Wounds Heal Better With Fish Skin

tuna fish

The treatment and healing of burn wounds continue to pose challenges in the field of medicine. Severe burn injuries can have serious consequences beyond the directly affected areas, ranging from pathological immune processes to multiple organ failure.

When wounds are so deep that the skin cannot regenerate on its own, often the only viable option is skin transplantation. In such cases, healthy skin from an unaffected part of the body is transplanted into the burn wound. If there is insufficient available native skin or human donor skin, xenotransplantations, involving the transfer of animal skin to humans, become a potential option.

Natural Material

Traditionally, pig skin has been frequently used for this purpose. Serving as a temporary barrier over the wound, it aims to protect against infections and fluid loss while promoting natural healing. However, there is always a risk of rejection of foreign material by the body.

Issues like these have prompted the search for alternatives, leading to the development of acellular fish skin. According to Lars-Peter Kamolz, Head of the Department of Surgery at the University Hospital in Graz, one significant advantage of fish skin is its high biocompatibility. Being a natural material, it generally does not trigger allergic reactions and can be well-tolerated by many patients.

Remarkable Skin Substitute

Acellular fish skin temporarily serves as a skin substitute in the treatment of burn wounds. With its high content of omega-3 fatty acids, it reduces inflammatory reactions and promotes proinflammatory cytokines that facilitate wound healing. Kamolz suggests that, due to these advantageous properties in wound healing, acellular fish skin could represent an effective approach to treating burn wounds.

The Department of Plastic, Aesthetic, and Reconstructive Surgery at the Medical University of Graz, the Icelandic company Kerecis, and the US Department of Defense are all working with Coremed, the Kamolz-led research center at Joanneum Research, to investigate the mechanisms underlying these effects. The raw material for this research project is sourced from Kerecis, which utilizes cod skins, typically a byproduct of the Icelandic fish industry, processed through a specific method to gently decellularize and sterilize them.

Reduced Pain

Existing evidence on the use of acellular fish skin indicates an acceleration of wound healing, reduction in pain and necessary dressing changes as well as treatment-related costs and improved aesthetic and functional outcomes compared to conventional treatment options,” explains Kamolz. The fish skin controls the initial inflammation of the burn wound.

This is crucial, as a prolonged inflammatory process can lead to chronic wounds or hypertrophic scars—thickenings and elevations beyond the original wound due to excessive production of connective tissue. “We definitely want to avoid that. Hence, we gladly use this skin for more complex wounds,” says the surgeon.

Effective for Burn Wounds

The researchers in Graz primarily contribute their expertise to the project, focusing on burn injuries. According to Kamolz, model experiments with fish skin as a wound covering have demonstrated significantly faster wound healing in the first days after the injury. Biomarkers also indicate improved blood circulation and the formation of new tissue. These beneficial properties are attributed to both the ingredients, like omega-3 fatty acids in fish skin, and its lattice-like architecture, similar to human skin.

The properties of fish skin prove particularly advantageous in the treatment of burn wounds colonized by bacteria. This is especially relevant in war zones, explaining the interest of the US Department of Defense. Currently, this technology is predominantly used clinically in the United States, with limited use in Austria—mainly in Graz, for instance, in the treatment of Ukrainian war injuries.

Shortened Treatment Duration

According to Kamolz, the cost savings from fish skin therapy result not from the material itself, which is expensive, but from the shorter treatment duration. “The material itself is not cheap but rather expensive. Therefore, it is more intended for complex wounds than for every routine wound. However, overall treatment costs are reduced,” he explains.

Preclinical data and case studies from the research have already been published and presented at conferences. A publication on biocompatible wound dressings is currently in preparation. Considerations are now directed towards modifying the product for additional diverse indications.