Display options
Cite
Lima Júnior EM, de Moraes Filho MO, Costa BA, et al. Nile Tilapia Fish Skin-Based Wound Dressing Improves Pain and Treatment-Related Costs of Superficial Partial-Thickness Burns: A Phase III Randomized Controlled Trial. Plast Reconstr Surg. 2021;147(5):1189-1198doi: 10.1097/PRS.0000000000007895.
Lima Júnior, E. M., de Moraes Filho, M. O., Costa, B. A., Fechine, F. V., Vale, M. L., Diógenes, A. K. L., Neves, K. R. T., Uchôa, A. M. D. N., Soares, M. F. A. D. N., & de Moraes, M. E. A. (2021). Nile Tilapia Fish Skin-Based Wound Dressing Improves Pain and Treatment-Related Costs of Superficial Partial-Thickness Burns: A Phase III Randomized Controlled Trial. Plastic and reconstructive surgery, 147(5), 1189-1198. https://doi.org/10.1097/PRS.0000000000007895
Lima Júnior, Edmar Maciel, et al. "Nile Tilapia Fish Skin-Based Wound Dressing Improves Pain and Treatment-Related Costs of Superficial Partial-Thickness Burns: A Phase III Randomized Controlled Trial." Plastic and reconstructive surgery vol. 147,5 (2021): 1189-1198. doi: https://doi.org/10.1097/PRS.0000000000007895
Lima Júnior EM, de Moraes Filho MO, Costa BA, Fechine FV, Vale ML, Diógenes AKL, Neves KRT, Uchôa AMDN, Soares MFADN, de Moraes MEA. Nile Tilapia Fish Skin-Based Wound Dressing Improves Pain and Treatment-Related Costs of Superficial Partial-Thickness Burns: A Phase III Randomized Controlled Trial. Plast Reconstr Surg. 2021 May 01;147(5):1189-1198. doi: 10.1097/PRS.0000000000007895. PMID: 33890902.
Copy Download .nbib Format: NLM
Share it on

Plast Reconstr Surg. 2021 May 01;147(5):1189-1198. doi: 10.1097/PRS.0000000000007895.

Nile Tilapia Fish Skin-Based Wound Dressing Improves Pain and Treatment-Related Costs of Superficial Partial-Thickness Burns: A Phase III Randomized Controlled Trial.

Plastic and reconstructive surgery

Edmar Maciel Lima Júnior, Manoel Odorico de Moraes Filho, Bruno Almeida Costa, Francisco Vagnaldo Fechine, Mariana Lima Vale, Ana Kely de Loyola Diógenes, Kelly Rose Tavares Neves, Alex Marques do Nascimento Uchôa, Maria Flaviane Araújo do Nascimento Soares, Maria Elisabete Amaral de Moraes

Affiliations

  1. From the Burn Treatment Center, Dr. José Frota Institute; and the Clinical Pharmacology Unit, Drug Research and Development Center, Federal University of Ceará.

PMID: 33890902 DOI: 10.1097/PRS.0000000000007895

Abstract

BACKGROUND: In a phase II study comparing Nile tilapia fish skin to silver sulfadiazine cream for outpatient management of superficial partial-thickness burns, the fish skin decreased reepithelialization time (average reduction, 1.43 days), dressing changes (average reduction, 3.72 dressings), and visual analogue scale pain scores. The present study aimed to further evaluate Nile tilapia fish skin efficacy for superficial partial-thickness burns. Unlike silver sulfadiazine cream, the fish skin has good adherence to the wound bed, which may prevent infections and decrease need for dressing changes. Thus, it could be a low-cost alternative to hasten healing and improve pain of burn patients.

METHODS: A phase III randomized controlled trial was conducted from April of 2017 to October of 2018 in Fortaleza, Brazil, and included 115 outpatients aged 18 to 70 years with superficial partial-thickness burns affecting 15 percent or less of body surface area and no previous treatment. Fifty-seven patients were treated with the glycerolized fish skin and 58 with silver sulfadiazine cream 1%. Primary outcomes were reepithelialization time, number of dressings, treatment-related costs, and pain intensity, assessed by means of visual analogue scale, Electronic von Frey, Burns Specific Pain Anxiety Scale, and analgesic use. Patients were evaluated every 48 hours.

RESULTS: Patients treated with fish skin required fewer days for reepithelialization (9.7 ± 0.6 days versus 10.2 ± 0.9 days; p = 0.001) and fewer dressings (1.6 ± 0.7 versus 4.9 ± 0.5; p < 0.001). They also had decreased analgesic needs and visual analogue scale, Burns Specific Pain Anxiety Scale, and Electronic von Frey measurements. Finally, fish skin use reduced the final average treatment-related cost per patient by 42.1 percent.

CONCLUSION: By hastening reepithelialization, improving burn-related pain, and decreasing treatment-related costs, Nile tilapia fish skin could benefit the resource-poor public health systems of developing countries.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Copyright © 2021 by the American Society of Plastic Surgeons.

