The treatment of chronic wounds is extremely problematic. Chronic wounds can take months or years to heal and some even never heal resulting in over 100.000 amputations taking place annually in the US alone. A new technology from Iceland, that is based on fish skin and is already used clinically, allows for improved healing of chronic and burn wounds.
MEDICA.de spoke with Fertram Sigurjonsson, CEO of Kerecis, about the development of this transplant technology and with Dr. Christopher Winters, a podiatrist and wound specialist of the American Health Network in Indiana, who applies it in treating his patients.
Dr. Winters, in what patient cases do you apply the wound care technology of Kerecis that is based on fish skin?
Winters: The main type of wounds that I have applied the Kerecis Omega 3 product on is diabetic foot ulcers. I have also used it on venous leg ulcers and a few atypical wounds such as vasculitis ulcers of the lower extremities.
Mr. Sigurjonsson, what exactly is the technology that you developed and how do you use fish skin for the treatment of chronic wounds?
Sigurjonsson: From the 18th century wounds were commonly treated with gauze. In the 1960s, research by George Winter led to the emergence of moist wound healing products. Most wound treatment products on the market today fall into this category that is often referred to as second generation wound healing products.
At the turn of the century third generation wound treatment products started to gain popularity, those are graft materials from human cadavers or mammals that have been processed in a special manner. Our contribution to the processed graft product segment is to use fish skin as our source material. Fish skin is largely made from the same material as human skin, with the addition of Omega 3 polyunsaturated fatty acids. The patented “Kerecis Omega3 fish skin” is a cellular dermal matrix that is cut to shape and inserted into the wound. In the wound, it activates the body's own cells and ultimately is converted into functional, living tissue.
Dr. Winters, what effects of the fish skin-based technology did you observe?
Winters: The tissue of the wound covering is very similar to human skin. Accordingly, it is relatively thick and fills the wound. It is quite durable and resistant to tearing which makes it ideal for a plantar foot ulcer. I have seen a size decrease of ulcer width and depth in just one week.
Mr. Sigurjonsson, how did you come up with the idea of using fish skin for wound treatment?
Sigurjonsson: I started my carrier in the medical device industry working at a prosthetic company. There we not only cared for people that have been amputated but also developed a product from silicone to treat chronic wounds. Since then I have been really interested in developing new technologies that might have the potential to prevent amputations. Watching the advance of the mammalian sourced grafts and the closeness to the ocean here in Iceland brought me to the idea of using fish skin.
Sigurjonsson: Our technology is always applied by doctors. It is most commonly used when treatment with regular second generation wound treatment products has failed and in in-patient wardens for example in vascular and diabetes departments.
Dr. Winters, what is the potential of this technology in your eyes?
Winters: The potential of this product is vast. I think the diabetic foot indication is key due to the thickness of the product and the fact that it will be subjected to sheer forces on the bottom of the foot. It likely will find use in deeper wounds and burns including exposed bone or tendon. I have treated some of these wounds with success.
And what has been the experience with your technology so far, Mr. Sigurjonsson?
Sigurjonsson: In the little over a year that our product has been on the market more than 1,000 people have been treated with good outcomes. We have also completed a randomized clinical trial on 140 wounds, were we compared our product with the market leading product that is sourced from pig intestines. The study demonstrated a statistical difference in wound closure rates for wounds treated with our product. We believe that is because of the content of the Omega 3 polyunsaturated fatty acids.