Kirsner RS, Margolis DJ, Baldursson BT, Petursdottir K, Davidsson OB, Weir D, Lantis JC 2nd, et al.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the Eur.... Date of publication 2020 Jan 1;volume 28(1):75-80.
1. Wound Repair Regen. 2020 Jan;28(1):75-80. doi: 10.1111/wrr.12761. Epub 2019
Oct 25.
Fish skin grafts compared to human amnion/chorion membrane allografts: A
double-blind, prospective, randomized clinical trial of acute wound healing.
Kirsner RS(1), Margolis DJ(2)(3), Baldursson BT(4), Petursdottir K(4), Davidsson
OB(5), Weir D(6), Lantis JC 2nd(7).
Author information:
(1)Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University
of Miami Miller School of Medicine, Miami, Florida.
(2)Department of Dermatology, University of Pennsylvania Perelman School of
Medicine, Philadelphia, Pennsylvania.
(3)Department of Biostatistics and Epidemiology, University of Pennsylvania
Perelman School of Medicine, Philadelphia, Pennsylvania.
(4)Department of Dermatology, Landspitali University Hospital of Iceland,
Reykjavik, Iceland.
(5)Mathematics Division of the Science Institute, University of Iceland,
Reykjavik, Iceland.
(6)Catholic Health Advanced Wound Healing Centers, Buffalo, New York.
(7)Division of Vascular/Endovascular Surgery, Mount Sinai St. Luke's-West
Hospitals, Icahn School of Medicine, New York, New York.
Chronic, nonhealing wounds consume a great deal of healthcare resources and are
a major public health problem, associated with high morbidity and significant
economic costs. Skin grafts are commonly used to facilitate wound closure. The
grafts can come from the patient's own skin (autograft), a human donor
(allograft), or from a different species (xenograft). A fish skin xenograft from
cold-water fish (Atlantic cod, Gadus morhua) is a relatively recent option that
shows promising preclinical and clinical results in wound healing. Chronic
wounds vary greatly in etiology and nature, requiring large cohorts for
effective comparison between therapeutic alternatives. In this study, we
attempted to imitate the status of a freshly debrided chronic wound by creating
acute full-thickness wounds, 4 mm in diameter, on healthy volunteers to compare
two materials frequently used to treat chronic wounds: fish skin and dHACM. The
purpose is to give an indication of the efficacy of the two therapeutic
alternatives in the treatment of chronic wounds in a simple, standardized,
randomized, controlled, double-blind study. All volunteers were given two
identical punch biopsy wounds, one of which was treated with a fish skin graft
and the other with dehydrated human amnion/chorion membrane allograft (dHACM).
In the study, 170 wounds were treated (85 wounds per group). The primary
endpoint was defined as time to heal (full epithelialization) by blinded
assessment at days 14, 18, 21, 25, and 28. The superiority hypothesis was that
the fish skin grafts would heal the wounds faster than the dHACM. To evaluate
the superiority hypothesis, a mixed Cox proportional hazard model was used.
Wounds treated with fish skin healed significantly faster (hazard ratio 2.37;
95% confidence interval: (1.75-3.22; p = 0.0014) compared with wounds treated
with dHACM. The results show that acute biopsy wounds treated with fish skin
grafts heal faster than wounds treated with dHACM.
© 2019 The Authors. Wound Repair and Regeneration published by Wiley
Periodicals, Inc. on behalf of by the Wound Healing Society.
DOI: 10.1111/wrr.12761
PMCID: PMC6972637
PMID: 31509319 [Indexed for MEDLINE]
