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Page 8 of 14 Pignet et al. Plast Aesthet Res 2024;11:40 https://dx.doi.org/10.20517/2347-9264.2024.54

In their case report, Alam et al. included two cases of patients who were - after the debridement - treated
[15]
with Kerecis® Omega3 Wound Matrix for small-size deep partial-thickness burns of the thigh and thumb .
Both patients already showed complete re-epithelialization at a two-week follow-up. Moreover, both
[15]
patients reported the FSG to be comfortable and noticed reduced pain levels during the treatment period .

Similarly, in a clinical study performed by Díaz-Puertas et al., the authors used NTG to treat patients with
deep partial-thickness burns (study arm C, explained in more detail above) covering 5%-15% of TBSA and
compared the product to topical silver sulfadiazine cream treatment. Patients receiving the NTG exhibited
[13]
significantly lower pain intensity .
Fish skin reduces donor site morbidity after autologous grafting
STSGs are widely used to treat various types of wounds such as ulcers or deep partial- and full-thickness
burns . The donor site resembles a partial-thickness burn wound, necessitating 2-3 weeks for healing .
[35]
[35]
This process can be negatively impacted by the wound size and patient-related factors, including age and
[36]
comorbidities . The ideal dressing for donor sites should be inexpensive, easy to apply, prevent infections,
[37]
and above all, allow for rapid re-epithelialization . The standard of care is non-adherent meshed gauze
[38]
dressings infused with different salves . Those products are cheap and easy to apply, but they can stick to
the wound bed and cause pain during dressing changes. According to Barnea et al., the primary burden for
[36]
patients during the initial ten days post grafting is pain at the donor site . While there is a variety of
dressing options for donor sites, the use of FSG is supported by promising results from clinical studies [6,15,24] .
In all included studies for this indication, Kerecis® Omega3 Wound Matrix was used. In total, only one case
report and two comparative cohort studies investigated the use of Kerecis® Omega3 Wound Matrix for
donor sites.

Alam et al. performed a case series with ten included patients using Kerecis® Omega3 Wound Matrix after
STSG harvests on the upper thigh . The first dressing change was performed seven days after surgery and
[15]
every three days thereafter until fully epithelialized . The study focused on pain, signs of infection, and
[15]
days until epithelialization (assessed only visually). Badois et al. compared the pain intensity, signs of
infection, and time until re-epithelialization (remaining wound area measured at their widest and longest
point) between Kerecis® Omega3 Wound Matrix (intervention group) and the standard of care treatment
with fatty gauze (control group) . Donor site defects were 0.4 mm (16/1,000 inch) thick and located at the
[24]
medial aspect of the upper arm. Kerecis® Omega3 Wound Matrix was re-applied if it broke down in the first
few days after surgery. The product was covered with moist compresses, followed by a semi-permeable film
dressing. Evaluations were performed from five days after surgery until epithelialization was completed .
[24]
Yoon et al., on the other hand, compared Kerecis® Omega3 Wound Matrix to a bovine collagen skin graft
(ProHeal® Collagen Wound Dressing, MedSkin Solutions, Germany) and to no treatment on donor sites on
the thigh with a thickness of 0.2-0.23 mm (8-9/1,000 inch). Polyurethane foam dressings were used on
top . The dressings were applied one to two days after split-thickness skin harvest and were not re-applied
[6]
thereafter . The main findings of those three publications are discussed below.
[6]
Enhanced healing time
Within 11.5 days (range 10-16 days) after application of Kerecis® Omega3 Wound Matrix, Alam et al.
observed 100% re-epithelialization in their case series of ten patients . Here, re-epithelialization was
[15]
assessed solely visually without using objective assessing methods. In their comparative cohort study, Badois
et al. measured the remaining wound area at their widest and longest point between Kerecis® Omega3
Wound Matrix and the standard of care treatment with fatty gauze . The average re-epithelialization time
[24]
after application of Kerecis® Omega3 Wound Matrix was nearly three times longer (31.5 ± 24.7 days) than