Tickner A, Aviles F, Kirsner R, Lullove E, Main L, Suski M, Wahab N, Lantis Ii JC, et al.
Wounds : a compendium of clinical research and practice. Date of publication 2023 Nov 1;volume 35(11):E376-E390.
1. Wounds. 2023 Nov;35(11):E376-E390. doi: 10.25270/wnds/23130.
Consensus recommendations for optimizing the use of intact fish skin graft in
the management of acute and chronic lower extremity wounds.
Tickner A(1), Aviles F(2), Kirsner R(3), Lullove E(4), Main L(5), Suski M(6),
Wahab N(7), Lantis Ii JC(8).
Author information:
(1)Saint Vincent Hospital Wound Healing Center, Worcester, MA.
(2)Center for Wound Healing, Natchitoches Regional Medical Center, Natchitoches,
LA.
(3)University of Miami Miller School of Medicine, Miami, FL.
(4)West Boca Center for Wound Healing, Boca Raton, FL.
(5)Center for Wound Healing, Mt Airy, NC.
(6)Center for Advanced Wound Healing, Los Robles Health System, Thousand Oaks,
CA.
(7)Roseman University College of Medicine, Las Vegas, NV.
(8)Department of Surgery, Icahn School of Medicine Mount Sinai West, New York,
NY.
BACKGROUND: Since 2017, the clinical use of IFSG has increased substantially in
the United States, with some use in Europe and Asia as well. However, scant
consensus data have been published on such use.
OBJECTIVE: The authors sought to develop consensus recommendations for the
clinical use of IFSG in the management of acute and chronic LEWs.
METHODS: A panel of 8 expert clinicians in the United States used a 2-cycle NFG
process to develop consensus statements based on their own clinical practice and
the literature. At their initial meeting in October 2021, panel members
discussed the management of DFUs, VLUs, atypical LEWs, and traumatic LEWs in
their practices. Consensus statements were drafted, voted on, and rated by
relative importance. At the second meeting in October 2022, the panel discussed
the initial survey results; a second survey was conducted, and panel members
revised the recommendations and indicated the relative importance of each in the
final report. A systematic literature review of English-language articles
published from January 2016 through November 2022 was conducted as well, using
the search terms: "fish skin," "piscine graft," "fish tissue," "intact fish skin
graft," "Cod skin," "Omega 3 fatty acid graft."
RESULTS: Forty-three statements were generated and grouped into 5 sections
comprising general recommendations for LEWs and recommendations specific to
DFUs, VLUs, atypical LEWs, and traumatic LEWs. The primary general
recommendation is the need to determine wound etiology based on clinical
evaluation and reviewing related test results. For DFUs and VLUs, the main
recommendations are to adhere to first-line therapy (ie, standard of care,
follow conventional guidelines [multilayer compression therapy], offloading, and
assessment of wound perfusion) before introducing IFSG.
CONCLUSIONS: Publications on and clinical experience in the use of IFSGs have
increased substantially in the past several years. The 43 consensus
recommendations are meant to guide physicians in the optimal use of IFSG in the
management of acute and chronic LEWs.
DOI: 10.25270/wnds/23130
PMID: 38048615 [Indexed for MEDLINE]
