Doctors in Brazil have used tilapia fish skin as an alternative dressing for burn victim, Maria Ines Candido da Silva after a gas cooker canister exploded at her workplace, the Casa Velha restaurant in Russas, northeast Brazil. The waitress suffered second degree burns to her arms, neck and part of her face.

Due to the severity of her wounds, the fish-skin dressing was kept on for 11 days. Over the course of 20 days, the strips of fish skin on her hand were changed several times to allow the damaged tissue to heal. Every two days, she visited the hospital to check that her bandages were intact. The 36-year-old mother of two described it as "a really bizarre experience".

“At first the fish skin felt really cold but within minutes of it being laid on, I didn’t feel any more pain and it felt cool and comforting. I was really surprised and grateful that it didn’t smell either,” she said.

Affordable, durable and effective

The application of animal collagen to speed up recovery processes for burns has been long known, as it provides the body with an essential structural protein. However, when collagen from other mammals is used, there is an increased risk of disease transmission, and greater likelihood of triggering an immune reaction.

Therefore researchers at the Nucleus of Research and Development of Medicines (NPDM) of the Federal University of Ceará (UFC) looked for alternatives - fish. Led by Dr. Odrico Moraes, Professor Elisabete Moraes and Dr. Ana Paula Negreiros, the biological dressing was developed over two years, with plastic surgeons Dr. Edmar Maciel at the Dr. José Frota Institute Burns Unit (IJF) in Fortaleza, and Dr. Marcelo Borges, at the São Marcos Hospital SOS Burns and Wounds Unit in Recife, north east Brazil - coordinators of the project. To date, 50 patients have undergone the pilot project trials.

Tilapia, a tropical freshwater, disease-resistant fish, was chosen as it is commonly consumed and is readily available in Brazil - 99% of the skin is discarded and donated for free to the project. Tilapia skin also contains optimum levels of collagen type 1 and has a high degree of humidity, therefore it does not dry out for a long time.

These conditions optimal for healing: the reduced risk of infection, the loss of liquids, plasma and protein from the injured area are minimised, and patients are provided with essential proteins.

Addresses the drawbacks of conventional treatments

The fish skin exhibits a tensile strength similar to that of human skin, making it flexible and easy to mould around a wound. They stay in place, covered with external bandages, for between seven to 11 days before being changed or removed. This is done using petroleum jelly to lift, slide and ease the dressing away from the healed area.

Prior to use, the fish skin is cured, decontaminated, cooled and preserved. This removes scales, muscle tissue, toxins, and any possibility of transmitted diseases, as well as the fishy smell. The processed skin is stretched and laminated, before being stored as strips measuring 10cm by 20cm, in refrigerated banks based in Sao Paulo. They remain usable for up to two years.

Conventionally, sulphur sulphadiazine, an ointment that heals wounds within an average of 2 weeks is used on burn victims. The dressings and bandages must also be changed daily and patients had to shower with antibacterial soap, to keep wounds clean and prevent the emission of a highly unpleasant odour after 24 hours. These treatments usually result in the need for painkillers as the stress can interfere with the healing process.

“Nurses used creams when I first arrived,” said Maria. "I was in excruciating pain already and some of my wounds were really deep. When they put the creams into my wounds it was like I was being tortured and the touch of the water to shower it off caused so much pain.”

The skin is said to reduce expected healing times by one to two days. “I would recommend it to anyone who has suffered like me,” commented Maria. MIMS

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