Omega-3 Rich Fish Skin Grafts Reduce Donor Skin Requirements For Full Thickness Burns
Randolph Stone, II1, David Larson1, John Wall1, Kyle Florell1, Hannah Dillon1, Skuli Magnusson2, Hilmar Kjartansson2, Shanmugasundaram Natesan1, Robert Christy1.
1US Army Institute of Surgical Research, Fort Sam Houston, TX, USA, 2Kerecis, Reykjavik, Iceland.
Background: Allografts (cadaver skin) are routinely used for treatment of burn injuries as a temporary covering to protect the wound while donor sites heal. However, allografts aren’t always available and have high cost associated with them. The purpose of this study was to evaluate fish skin graft (FSG) as a temporary cover to prepare the wound bed for meshed split thickness skin graft (mSTSG) application and as protection over a highly mSTSG. Methods: Full-thickness 5x5 cm burn wounds were created on the dorsum of anesthetized Yorkshire pigs using appropriate pain control methods. Twenty-four hours post-burn, day 0 (D0) wounds were excised down to a viable wound bed and a temporary cover was applied. Then on day 7 (D7), wounds were grafted with a mSTSG. Thirty six wounds were divided into three groups: 1) (D0) FSG then (D7) 1.5:1 mSTSG; 2) (D0) cadaver skin then (D7) 1.5:1 mSTSG; 3) (D0) FSG then (D7) 3:1 mSTSG and FSG applied over the graft. Quantitative measurements include contraction rates, transepidermal water loss (TEWL), hydration, and blood flow. Results: Wounds treated with FSG had similar quantitative measurement outcomes compared to cadaver skin treated burn wounds. The 3:1 mSTSG applied with FSG resulted in similar healing as the wounds treated with the 1.5:1 mSTSG. Conclusions: FSG was found to be non-inferior compared to cadaver skin as a temporary cover as both resulted in similar healing. Most importantly, the wounds treated with FSG and 3:1 mSTSG required 50% less graft and resulted in no meshed pattern typically observed with highly meshed grafts.
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