Accelerated wound healing of enzymatically debrided deep dermal burn wounds after the use of fish skin (Kerecis Omega3 Wound®) in comparison to Suprathel®.

Abstract

Recent studies have shown that long-term scarring from burns is significantly reduced through the use of enzymatic debridement. Following enzymatic debridement of deep dermal burns, numerous wound dressings are available that provide an adequate wound environment and ideal conditions for rapid wound healing. In German burn centres, Suprathel® has mostly been used for this purpose. Since 2019, the alternative Kerecis Omega3 Wound®, which is derived from fish skin, has been used as an alternative in burn medicine. Therefore, we conducted a single-centre prospective, open, comparative, and intra-individual clinical study to gain initial experience in the use of Kerecis Omega3 Wound®, establish a treatment algorithm and compare Suprathel® and Kerecis Omega3 Wound® in the treatment of deep dermal burns after enzymatic debridement with respect to wound healing, exudation and pain. After enzymatic debridement of deep dermal burns of the hand and foot, wounds were divided into two areas: one was treated with Suprathel® and the other with Kerecis Omega3 Wound®. Dressing changes and wound checks were carried out on days 2, 4, 8, 12, 16, 24, and 48, after application. With this, initial experience concerning the handling of Kerecis Omega3 Wound® was gained and wound healing, infection, exudation, and pain were documented. In the period from January 1, 2022, to October 1, 2023, 22 patients between the ages of 18 and 83 years with deep dermal burns were treated. Satisfactory results were obtained in all cases; no patients had to undergo a second debridement followed by skin grafting. Mean healing time after the use of Kerecis Omega3 Wound was 17 days (min 8 days, max 25 days) whereas it was 23 days (min 12 days, max 42 days) in the Suprathel-Areas. No infections were observed in both groups. Exudation throughout the wound healing process was significantly higher in the Kerecis Omega3 Wound group than in the Suprathel group, whereas no significant differences in pain levels were documented. The management of dressing changes, the assessment of the progress of wound healing and adjusting the level of moisture in the dressings were obstacles, which could only be overcome by appropriate experience of the burn surgeon. In particular, adjusting the degree of moisture had a major influence on the progress of wound healing. Depending on these parameters, very different healing processes of the fish skin, from early dissolution into the so-called "active slough", to the drying out of the wound dressing to form a crust and remaining there for several weeks. In all 22 patients, however, the treatment led to spontaneous wound healing and satisfactory results without the need of skin grafting or other surgical procedures. Kerecis Omega3 Wound® is safe to use and suitable for the treatment of deep dermal burn wounds following enzymatic debridement. Its application leads to accelerated wound healing compared to the use of Suprathel®, however, owing to the different courses of the external appearance of the wound during wound healing, a high degree of user experience is necessary. Kerecis Omega3 Wound® might be useful to improve scarring after enzymatically debrided deep dermal burn wounds. Thus, a comparison between Kerecis Omega3 Wound® and Suprathel® concerning their long-term results is still pending.