Acellular and Lyophilized Piscis Dermis and Suspended Skin Cell Transplantation for the Management of a Full Thickness Burn Wound in a Canine Model

Introduction: Full-thickness skin burn wounds may be challenging to treat, even more so on animals. This is true not only for their unique skin flora but also due to their particular and more unpredictable behavior. Skin substitutes may enhance the development of an optimal wound bed for grafting and provide temporary wound coverage. Decellularized and lyophilized north Atlantic cod fish dermis have properties in the 4-stages of wound healing. Subsequent resurfacing with autologous split-thickness skin graft (STSG) and suspended skin cell transplantation (SSCT) may lead to faster and complete healing of the skin grafts with reduced donor sites. Methods: A 6-year old neutered male dog, boxer, experienced a full thickness skin burn while undergoing a mass removal and dental proce- dure. Iatrogenic injuries to bilateral lower extremities affecting nearly 10%TBSA were sustained from a warm air device while being under gen- eral anesthesia. Once demarcated, all the burn wounds were tangentially excised. Subsequently, the wounds were resurfaced with fish dermis Xe- nograft and negative pressure wound therapy was applied. 14-days later, when the wound beds appeared optimal for grafting, autologous STSG was performed, using punch biopsies, in addition to SSCT. Results: Xenograft integration and optimal granulation tissue was evi- denced in >95% of the surface area within 14-days after grafts application. This was considered ideal for resurfacing. Skin coverage with a STSG and SSCT revealed nearly 100% skin graft take and epithelization in all cases within 12 additional days. Discussion: Decellularized and lyophilized fish dermis provide excel- lent wound coverage and enhances the formation of the optimal wound bed for grafting on a canine patient. Subsequent, autologous suspended cell transplantation reduces time of healing with smaller donor sites and donor site morbidity. Further animal studies may be performed to reproduce these results to further validate its use in human beings for the treatment of full thickness burn wounds.