Real-world outcomes of acellular fish skin grafts for chronic wounds: A retrospective analysis of effectiveness and costs.

Chronic wounds (CW) are a major public health problem. Acellular fish skin grafts (AFSG) are increasingly used in advanced wound care, but data on their effectiveness and costs in real-world settings are scarce. We therefore retrospectively analysed the wound surface area (WSA), pain scores, and AFSG-related costs in patients with CW over a 12-week follow-up period. In this single-centre observational study, we analysed two datasets of 34 (full dataset) and 22 (WSA-dataset) CW patients treated with AFSG in a university hospital. Of 34 AFSG-treated patients (mean age 75.9 ± 11.4 years, 44.0% females) with 50 CW of various aetiologies (median ulcer duration 32 weeks), 66.6% experienced pain improvement at 12 weeks. Of 22 patients, 19 (86.4%) showed a mean reduction in WSA of -60.7% ± 143.8% (p = 0.0025); 36.4% of CW were healed. AFSG-related costs were 1232.3 EUR/patient and 130.4 EUR/reduced cm2 (n = 22), which was 6.5 times more cost-effective compared to previous study results using living cellular skin substitutes. During 12 weeks of follow-up in a real-world setting, AFSG resulted in reduced WSA in most patients, improved pain in two-thirds, and healed CW in one-third. AFSG may be more cost-effective than other products, but prospective head-to-head comparisons are needed.