(CS-150) Application of Fish Skin Grafts on Decubitus Ulceration in a Quadriplegic Patient

Introduction
Pressure ulcers (PU) are a significant health burden in the United States, affecting approximately 3 million adults annually1. The manifestation of PUs involves the patient's overall health and extrinsic factors, including friction, shearing forces, temperature, time, and humidity2. Immobility due to neurological diseases is a significant risk factor for developing PUs2. Further, PUs is notoriously difficult to heal in the quadriplegic population. Fish skin graft (FSG) is a novel product derived from Atlantic cod fish and has proven to augment acute and chronic wound healing3,4. Therefore, the purpose of this case is to evaluate FSG in a quadriplegic patient with complicated PUs.
Methods
The patient is a 36-year-old quadriplegic male that presented with a one-month-old stage IV PU on the left gluteal muscle that had failed conservative wound care. The patient underwent surgical debridement and subsequent negative wound therapy followed by a cadaveric skin graft which failed to improve the wound status. Due to transportation challenges, treating the patient in his home with FSG and negative pressure therapy was decided.
Results
Three weeks after one application with the FSG, the wound had significantly improved (Initial-3.8x2.8x3.4, Follow-up- 2.2x1.5x2.0). Three-month follow-up revealed complete closure of the PU.
Discussion
This case illustrates clinical efficacy in treating PUs using FSG in a male quadriplegic. The product proved a safe and effective option for wound closure at the patient's residence. The FSG was easily applied at the patient's home, required minimal maintenance, and augmented healing after conservative wound care, and cadaveric tissue had failed. More extensive prospective studies should investigate FSG efficacy in treating PUs in patients with neurological diseases.