(CS-128) Fragmented Acellular Fish Skin Graft Augmented with Bone Marrow Aspirate: A Case Study

Jonathan Hook, DPM – Weil Foot & Ankle Institute

Introduction: Chronic wounds can be both detrimental to the patient and a financial burden on our health system. Acellular fish skin grafts contain omega-3 polyunsaturated fatty acids, which reduce inflammatory responses and advance cytokines to promote wound healing. . Bone marrow aspirate contain hematopoietic stem cells, including mesenchymal stem cells, which have been reported to have the ability to convert into many cell types due to their naive state.

Methods: A 65 year old male with a chronic non-healing ulcer to the dorsal midfoot who had failed previous wound care treatment was taken to the OR for initial debridement and grafting. Bone marrow aspirate was obtained from donor site in the distal tibia and the fragmented fish skin graft was then rehydrated in normal saline. These were then mixed and applied to skin depth before the usual dressings were applied.

Results: Wound achieved closure at 5 months with no complications

Discussion: Kerecis® Omega3 Wound graft (Kerecis), a new technology incorporating intact fish skin, is rich in omega-3 polyunsaturated fatty acids. When one applies this modality to wound beds, the graft recruits the body’s own cells and is ultimately turned into living tissue. The product itself acts as a bacterial barrier and promotes three-dimensional cellular ingrowth in comparison to human amnion grafts. Bone marrow aspirate in combination with fragmented acellular fish skin grafts are applicable in a wide range of disease processes with consistent, durable results