Abstract
INTRODUCTION: A systematic review was conducted to investigate the efficacy of acellular fish skin grafts (AFSGs) for the treatment of complicated wounds. AFSGs can be used as a regenerative and antimicrobial tool for healing complicated wounds, but clinical evidence remains unclear. OBJECTIVE: This systematic review aimed to summarize the efficacy of AFSGs on complicated wounds using evidence from existing published studies. METHODS: Electronic databases like PubMed, ScienceDirect, Google Scholar, and Clinicaltrials.gov were searched for relevant literature reporting on the efficacy of AFSGs for wound healing. Based on the inclusion and exclusion criteria, nine studies were selected for data extraction. The quality of the articles was evaluated using the RoB 2 and ROBINS-I tools. RESULTS: Existing evidence shows that AFSGs accelerate wound healing, reduce pain, prevent antibiotic administration, and cause no autoimmune reactions. The total re-epithelialization time for diabetic foot ulcers (DFUs) was observed as 15 ± 8 weeks, depending on the severity of the ulcers. Acute full thickness biopsy wounds healed within 3.75 ± 0.25 weeks. As reported in papers, AFSGs showed significantly better effects than standard-of-care therapy, collagen alginate dressings, dehydrated human AMNION/chorion membrane, and/ or porcine small-intestine submucosa. However, instances of rashes, erythema, pain, and hypergranulation were reported when AFSGs were applied to biopsy wounds. CONCLUSION: Overall, the evidence obtained in this systematic review indicates that AFSGs represent a clinically and financially effective option for the treatment of wounds when compared with conventional alternatives.