Doctors in Brazil using tilapia fish skin to treat burn victims

4 hours ago (pbs.org)

I've read Dune - I know exactly where this is going. Please do not apply sand trout directly to you skin unless you are ready to control the spice.

There is an Icelandic company called Kerecis that produces these kinds of fish skin based grafts. There are some videos of some of their patient's before and after over at their webpage[0] but be warned, they might be a bit graphic for some.

[0]: https://kerecis.com

I thought this a pretty mature technique? I have seen more than once our local vet using this technique to treat cats with large wounds -- with great results by the way. Interestingly, they too used tilapia fish skin, and not any of the more common local fish species. I wonder if there is something special about tilapia fish skin, or it was simply the species on which the technique was developed, and nobody bothered to try using other fish species.

  • > I thought this a pretty mature technique? […]

    Yes, it is very mature. The article was written in 2017.

  • What's special is that tilapia is probably cheaper than even the local fish since it's farmed in massive quantities and shipped all over the world as food.

    If other fish skins were tried it must have been similar results.

    • Tilapia imports are heavily restricted to Australia, The live fish will not be allowed, they are considered "restricted noxious fish".

      The rules are:

      Illegal to Keep: You cannot keep tilapia (dead or alive), sell them, give them away, or use them as bait.

      Immediate Euthanasia: Humanely kill the fish as soon as you catch it.

      Disposal:

      Bury: Bury them deep and well away from the water's edge to prevent scavengers from dragging them back in or floodwaters from releasing eggs.

      Bin: Place them in a rubbish bin.

      No Filleting: You cannot take fillets and dispose of the rest; the entire fish must be destroyed.

      Various state departments have hotlines for reporting tilapia.

      There are different hotlines per state:

      Queensland Department of Agriculture and Fisheries (DAF) (13 25 23)

      New South Wales Department of Primary Industries (DPI) (1800 675 888)

      Victoria (VFA) Reporting hotline (13FISH or 13 34 74)

      Western Australia Dept. of Primary Industries & Regional Development (1800 815 507)

      I've had rewards for reporting them (fishing reel, free bait, etc).

      1 reply →

It's old news. There is even “And Dream of Sheep” — Grey’s Anatomy, Season 15 Episode 17. That’s the episode where they mention using tilapia fish skin to treat burns. Original U.S. air date: March 14, 2019.

I'm pretty sure they've done this for decades. I seem to remember someone using potato skins like 30 years ago.

TLDR;

Its a fantastic substitute for bandages in the sense that you don't need to take off the fish skin everyday.

Its also better are retaining moisture in the burn wounds than cotton badages.

No need for antibiotics, painkillers etc

Its also really cheap. Fish farms regard them as waste.

  • > Fish farms regard them as waste.

    I have only seen tilapia sold whole - the skin is one of the best parts when you fry them.

This has been going for long enough that there's been several metastudies debunking it. Was hyped in the news around 2017.

Fish skin or silver sulfadiazine had similar effects and to me are both approximating placebo from the studies I read. The fish does nothing for pain and no difference in the scarring time vs the silver ointments.

  • fish skin (rich in collagen) sounds like a version of collagen patch. And for collagen patch for example https://pmc.ncbi.nlm.nih.gov/articles/PMC3081477/ where despite the "Conclusion" the "Results" show that it helps (and one can also expect that collagen patching is starting point to engineering artificial skin) :

    Results:

    With two weeks of treatment, 60% of the ‘collagen group’ wounds and only 42% of the ‘conventional group’ wounds were sterile (P=0.03). Healthy granulation tissue appeared earlier over collagen-dressed wounds than over conventionally treated wounds (P=0.03). After eight weeks, 52 (87%) of ‘collagen group’ wounds and 48 (80%) of ‘conventional group’ wounds were >75% healed (P=0.21). Eight patients in the ‘collagen group’ and 12 in the ‘conventional group’ needed partial split-skin grafting (P=0.04). Collagen-treated patients enjoyed early and more subjective mobility.

    Conclusion:

    No significant better results in terms of completeness of healing of burn and chronic wounds between collagen dressing and conventional dressing were found. Collagen dressing, however, may avoid the need of skin grafting, and provides additional advantage of patients’ compliance and comfort.

> In the US, animal-based skin substitutes require levels of scrutiny from the Food and Drug Administration and animal rights groups that can drive up costs, Lee said. Given the substantial supply of donated human skin, tilapia skin is unlikely to arrive at American hospitals anytime soon.

This reminds me of Milton Friedman’s arguments against the FDA.

  • I wonder what’s the difference between countries that drives that. It’s not like Brazil doesn’t have its own FDA, which is much more strict than the US one, from what I know. Maybe some kind of lobbying? Or are animal rights group that much stronger?

    • I was having a conversation about this with my father-a retired pharmaceutical industry executive-a few weeks back, about why certain generic prescription medication formulations were unavailable in Australia yet sold in New Zealand. He explained to me that the Australian pharmaceutical regulator (the TGA) and its New Zealand equivalent (Medsafe) had very different regulatory philosophies. Medsafe, if a major international regulator (such as the US FDA or the EU’s EMA) had already approved something, they’ll just approve it too (“if it is good enough for them it is good enough for us”); the TGA’s attitude was very different, just because the FDA or EMA had approved it didn’t mean they automatically would, they wanted to analyse the safety data for themselves and make up their own mind. For blockbuster patented drugs, the extra regulatory cost of Australia was worth it, but for the long tail of miscellaneous generic formulations, the extra cost of dealing with the TGA could make some of them financially nonviable.

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    • I imagine it is about this:

      > But Brazil lacks the human skin, pig skin, and artificial alternatives that are widely available in the US.

      This is not an improvement on existing methods (it may end up being, but that is not the motivation) but rather a case of it being all they have to work with.

      Tilapia skin is probably better than no skin at all.

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