Acellular fish skin graft for diabetic foot ulcers

NewsBot · Feb 16, 2019

Members do not see these Ads. Sign Up.
Treatment of diabetic foot wounds with acellular fish skin graft rich in omega-3: a prospective evaluation.
Woodrow T, Chant T, Chant H
J Wound Care. 2019 Feb 2;28(2):76-80.

OBJECTIVE::
To evaluate the potential benefit of an intact fish skin graft rich in omega-3 (Kerecis Omega3), in the management of postoperative diabetic foot wounds.

METHOD::
Prospective evaluation in eight patients with diabetes following forefoot surgery. The dressing was applied weekly for a period of six weeks in the diabetic foot clinic. At each visit the wound was photographed and independently measured using ImageJ software to calculate wound area. Secondary outcome measures were pain, infection, odour, discharge and irritation.

RESULTS::
The wound area range was 0.94 to 29.55cm². In wounds of less than three months duration, regardless of size, the median percentage wound area reduction was over 84.9% at six weeks (n=6, range: 71.3 to 100%). There were two wounds over three months duration, in these the wound area reduction was <42% at six weeks (n=2, range: 41.2 to 41.1%). No patients developed infection or skin reactions. None reported odour, discharge or itching.

CONCLUSION::
Our initial results demonstrate that the trend towards healing is more marked in wounds less than three months duration. This would suggest that the fish skin graft has potential to decrease time to healing in this patient group when used early on in the healing process, perhaps as a routine adjunct to postoperative diabetic foot wound management.

CONCLUSION::
Postoperative diabetic foot wounds are difficult to heal. In this series, fish skin grafts show promise as an agent to accelerate wound healing. We suggest larger randomised trials to further evaluate its use in acute and chronic wounds.
Click to expand...

DaVinci · Feb 16, 2019

Did I read that right? Fish? WTF?

Craig Payne · Feb 16, 2019

No control group … fishy ..

NewsBot · Apr 23, 2021

A Multicenter, Blinded, Randomized Controlled Clinical Trial Evaluating the Effect of Omega-3-Rich Fish Skin in the Treatment of Chronic, Nonresponsive Diabetic Foot Ulcers
Eric J Lullove et al
Wounds. 2021 Apr 14

Introduction: Omega-3-rich fish skin grafts have been shown to accelerate wound healing in full-thickness wounds.

Objective: The goal of this study was to compare the fish skin graft with standard of care (SOC) using collagen alginate dressing in the management of treatment-resistant diabetic foot ulcers (DFUs), defined as superficial ulcers not involving tendon capsule or bone.

Materials and methods: Patients with DFUs who were first treated with SOC (offloading, appropriate debridement, and moist wound care) for a 2-week screening period were then randomized to either receiving SOC alone or SOC plus fish skin graft applied weekly for up to 12 weeks. The primary endpoint was the percentage of wounds closed at 12 weeks.

Results: Forty-nine patients were included in the final analysis. At 12 weeks, 16 of 24 patients' DFUs (67%) in the fish skin arm were completely closed, compared with 8 of 25 patients' DFUs (32%) in the SOC arm (P value = .0152 [N = 49]; significant at P < .047). At 6 weeks, the percentage area reduction was 41.2% in the SOC arm and 72.8% in the fish skin arm.

Conclusions: The application of fish skin graft to previously nonresponsive DFUs resulted in significantly more fully healed wounds at 12 weeks than SOC alone. The study findings support the use of fish skin graft for chronic DFUs that do not heal with comprehensive SOC treatment.
Click to expand...

NewsBot · May 13, 2022

Faster Than Projected Healing in Chronic Venous and Diabetic Foot Ulcers When Treated with Intact Fish Skin Grafts Compared to Expected Healing Times for Standard of Care: An Outcome-Based Model from a Swiss Hospital
Thomas Zehnder, Marlise Blatti
Int J Low Extrem Wounds. 2022 May 12

