From the Ocean to the Operating Room: The Role of Fish Skin Grafts in Burn Management-A Systematic Review

Background: The treatment of burns is a socio-economic challenge for both patients and the National Health Service. Early debridement and skin graft reduces the risk of local and systemic complications. However, when skin autografting is unfeasible or contraindicated, alternative options are required. Recent research has introduced new potential tools: fish skin grafts (FSGs). This systematic review focuses on FSGs with the aim of improving the management of burn patients. Methods: A systematic search on articles concerning FSG for the treatment of burns was performed by searching PubMed, Web of Science and Embase according to the PRISMA statement. Clinical trials, retrospective studies, case series and case reports were included. Results: A total of 36 studies were identified through the search strategy and imported for screening. After duplicate removal, 26 studies were considered. Based on predetermined criteria, 20 full texts were assessed for eligibility, leaving 18 articles to be included in the systematic review. Conclusions: By virtue of the safety and effectiveness of FSGs, including low risk of zoonosis transmission and valuable outcomes even in austere environments, FSGs could represent a new alternative for the treatment of burns.