Treatment of diabetic foot wounds with acellular fish skin graft rich in omega-3: a prospective evaluation

Objective: To evaluate the potential benefit of an intact fish skin graft rich in omega-3 (Kerecis Omega3), in the management of postoperative diabetic foot wounds. Method: Prospective evaluation in eight patients with diabetes following forefoot surgery. The dressing was applied weekly for a period of six weeks in the diabetic foot clinic. At each visit the wound was photographed and independently measured using ImageJ software to calculate wound area. Secondary outcome measures were pain, infection, odour, discharge and irritation. Results: The wound area range was 0.94 to 29.55cm(2). In wounds of less than three months duration, regardless of size, the median percentage wound area reduction was over 84.9% at six weeks (n=6, range: 71.3 to 100%). There were two wounds over three months duration, in these the wound area reduction was <42% at six weeks (n=2, range: 41.2 to 41.1%). No patients developed infection or skin reactions. None reported odour, discharge or itching. Conclusion: Our initial results demonstrate that the trend towards healing is more marked in wounds less than three months duration. This would suggest that the fish skin graft has potential to decrease time to healing in this patient group when used early on in the healing process, perhaps as a routine adjunct to postoperative diabetic foot wound management. Conclusion: Postoperative diabetic foot wounds are difficult to heal. In this series, fish skin grafts show promise as an agent to accelerate wound healing. We suggest larger randomised trials to further evaluate its use in acute and chronic wounds.