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Fish-Skin Grafts for Burn Wounds: How Do They Work?

Burn wounds can vary from superficial skin damage to deep injuries requiring surgery and prolonged wound care.

One newer option in burn management is a medical graft made from processed fish skin. Kerecis is a well-known example of this technology.

Although sometimes described as a “fish-skin allograft,” the technically correct term is an acellular fish-skin graft or xenograft because it comes from another species.

What Is a Fish-Skin Graft?

Kerecis fish-skin grafts are produced from North Atlantic cod skin.

During manufacturing, the fish cells are removed while much of the skin’s natural three-dimensional structure is retained. The resulting material acts as a scaffold that supports the patient’s own cells as they migrate into the injured area.

The graft is processed as a medical product and should not be confused with placing untreated fish skin directly onto a wound.

How Is It Used for Burn Cases?

The burn wound must first be properly assessed and cleaned. Dead or unhealthy tissue may need to be removed through a process called debridement.

The fish-skin graft is then prepared and applied directly over the wound. It is covered with an appropriate secondary dressing and monitored during follow-up.

As healing progresses, the material becomes incorporated into the wound environment. Further applications may be required depending on the depth, size and progress of the burn.

Which Burns May Benefit?

Fish-skin grafts may be considered for selected partial-thickness burns, complex wounds and certain wounds requiring temporary biological coverage.

They may also be used in donor sites or as a protective covering in specific reconstructive situations.

However, they are not automatically suitable for every burn. Deep full-thickness burns may still require excision and the patient’s own skin graft, known as an autograft.

Treatment decisions depend on burn depth, wound size, location, contamination, infection risk and the patient’s overall health.

What Are the Possible Benefits?

Fish skin provides a natural extracellular matrix that supports tissue regeneration and helps maintain a favourable wound environment.

Clinical reports suggest potential benefits such as good wound conformity, reduced pain during treatment and support for re-epithelialisation. Kerecis also produces specially shaped products for complex areas such as the hand.

Nevertheless, results differ between patients, and the available evidence continues to develop. Fish-skin grafts should be viewed as one tool within comprehensive burn care rather than a guaranteed replacement for conventional skin grafting.

More information about the technology is available from the Kerecis official website.

Are Fish-Skin Grafts Safe?

Every wound treatment has possible limitations and risks.

Potential concerns include local reaction, infection, failure of the graft to integrate, delayed healing and the need for additional surgery. Patients with a known fish allergy should inform their treating doctor before treatment.

Careful patient selection, wound preparation, sterile technique and structured follow-up are important for safety.

Choosing a Plastic Surgeon in Malaysia

Patients searching for a plastic surgeon in Malaysia should choose a properly trained and registered specialist with experience in burns, wounds and reconstructive surgery.

When choosing a top plastic surgery centre, consider its wound-care facilities, surgical support, infection-control standards and access to appropriate follow-up—not advertising alone.

Patients seeking a good and safe doctor can consult Dr Wan Syazli for a personalised assessment. Dr Wan Syazli will evaluate the burn and explain whether conventional dressings, fish-skin graft technology, surgery or autologous skin grafting is most appropriate.

The priority is safe wound healing, preservation of function and the best possible long-term scar outcome.

This article provides general educational information and does not replace medical assessment. Treatment suitability, availability, risks and outcomes vary between patients.