Use of acellular intact fish skin grafts in treating acute paediatric wounds during the COVID-19 pandemic : A case series

Publisher Copyright: © 2022 MA Healthcare Ltd. All rights reserved.OBJECTIVE: More specific strategies are needed to support children requiring skin grafting. Our goal was to identify procedures that reduce operating times, post-operative complications, pain and length of hospital stay. Patient safety, optimal wound bed support and quick micro-debridement with locoregional anaesthesia were prioritised. Ultimately, a novel acellular fish skin graft (FSG) derived from north Atlantic cod was selected for use. METHOD: We admitted consecutive paediatric patients with various lesions requiring skin grafting for definitive wound closure. All FSGs were applied and bolstered in the operating room following debridement. RESULTS: In a cohort of 15 patients, the average age was 8 years and 9 months (4 years 1 month-13 years 5 months). Negative pressure wound therapy (NPWT) was given to 12 patients. Rapid wound healing was observed in all patients, with a wound area coverage of 100% and complete healing in 95% of wounds. Time until engraftment in patients receiving NPWT was reduced by about a half (to an average 12 days) from our standard experience of 21 days. Ten patients received locoregional anaesthesia and were discharged after day surgery. The operating time was <60 minutes, and no complications or allergic reactions were reported. Excellent pliability of the healed wound was achieved in all patients, without signs of itching and scratching in the postoperative period. This case series is the first and largest using FSG to treat paediatric patients with different wound aetiologies. We attribute the rapid transition to acute wound status and the good pliability of the new epidermal-dermal complex to the preserved molecular components of the FSG, including omega-3. CONCLUSION: FSG represents an innovative and sustainable solution for paediatric wound care that results in shorter surgery time and reduced hospital stays, with accelerated wound healing times.Peer reviewe

Intact Fish Skin Graft vs. Standard of Care in Patients with Neuroischaemic Diabetic Foot Ulcers (KereFish Study) : An International, Multicentre, Double-Blind, Randomised, Controlled Trial Study Design and Rationale

Publisher Copyright: © 2022 by the authors.Background: Cell and/or tissue-based wound care products have slowly advanced in the treatment of non-healing ulcers, however, few studies have evaluated the effectiveness of these devices in the management of severe diabetic foot ulcers. Method: This study (KereFish) is part of a multi-national, multi-centre, randomised, controlled clinical investigation (Odin) with patients suffering from deep diabetic wounds, allowing peripheral artery disease as evaluated by an ankle brachial index equal or higher than 0.6. The study has parallel treatment groups: Group 1 treatment with Kerecis® Omega3 Wound™ versus Group 2 treatment with standard of care. The primary objective is to test the hypothesis that a larger number of severe diabetic ulcers and amputation wounds, including those with moderate arterial disease, will heal in 16 weeks when treated with Kerecis® Omega3 Wound™ than with standard of care. Conclusion: This study has received the ethics committee approval of each participating country. Inclusion of participants began in March 2020 and ended in July 2022. The first results will be presented in March 2023. The study is registered in ClinicalTrials.gov as Identifier: NCT04537520.Peer reviewe

Upphenging á aftursveigðu legi vegna sársauka við samfarir : aðgerðir framkvæmdar á Sjúkrahúsi Akraness 1983 til 1985

