Fish skin grafts compared to human amnion/chorion membrane allografts: A double-blind, prospective, randomized clinical trial of acute wound healing

Robert S. Kirsner, David J. Margolis, Baldur T. Baldursson, Kristin Petursdottir, Olafur B. Davidsson, Dot Weir, John C. Lantis

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalWound Repair and Regeneration
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Chorion
Amnion
Wound Healing
Allografts
Fishes
Randomized Controlled Trials
Transplants
Skin
Membranes
Wounds and Injuries
Gadus morhua
Heterografts
Biopsy
Autografts

ASJC Scopus subject areas

  • Surgery
  • Dermatology

Cite this

Fish skin grafts compared to human amnion/chorion membrane allografts : A double-blind, prospective, randomized clinical trial of acute wound healing. / Kirsner, Robert S.; Margolis, David J.; Baldursson, Baldur T.; Petursdottir, Kristin; Davidsson, Olafur B.; Weir, Dot; Lantis, John C.

In: Wound Repair and Regeneration, 01.01.2019.

Research output: Contribution to journalArticle

Kirsner, Robert S. ; Margolis, David J. ; Baldursson, Baldur T. ; Petursdottir, Kristin ; Davidsson, Olafur B. ; Weir, Dot ; Lantis, John C. / Fish skin grafts compared to human amnion/chorion membrane allografts : A double-blind, prospective, randomized clinical trial of acute wound healing. In: Wound Repair and Regeneration. 2019.
@article{99a8b5bd2e3546a4a560a2796ecbd54a,
title = "Fish skin grafts compared to human amnion/chorion membrane allografts: A double-blind, prospective, randomized clinical trial of acute wound healing",
abstract = "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.",
author = "Kirsner, {Robert S.} and Margolis, {David J.} and Baldursson, {Baldur T.} and Kristin Petursdottir and Davidsson, {Olafur B.} and Dot Weir and Lantis, {John C.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/wrr.12761",
language = "English (US)",
journal = "Wound Repair and Regeneration",
issn = "1067-1927",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Fish skin grafts compared to human amnion/chorion membrane allografts

T2 - A double-blind, prospective, randomized clinical trial of acute wound healing

AU - Kirsner, Robert S.

AU - Margolis, David J.

AU - Baldursson, Baldur T.

AU - Petursdottir, Kristin

AU - Davidsson, Olafur B.

AU - Weir, Dot

AU - Lantis, John C.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85074594012&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074594012&partnerID=8YFLogxK

U2 - 10.1111/wrr.12761

DO - 10.1111/wrr.12761

M3 - Article

C2 - 31509319

AN - SCOPUS:85074594012

JO - Wound Repair and Regeneration

JF - Wound Repair and Regeneration

SN - 1067-1927

ER -