Patient 3: 65 year old female, scald burn.

The patient had inflammatory arthritis and rheumatoid arthritis, chronic kidney disease stage 3, obesity and pulmonary valve dysfunction, and concurrent small cell carcinoma stage IV, and was undergoing chemotherapy.

The patient presented on day 10 post injury, with a 3% TBSA scald burn, previous treatment was standard of care and Collagenase SantylTM (Smith & Nephew, London, United Kingdom). Patient was discharged from the practice due to follow up limitations and chemotherapy treatments. During follow up (1 year after treatment), patient had improved pigment matching, skin was soft and pliable with no itching, and showed a full range of motion without limitation.

4a: Appearance of wound on day 10.

4b: Post debridement.

4c: Fish skin graft application.

4d: Post-operative day 8.

4e: Post-operative 15.

4f: Post-operative 25.

Results

Overall, the cohort of patients treated with FSG had an observed decrease in healing time, complications, and patient-reported pain. The clinical challenges encountered are outlined. Integration of the product ranged from day 8 - 15, with a phase of caramelization from day 3 - 7.

Conclusions

In this case study, the fish skin graft demonstrated comparable or better results to historic xenograft usage. Certain characteristics observed during and after wound closure indicate higher speed of product integration compared to standard of care products, reaching the same healing objectives in a shorter time. This allows for earlier physio therapy, hospital discharge or application of split thickness skin graft (STSG). Animal studies have shown that Omega-3 fatty acids in the fish skin graft have an inhibitory effect on bacterial growth, improve epithelial cell migration, angiogenesis and accelerated blood perfusion in the wound bed.4,5 The fish skin graft used has shown to be a safe, effective alternative, and has promising results as a non-mammal xenograft in burn care management. The almost complete preservation of its tissue characteristics during biologic processing may offer further benefits not yet identified in mammal alternatives and should be trialled in larger scale studies.