Efficacy of Kerecis Fish Skin Grafts in Wound Care and Surgical Procedures
Kerecis fish skin grafts demonstrate promising results for wound healing, particularly in complex wounds, with evidence showing faster healing compared to some conventional alternatives, though more high-quality research is needed before recommending them as first-line therapy.
Overview of Kerecis Fish Skin Grafts
- Kerecis is a decellularized skin matrix derived from North Atlantic Cod (Gadus morhua) that serves as a xenograft for wound treatment 1, 2
- The product contains polyunsaturated fatty acids (PUFAs) which contribute to its anti-inflammatory and angiogenic properties that may promote wound healing 2, 3
- Fish skin grafts are used in both acute and chronic wounds, including complex cases with exposed structures such as tendons 1
Clinical Evidence for Efficacy
Comparative Studies
- A double-blind, prospective, randomized clinical trial comparing fish skin grafts to dehydrated human amnion/chorion membrane allograft (dHACM) for acute wounds showed that fish skin-treated wounds healed significantly faster (hazard ratio 2.37; 95% CI: 1.75-3.22; p = 0.0014) 4
- In burn patients with split-thickness donor sites, Kerecis treatment resulted in faster average wound healing time (10.7 ± 1.5 days) compared to bovine collagen skin graft treatment (13.1 ± 1.4 days) 3
Complex Wound Applications
- Case reports demonstrate successful use in treating complex wounds including:
Burn Treatment Outcomes
- When used following enzymatic debridement for burn wounds, fish skin demonstrated:
- Accelerated wound healing
- Higher water-storage capacity
- Better pain relief
- Improved functional and cosmetic outcomes (elasticity, skin thickness, pigmentation)
- Decreased pain and itch scores compared to split-thickness skin grafts (STSG) or Suprathel 5
Limitations in Current Evidence
- Most current evidence comes from small case series or individual case reports 1, 2
- Limited high-quality randomized controlled trials comparing fish skin grafts to standard therapies 4
- Current guidelines on surgical wound care interventions do not specifically address fish skin grafts 6
Considerations in Wound Care Decision-Making
- The International Working Group on the Diabetic Foot (IWGDF) notes that for skin substitutes in general, there is insufficient evidence to establish which particular products may be more effective 6
- Surgical wound care practices show considerable variability, reflecting uncertainty about what constitutes appropriate care 6
- Cost considerations are important when selecting advanced wound care products, as one case of surgical site infection can cost up to $30,000 depending on severity 6
Potential Advantages of Fish Skin Grafts
- May facilitate rapid epithelialization in wounds with exposed structures 1
- Potential to decrease pain during the healing process 1, 5
- May serve as an antimicrobial barrier 1
- Could reduce the need for additional skin grafting in some cases 1
Current Position in Treatment Algorithm
- Fish skin grafts should be considered as an option for complex wounds where conventional approaches have failed or are contraindicated 1, 2
- May be particularly beneficial in wounds with exposed tendons or other structures where rapid coverage is needed 1
- Could be valuable in patients with limited donor sites for autologous grafting 3
Conclusion and Recommendations
- While promising, fish skin grafts should not yet replace standard of care treatments that have more established evidence 6
- Consider fish skin grafts for complex wounds that are not responding to conventional therapy, particularly those with exposed structures 1, 2
- Further high-quality research with larger sample sizes and longer follow-up periods is needed to establish definitive recommendations for routine use 6