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Burn

GraftGuide®

Fish Skin Graft for Burn Wound Management
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GraftGuide is intact fish skin which is used to regenerate tissue on surgical, traumatic, and acute wounds.[3] Because there is no known risk of viral or prion disease transfer
from North-Atlantic cod to humans, the fish skin only needs mild processing with our proprietary method.[2]

This process preserves the skin’s natural qualities[2], including: its three-dimensional structure, mechanical properties, molecular organization, and composition (including omega-3 fatty acids, glycosaminoglycans, proteoglycans, elastin, soluble collagens, and fibronectin).[1-4]

GraftGuide promotes healing with minimal impairment of functionality and positive cosmetic outcomes.[4] The product is homologous to human skin[1] and when applied
to damaged tissue, such as a burns or wounds, helps to support the body’s own cells to regenerate tissue.[5-12]

GraftGuide Benefits

Provides a natural microbial barrier[1], protecting against environmental insults
Preserves the structure and porosity of the fish skin graft[1], ideal for cellular ingrowth[1][10]
Adheres to burn wounds in a variety of shapes and sizes, including mobile joints
Resists shearing forces, allowing early physiotherapy[10]
Supports the restoration of the skin’s pigmentation, while minimizes scarring [4][6] [10-12][15]

GraftGuide Product Variations

GraftGuide

Standard

The intact fish-skin graft in various sizes

Description & Sizing
SKU
Total Units
7 x 10 cm
50202S03D0D
70
7 x 20 cm
50202S21D0D
140
GraftGuide

Micro

The intact fish skin that has been fragmented. It offers more surface area than the non-fragmented version and is designed to adhere to and fill deep wound spaces and irregular geometries.

Description & Sizing
SKU
Total Units
114 cm²
50202P32D0D
up to 114
GraftGuide

Mano

The intact fish-skin graft in the shape of the hand to easily allow application on its complex 3D structure. Available in two sizes, medium and large, and in either left or right versions, for use in palmar or dorsum applications. Designed to reduce operation time when managing burn injuries.

Description & Sizing
SKU
Total Units
Medium 147 cm²
50202N33D0D
147
Medium 147 cm²
50202N34D0D
147
Large 196 cm²
50202N35D0D
196
Large 196 cm²
50202N36D0D
196
Mano
GraftGuide

Meshed 2:1

2:1 pre-meshed intact fish-skin graft designed to expand and cover larger wounds. Provides a viable clinical and economic solution for large wounds

Description & Sizing
SKU
Total Units
7 x 10 cm meshed 2:1
50202N03D0D
up to 126
7 x 20 cm meshed 2:1
50202N21D0D
up to 252
250 cm² meshed 2:1
50202N24D0D
up to 450
300 cm² meshed 2:1
50202N23D0D
up to 540

Indications

  • Partial- and full-thickness wounds
  • Trauma wounds (including second-degree burns)
  • Surgical wounds (donor sites/grafts, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence)
Instructions for Use (USA)

GraftGuide can be used in the following ways

Secondary Intention
Apply GraftGuide to help accelerate full epithelialization and wound closure
Bridging
Apply GraftGuide to accelerate the preparation of a healthy wound bed for an allo- or autograft to graft take, in a two-stage procedure
Primary Closure
Using the Alexander surgical method, apply GraftGuide over a highly-meshed STSG

Need more information?

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From the town of Ísafjörður in northwest Iceland, Kerecis develops, manufactures, and distributes patented fish-skin medical devices that support soft tissue regeneration in the body, with regulatory approvals in the United States, Europe, and beyond.

Important Information

This website and its content is not intended to provide diagnosis, treatment, or medical advice. Products, services, information, and other content provided on this website, including information provided directly or through links to third-party websites, are for informational purposes only. Information on this website should not be considered a substitute for professional advice from a healthcare provider. Always consult with a physician or other healthcare professional regarding any medical or health-related diagnosis or treatment options.

Products and their variations may not be available in all countries and could be known under different trade names. Products, product names, indications, and claims vary by jurisdiction. Always verify with your local healthcare professional and consult the printed package information before use. Information on this website may not be current and might not reflect the latest product labeling - please refer to latest IFU's on the website. For questions about product availability, please contact your Kerecis representative or use the contact form on our website.