Purpose: Inadequate response to wound management is defined as a reduction in the wound area of <40-50% following four weeks of standard of care (SOC) and should be managed with a skin substitute product. We set out to evaluate a novel outcome-based model focusing on the management of hard-to-heal venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs) using SOC treatment or intact fish skin grafts (FSGs) in a regional hospital. Methods: We built an outcome-based model applying surrogate markers and endpoints of wound healing for VLU and DFU to determine the healing trajectory with SOC treatment. We could predict if VLU and DFU would heal by weeks 20 and 24, respectively, after four weeks of evaluating the initial wound area reduction. 51 patients were recruited (26 VLUs and 25 DFUs) and 42 wounds were randomized. 17 wounds deemed unlikely to heal by week 8 received management with FSG as per the Swiss Society for Dermatology and Venereology (SGDV) and the Swiss Association for Woundcare (SAfW) guidelines for the use of skin replacement products, and 26 wounds continued SOC for weeks 5-8. Results/Discussion: 12 wounds managed with FSG beat the modeled SOC healing predictions, with the majority healed >50% sooner and as early as <10% of the time than was predicted. Of these 17, five wounds failed to achieve the required size reduction in Week 4-8 (over 25% improvement in wound area vs. SOC). The FSG were assigned to treatment-resistant VLU and DFUs and were still able to heal these wounds most of the time and even changed the wound's healing trajectory that increased in size in the initial four weeks. Conclusion: This pilot study showed that management with FSG results in faster healing wounds than SOC predicted, while SOC-treated wounds mostly followed model predictions.
Click to expand...

NewsBot · Jul 8, 2022

Evaluating the effect of omega-3-rich fish skin in the treatment of chronic, nonresponsive diabetic foot ulcers: penultimate analysis of a multicenter, prospective, randomized controlled trial
Eric J Lullove et al
Wounds. 2022 Apr;34(4):E34-E36.

Objective: This is the second of 3 planned articles reporting on a prospective, multicenter, randomized controlled trial assessing the efficacy of fish skin graft in the management of diabetic foot ulcers in comparison with the standard of care (collagen alginate dressing).

Materials and methods: The primary end point of this prospective randomized trial is the number of closed wounds at 12 weeks.

Results: As of the time of this writing, 94 patients had completed the protocol. At 12-week follow-up, healing was achieved in 63.0% of index ulcers (29 of 46 patients) in the acellular fish skin graft group compared with 31.3% in the control group (15 of 48 patients) (P =.0036). In both groups, the mean time to healing was 7 weeks. The median number of applications of the fish skin graft to achieve healing was 6.

Conclusion: A clinically and statistically significant difference in healing was observed between patients treated with acellular fish skin graft and those treated with a collagen alginate dressing. The data support the completion of this prospective randomized trial.
Click to expand...

NewsBot · Apr 7, 2023

Final efficacy and cost analysis of a fish skin graft vs standard of care in the management of chronic diabetic foot ulcers: a prospective, multicenter, randomized controlled clinical trial
John C Lantis Ii et al
Wounds. 2023 Apr;35(4):71-79

Introduction: DFUs remain a cause of significant morbidity.

Objective: This is the third of 3 planned articles reporting on a prospective, multicenter, randomized controlled trial evaluating the use of omega-3-rich acellular FSG compared with CAT in the management of DFUs.

Materials and methods: A total of 102 patients with a DFU (n = 51 FSG, n = 51 CAT) participated in the trial as ITT candidates, with 77 of those patients included in the PP analysis (n = 43 FSG, n = 34 CAT). Six months after treatment, patients with healed ulcers were followed up for ulcer recurrence. A cost analysis model was applied in both treatment groups.

Results: The proportion of closed wounds at 12 weeks was compared, as were the secondary outcomes of healing rate and mean PAR. Diabetic foot wounds treated with FSG were significantly more likely to achieve closure than those managed with CAT (ITT: 56.9% vs 31.4%; P =.0163). The mean PAR at 12 weeks was 86.3% for FSG vs 64.0% for CAT (P =.0282).

Conclusions: Treatment of DFUs with FSG resulted in significantly more wounds healed and an annualized cost savings of $2818 compared with CAT.
Click to expand...

NewsBot The Admin that posts the news.

DaVinci Well-Known Member

Craig Payne Moderator

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Acellular dermal regenerative tissue matrix for diabetic foot ulcers

Acellular matrix therapy for diabetic foot wounds

Injury Patterns in Ice-Fishing

Shellfish allergy and Local Anaesthtic allergy

Can you 3D Print a fish?

Fish Nibblers no more?

Zoonotic Disease Pathogens in Fish Used for Pedicure

Share This Page