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Dyspareunia is a problem that presumably affects a large number of women. This report describes the results of ventrisuspension of the uterus performed for dyspareunia presumably due to retroflexion of the uterus. This was done through a multiple choice questionnaire sent to the patients 1 -3 years after the operation. Of 32 women answering the questionnaire 29 were satisfied with the results, in 21 symptoms disappeared totally. Symptoms recurred in 6 women of whom 3 had moderate to severe adhesions before operation.Innri sársauki við samfarir (dyspareunia) er algeng kvörtun hjá konum sem leita til kvensjúkdómalækna. Með innri sársauka er átt við sársauka í kviði og grindarholi sem kemur við eða strax á eftir samförum. Innri sársauki við samfarir er sameiginlegt einkenni margra sjúkdóma. Oft valda því eftirköst sýkinga í innri kynfærum og grindarholi svo og legslímuvilla (endometriosis) (1), blóðríki í grindarholi (pelvic congestion) (2) og fleira. Stundum finnst engin líffærafræðileg orsök. Aftursveigt leg er einnig talið geta orsakað sársauka við samfarir (1), en er annars algengt fyrirbæri og yfirleitt meinlaust eða eðlilegt. Í þessari grein er fjallað um rannsókn sem höfundur gerði á árangri aðgerðar sem nefhist upphenging á legi (ventrisuspensio uteri), hjá konum sem höfðu verki og sársauka, sem talið var að rekja mætti til aftursveigðs legs. Höfundi er ekki kunnugt um, að áður hafi verið ritað um árangur slíkra aðgerða hér á landi

Regenerative and Antibacterial Properties of Acellular Fish Skin Grafts and Human Amnion/Chorion Membrane: Implications for Tissue Preservation in Combat Casualty Care.

To access publisher's full text version of this article click on the hyperlink belowImprovised explosive devices and new directed energy weapons are changing warfare injuries from penetrating wounds to large surface area thermal and blast injuries. Acellular fish skin is used for tissue repair and during manufacturing subjected to gentle processing compared to biologic materials derived from mammals. This is due to the absence of viral and prion disease transmission risk, preserving natural structure and composition of the fish skin graft.The aim of this study was to assess properties of acellular fish skin relevant for severe battlefield injuries and to compare those properties with those of dehydrated human amnion/chorion membrane.We evaluated cell ingrowth capabilities of the biological materials with microscopy techniques. Bacterial barrier properties were tested with a 2-chamber model.The microstructure of the acellular fish skin is highly porous, whereas the microstructure of dehydrated human amnion/chorion membrane is mostly nonporous. The fish skin grafts show superior ability to support 3-dimensional ingrowth of cells compared to dehydrated human amnion/chorion membrane (p < 0.0001) and the fish skin is a bacterial barrier for 24 to 48 hours.The unique biomechanical properties of the acellular fish skin graft make it ideal to be used as a conformal cover for severe trauma and burn wounds in the battlefield.Office of Naval Research and Kerecis Limited, Eyrargata,Isafjordur, Icelan

Healing rate and autoimmune safety of full-thickness wounds treated with fish skin acellular dermal matrix versus porcine small-intestine submucosa: a noninferiority study.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageA novel product, the fish skin acellular dermal matrix (ADM) has recently been introduced into the family of biological materials for the treatment of wounds. Hitherto, these products have been produced from the organs of livestock. A noninferiority test was used to compare the effect of fish skin ADM against porcine small-intestine submucosa extracellular matrix in the healing of 162 full-thickness 4-mm wounds on the forearm of 81 volunteers. The fish skin product was noninferior at the primary end point, healing at 28 days. Furthermore, the wounds treated with fish skin acellular matrix healed significantly faster. These results might give the fish skin ADM an advantage because of its environmental neutrality when compared with livestock-derived products. The study results on these acute full-thickness wounds might apply for diabetic foot ulcers and other chronic full-thickness wounds, and the shorter healing time for the fish skin-treated group could influence treatment decisions. To test the autoimmune reactivity of the fish skin, the participants were tested with the following ELISA (enzyme-linked immunosorbent assay) tests: RF, ANA, ENA, anti ds-DNA, ANCA, anti-CCP, and anticollagen I and II. These showed no reactivity. The results demonstrate the claims of safety and efficacy of fish skin ADM for wound care

Interior of prisoners' barracks, Maria Island, Tasmania ca 1900 [picture] /

Title from caption.; Part of collection: Albums of photographs of Tasmania, 1820-1860.; Condition: Yellowing; glued to album page.; Also available in an electronic version via the Internet at: http://nla.gov.au/nla.pic-vn4235717