References

  1. Greenhalgh DG. Management of burns. N Engl J Med. 2019;380:2349–2359. - PubMed
  2. World Health Organization. Burns. Available at: http://www.who.int/news-room/fact-sheets/detail/burns. Accessed October 5, 2019. - PubMed
  3. Kaddoura I, Abu-Sittah G, Ibrahim A, Karamanoukian R, Papazian N. Burn injury: Review of pathophysiology and therapeutic modalities in major burns. Ann Burns Fire Disasters 2017;30:95–102. - PubMed
  4. Wasiak J, Cleland H, Campbell F, Spinks A. Dressings for superficial and partial thickness burns. Cochrane Database Syst Rev. 2013;3:CD002106. - PubMed
  5. Wasiak J, Cleland H. Burns: Dressings. BMJ Clin Evid. 2015;2015:1903. - PubMed
  6. Jeschke MG, Shahrokhi S, Finnerty CC, Branski LK, Dibildox M; ABA Organization & Delivery of Burn Care Committee. Wound coverage technologies in burn care: Established techniques. J Burn Care Res. 2018;39:313–318. - PubMed
  7. Abdel-Sayed P, Hirt-Burri N, de Buys Roessingh A, Raffoul W, Applegate LA. Evolution of biological bandages as first cover for burn patients. Adv Wound Care (New Rochelle) 2019;8:555–564. - PubMed
  8. Hermans MH. Porcine xenografts vs. (cryopreserved) allografts in the management of partial thickness burns: Is there a clinical difference? Burns 2014;40:408–415. - PubMed
  9. Storm-Versloot MN, Vos CG, Ubbink DT, Vermeulen H. Topical silver for preventing wound infection. Cochrane Database Syst Rev. 2010;3:CD006478. - PubMed
  10. Lima Júnior EM, De Moraes Filho MO, Costa BA, et al. Innovative burn treatment using tilapia skin as a xenograft: A phase II randomized controlled trial. J Burn Care Res. 2020;41:585–592. - PubMed
  11. Alves APNN, Lima Júnior EM, Piccolo NS, et al. Study of tensiometric properties, microbiological and collagen content in Nile tilapia skin submitted to different sterilization methods. Cell Tissue Bank. 2018;19:373–382. - PubMed
  12. Costa BA, Lima Júnior EM, de Moraes Filho MO, et al. Use of tilapia skin as a xenograft for pediatric burn treatment: A case report. J Burn Care Res. 2019;40:714–717. - PubMed
  13. Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: A reanalysis of two clinical trials of postoperative pain. J Pain 2003;4:407–414. - PubMed
  14. Echevarria-Guanilo ME, Dantas RA, Farina JA Jr, et al. Reliability and validity of the Brazilian-Portuguese version of the Burns Specific Pain Anxiety Scale (BSPAS). Int J Nurs Stud. 2011;48:47–55. - PubMed
  15. Tena B, Escobar B, Arguis MJ, Cantero C, Rios J, Gomar C. Reproducibility of Electronic Von Frey and Von Frey monofilaments testing. Clin J Pain 2012;28:318–323. - PubMed
  16. Diógenes AKL, Fechine FV, Costa BA, et al. Concurrent validity of electronic von Frey as an assessment tool for burn associated pain. Burns 2020;46:1328–1336. - PubMed
  17. de Oliveira M. Tilapia’s turn. Available at: http://revistapesquisa.fapesp.br/en/2017/05/17/tilapias-turn. Accessed January 30, 2020. - PubMed
  18. Alves APNN, Verde MEQL, Ferreira Júnior AEC, et al. Avaliação microscópica, estudo histoquímico e análise de propriedades tensiométricas da pele de tilápia do Nilo. Rev Bras Queimaduras 2015;14:203–210. - PubMed
  19. Lima Junior EM, Bandeira T de JPG, Miranda MJB, et al. Characterization of the microbiota of the skin and oral cavity of Oreochromis niloticus. J Heal Biol Sci. 2016;4:193–197. - PubMed
  20. Lima Junior EM, Picollo NS, Miranda MJB, et al. Uso da pele de tilápia (Oreochromis niloticus), como curativo biológico oclusivo, no tratamento de queimaduras. Rev Bras Queimaduras 2017;16:10–17. - PubMed
  21. Lima-Junior EM, de Moraes Filho MO, Costa BA, et al. Innovative treatment using tilapia skin as a xenograft for partial thickness burns after a gunpowder explosion. J Surg Case Rep. 2019;6:1–4. - PubMed
  22. Lima Júnior EM, Moraes Filho MO, Forte AJ, et al. Pediatric burn treatment using tilapia skin as a xenograft for superficial partial-thickness sounds: A pilot study. J Burn Care Res. 2020;41:241–247. - PubMed
  23. Caruso DM, Foster KN, Blome-Eberwein SA, et al. Randomized clinical study of Hydrofiber dressing with silver or silver sulfadiazine in the management of partial-thickness burns. J Burn Care Res. 2006;27:298–309. - PubMed
  24. Austin RE, Merchant N, Shahrokhi S, Jeschke MG. A comparison of Biobrane and cadaveric allograft for temporizing the acute burn wound: Cost and procedural time. Burns 2015;41:749–753. - PubMed
  25. Chen J, Gao K, Liu S, et al. Fish collagen surgical compress repairing characteristics on wound healing process in vivo. Mar Drugs 2019;17:33. - PubMed
  26. Peng KC, Lee SH, Hour AL, Pan CY, Lee LH, Chen JY. Five different piscidins from Nile tilapia, Oreochromis niloticus: Analysis of their expressions and biological functions. PLoS One 2012;7:e50263. - PubMed
  27. Pan CY, Tsai TY, Su BC, Hui CF, Chen JY. Study of the antimicrobial activity of tilapia piscidin 3 (TP3) and TP4 and their effects on immune functions in hybrid tilapia (Oreochromis spp.). PLoS One 2017;12:e0169678. - PubMed
  28. Devgan L, Bhat S, Aylward S, Spence RJ. Modalities for the assessment of burn wound depth. J Burns Wounds 2006;5:e2. - PubMed

Publication Types