WHAM Evidence Summary: Fish Skin for Treating Burns

What is the best available evidence for fish skin for treating burns? SUMMARYIn low and middle resource settings, fish skin has been used as a low cost, traditional biological dressing for treatment of burns and other wounds.The high collagen concentration and tensile strength 1-4 of fish skin has led to its use as a xenograft.There is insufficient clinical evidence on healing outcomes to make a recommendation on using fish skin for treating burns.Level 1 evidence 5-7 at high risk of bias suggests that complete healing might be faster with a fish skin dressing compared to the local standard care (most frequently, silver sulfadiazine cream replaced every two days), but the time to healing difference was negligible in most studies and may not be clinically significant.Level 1 evidence 5-7 on effectiveness in achieving better control of pain intensity showed mixed results.However, no studies reported that fish skin dressings were inferior to local standard care, adverse events were not reported to be an issue and some low level evidence indicated people receiving fish skin dressings were satisfied with the outcomes. CLINICAL PRACTICE RECOMMENDATIONSAll recommendations should be applied with consideration to the wound, the person, the health professional and the clinical context.There is insufficient evidence to make a recommendation on the use of fish skin dressings to promote healing in burns.