Fish-Skin Graft Shortens Hospital Stay in Severe Burns

Comparative, real-world evidence across multiple U.S. burn centers can inform graft selection and perioperative care. A new clinical analysis now shows that an intact fish-skin grafting technology can shorten hospitalization compared with synthetic alternatives.

Intact fish-skin grafts developed by Kerecis were assessed against products that do not replicate the structure of native human tissue and are made from reconstituted cross-linked collagen and synthetic polyurethane. The findings were announced at the American Burn Association (ABA) Annual Meeting in Orlando, Florida. The analysis focused on severely burned patients who required skin grafting and measured hospital length of stay and key complications.

The preprint discusses that the observed difference in length of stay appears to be driven by two factors: the ability of intact fish-skin to prepare a substantive wound bed efficiently, well suited for skin grafting, and the tendency of reconstituted and synthetic polyurethane products to impose an integration timeline that may exceed what many of these wounds require. For burns common in clinical practice that necessitate a dermal template, the analysis indicates intact fish-skin supports faster preparation and reliable graft take with a clean complication profile.

The retrospective, propensity-matched cohort study used de-identified data from the ABA’s national Burn Care Quality Platform, analyzing outcomes across 61 burn centers. Data management and statistical analysis were performed independently by BData and Frameshift. Generalized linear mixed models adjusted for age, gender, total body surface area burned, burn severity, inhalation injury, and trauma diagnosis.

Among 465 patients treated with either intact fish-skin grafts or synthetic comparators, hospital length of stay was 24.2 days versus 33.5 days, respectively, representing a statistically significant 9.3-day reduction (p = 0.005). All four complication endpoints—sepsis, graft loss, venous thromboembolism, and hospital-acquired pressure injury—were numerically lower with intact fish-skin, including graft loss in 3.2% versus 8.3% of patients.

A prespecified sensitivity analysis in a broader mixed-product cohort (n = 687) confirmed these findings, with an adjusted length of stay of 27.6 days for intact fish-skin compared with 38.5 days for synthetic products (p < 0.001). The research was presented during the symposium “Decoding Fish Skin in Burn Care: Treatment Algorithms, Mechanism of Action, and Real-World Application,” and a preprint of the study is available.

“The intact fish-skin grafts achieved wound-bed readiness and closure significantly faster than the synthetic products, and the graft loss rate was lower, not higher. The wound bed that forms under fish-skin is not just quick to develop. It holds up. That matters, because speed without reliability is not progress,” said Rajiv Sood, MD, FACS, professor of surgery, member of Kerecis Scientific Advisory Board and the research lead author.

“The question this study raises is not simply whether one product closes wounds faster than another. It is whether every burn wound actually requires three to four weeks of staged integration before it can accept a graft. For many of the injuries in this dataset, the answer appears to be no.” added Dr. Sood.

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