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ORTALEZA, Brazil — In this historic city by the sea in northeast Brazil, burn patients look as if they’ve emerged from the waves. They are covered in fish skin — specifically strips of sterilized tilapia.

Doctors here are testing the skin of the popular fish as a bandage for second- and third-degree burns. The innovation arose from an unmet need. Animal skin has long been used in the treatment of burns in developed countries. But Brazil lacks the human skin, pig skin, and artificial alternatives that are widely available in the US.

The three functional skin banks in Brazil can meet only 1 percent of the national demand, said Dr. Edmar Maciel, a plastic surgeon and burn specialist leading the clinical trials with tilapia skin.

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As a result, public health patients in Brazil are normally bandaged with gauze and silver sulfadiazine cream.

“It’s a burn cream because there’s silver in it, so it prevents the burns from being infected,” said Dr. Jeanne Lee, interim burn director at the the regional burn center at the University of California at San Diego. “But it doesn’t help in terms of debriding a burn or necessarily helping it heal.”

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The gauze-and-cream dressing must be changed every day, a painful process. In the burn unit at Fortaleza’s José Frota Institute, patients contort as their wounds are unwrapped and washed.

Enter the humble tilapia, a fish that’s widely farmed in Brazil and whose skin, until now, was considered trash. Unlike the gauze bandages, the sterilized tilapia skin goes on and stays on.

The first step in the research process was to analyze the fish skin.

“We got a great surprise when we saw that the amount of collagen proteins, types 1 and 3, which are very important for scarring, exist in large quantities in tilapia skin, even more than in human skin and other skins,” Maciel said. “Another factor we discovered is that the amount of tension, of resistance in tilapia skin is much greater than in human skin. Also the amount of moisture.”

In patients with superficial second-degree burns, the doctors apply the fish skin and leave it until the patient scars naturally. For deep second-degree burns, the tilapia bandages must be changed a few times over several weeks of treatment, but still far less often than the gauze with cream. The tilapia treatment also cuts down healing time by up to several days and reduces the use of pain medication, Maciel said.

Antônio dos Santos, a fisherman, was offered the tilapia treatment as part of a clinical trial after he sustained burns to his entire right arm when a gas canister on his boat exploded. He accepted.

“After they put on the tilapia skin, it really relieved the pain,” he said. “I thought it was really interesting that something like this could work.”

The initial batches of tilapia skin were studied and prepared by a team of researchers at the Federal University of Ceará. Lab technicians used various sterilizing agents, then sent the skins for radiation in São Paulo to kill viruses, before packaging and refrigerating the skins. Once cleaned and treated, they can last for up to two years.

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.

But it may be a boon in developing countries.

“I’m willing to use anything that might actually help a patient,” Lee said. “It may be a good option depending on what country you’re talking about. But I also think the problem is that you need to find places that have the resources to actually process the skin and sterilize it, and make sure it doesn’t have diseases.”

In Brazil, in addition to the clinical trials, researchers are currently conducting histological studies that compare the composition of human, tilapia, pig, and frog skins. They are also conducting studies on the comparative costs of tilapia skin and conventional burn treatments. If clinical trials show continued success, doctors hope a company will process the skins on an industrial scale and sell it to the public health system.

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  • Congratulations to this article, my namr   Khaled Basala , a student at the Faculty of aquatic  and Fisheries Sciences in kafr ELshiekh university , Egypt, and I have read your article entitled “Can tilapia skin being used to bandage burns?” And I have areview article  in my college on this Topic . I hope you will help me to  find all references and papers in  this point …. alot thanks to your time .

  • Hi,

    Interesting story, but can you please give the sources of the article and maybe a link to the earlier publications ? (case study and current research ?)

    I can’t manage to find informations about this on scientific database. (but to be honest i didn’t give it a lot of time either).

    Thanks.

  • I think this is an incredible breakthrough! As the article/video mentioned, the changing of the bandages and debriding of the wounds in traditional burn treatments are horrendously painful. Some patients must be sedated before it’s done. I hope it continues to develop positively, not just for countries who don’t have the resources that the USA or other more developed nations have, but even for those that do.

  • 13 dias sem troca de curativos, indolor e sem complicação nem sequer na hora de remover, sucesso absoluto, maravilhosa descoberta da engenhosidade brasileira. Parabéns aos pesquisadores. Solução que vai ajudar milhões de pessoas em todo o mundo com baixíssimo custo, isso sim é ciência.

  • É possível aplicar a pele da tilápia em portadores de Alzheimer com escaras?
    Em sendo possível qual é o meio de obtenção?

  • Articles like this makes my heart rejoice. I am so glad that there are more studies being done on burn treatment. I went through hell with 3rd degree burns to 35% of my body. Due to the damage I could not wear pressure bandages and experienced severe keloid scarring. It took us 4 years to realize that Axhilirit healing oil (a traditional plant oil mix that has been in my family for generations) treats severe burns within days and removed almost all my keloids (still busy with treatments) but there is no scarring left in my face.

  • When I Saw first tilapia treatment in my facebook Im really happy and goodluck for those who’s really needed , Im very thankful all team God bless and carry on And I hope it will come very soon in my country.

    Regards.
    Shahbaz Ahmad sherani pakistan
    00923408818813

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