Efficacy of tilapia skin xenograft compared to paraffin-impregnated gauze as a full-thickness burn dressing after excisional debridement: A case series

Introduction and importance: Due to its high collagen, good adherence to wound bed, and great wound healing properties, Tilapia (Oreochromis niloticus) skin has been studied as a biomaterial in regenerative medicine, including as a burn dressing. This paper evaluated the efficacy of tilapia skin xenograft as a temporary full-thickness burn dressing. Methods: Four acute burn patients aged 23–48 years old with total body surface area ranging from 27.5 to 37% with a similar burn area on both sides of the limbs were included. Each limb was dressed in tilapia skin or paraffin-impregnated gauze. Two subjects passed away due to septic shock. All limbs treated with tilapia skin xenograft required fewer dressing changes compared to the limbs treated with paraffin-impregnated gauze. All remaining subjects underwent skin autograft transplantation surgery on the eleventh day after the debridement surgery. No allergic reaction was found in any of the subjects. Outcomes: The tilapia xenograft performed better in controlling and containing the exudates compared to the paraffin-impregnated gauze, as reflected in the fewer dressing changes needed. The cause of death of the two patients was questionable as both of them have severe pneumonia and COVID-19 still could not be ruled out yet. Conclusion: The tilapia skin xenograft was not inferior to the standard paraffin-impregnated gauze for full-thickness burn dressing in terms of time needed for wound bed preparation for autograft surgery.