Products are derived from fish sources and should not be used in patients with a known allergy to fish or sensitivity to fish products. Note that fish allergy is distinct from shellfish allergy. SurgiClose Silicone and Shield products contain silicone and are not suitable for patients with silicone sensitivity. SurgiBind is not indicated for procedures requiring load-bearing support, such as hernia repair, for intraperitoneal organ contact, or where a bridging effect is needed. SurgiBind Tendon Protect is not indicated to replace or repair the damaged tendon or to reinforce the strength of any tendon repair. Always follow the product’s labeling for indications and contraindications.

A surgeon must always rely on their professional clinical judgment when deciding whether to use a specific product for a patient. Kerecis does not dispense medical advice and strongly recommends that surgeons be adequately trained in the use of its products before employing them in surgical procedures. The information provided on this website is intended to demonstrate the product offerings and should not replace the package insert, product label, or instructions for use. For regulatory and medical practice reasons, product availability may vary by market. Contact your Kerecis representative for further clarification.

1

Magnusson, S., Baldursson, B. T., Kjartansson, H., Rolfsson, O. & Sigurjonsson, G. F. Regenerative and Antibacterial Properties of Acellular Fish Skin Grafts and Human Amnion/Chorion Membrane: Implications for Tissue Preservation in Combat Casualty Care. Mil. Med. 182, 383–388 (2017).

2

Baldursson, B. T. et al. Healing rate and autoimmune safety of full-thickness wounds treated with fish skin acellular dermal matrix versus porcine small-intestine submucosa: a non-inferiority study. Int. J. Low. Extrem. Wounds 14, (2015).

3

Magnusson, S. et al. Decellularized fish skin: characteristics that support tissue repair. Laeknabladid 101, 567–573 (2015).

4

Alam K, Jeffery SLA. Acellular Fish Skin Grafts for Management of Split Thickness Donor Sites and Partial Thickness Burns: A Case Series. Mil Med. 2019;184(Suppl 1):16-20 (2019).

5

Pujji O, Jeffery SLA, Safe burn excision prior to military repatriation: an achievable goal? BMJ Military Health 2018;164: 358-359 (2018).

6

Shupp JW, McLawhorn MM, Burkey SE, Kjartansson H. Fish Skin Compared to Cadaver Skin as a Temporary Covering for Full Thickness Burns: An Early Feasibility Trial. Poster presented at: AMUS 2020 Annual Meeting December 6, 2020, Virtual.

7

Badois, N. et al. Acellular fish skin matrix on thin-skin graft donor
sites: a preliminary study. J Wound Care 28, 624–628 (2019).

8

Kirsner, R. S. et al. Fish skin grafts compared to human amnion/chorion membrane allografts: A double-blind, prospective, randomized clinical trial of acute wound healing. Wound Repair Regen 28, 75–80 (2020).

9

Lullove EJ, et al. A multicenter, blinded, randomized controlled clinical trial evaluating the effect of Omega-3–rich fish skin in the treatment of chronic, nonresponsive diabetic foot ulcers. Wounds. Published online April 15, 2021.

10

Wallner C. et al. A Comparison of Intact Piscine Skin, Split-thickness Skin Graft, and Lactic Acid Membrane in Treating Superficial and Deep Burn Wounds Following Enzymatic Debridement, J Burn Care Res, 2021; 42 (Suppl 1): 125-126

11

Stone, R. et al. Omega-3 Rich Fish Skin Grafts Reduce Donor Skin Requirements for Full Thickness Burns. J. Burn Care Res. 39, S234–S235 (2018).

12

Stone R 2nd, Saathoff EC, Larson DA, et al. Accelerated Wound Closure of Deep Partial Thickness Burns with Acellular Fish Skin Graft. Int J Mol Sci. 2021;22(4):1590. Published 2021 Feb 4.

13

Magnusson, S., Christopher Winters, D. P. M., Baldursson, B. T., Kjartansson, H., Rolfsson, O., & Sigurjonsson, G. F. Acceleration of wound healing through utilization of fish skin containing omega-3 fatty acids. Today’s Wound Clinic, 10(5) (2016).

14

Lantis JC, Sigurdardottir RS, Haflidadottir IL, et al. : Fish skin Omega3’s induce cell migration and transcription of ALOX15 – a specialized pro-resolving mediator forming lipoxygenase. Symp Adv Wound Care Fall Meet Oct 20–22 Las Vegas Poster Present (2017).

15

Wang, Y., Beekman, J., Hew, J., Jackson, S., Issler-Fisher, A. C., Parungao, R., Lajevardi, S. S., Li, Z. & Maitz, P. K. Burn injury: challenges and advances in burn wound healing, infection, pain and scarring. Advanced drug delivery reviews, 123, 3-17 (2018).

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