Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018;23(Suppl 2):46-55.
doi: 10.1007/s00772-018-0428-2. Epub 2018 Aug 1.

The marine Omega3 wound matrix for treatment of complicated wounds: A multicenter experience report

B Dorweiler  1 , T T Trinh  1 , F Dünschede  1 , C F Vahl  1 , E S Debus  2 , M Storck  3 , H Diener  2
Affiliations
Review

The marine Omega3 wound matrix for treatment of complicated wounds: A multicenter experience report

B Dorweiler et al. Gefasschirurgie. 2018.

Abstract
in English, German

Introduction: The Kerecis™ Omega3 Wound matrix is a decellularized skin matrix derived from fish skin and represents an innovative concept to achieve wound healing. The aim of this study was to report the cumulative experience of three centers for vascular surgery regarding use of the Omega3 Wound matrix in selected patients with complicated wounds.

Material and methods: In this study 23 patients with 25 vascular and/or diabetes mellitus-associated complicated wounds and partially exposed bony segments were treated with the Omega3 Wound matrix in three vascular centers. In several patients, conventional wound treatment with vacuum therapy had previously been carried out sometimes over several weeks without durable success. Following initial debridement in the operating room, the matrix was applied and covered with a silicone mesh. In the further course, wound treatment was conducted on an outpatient setting if possible.

Results: In total 25 wounds were treated with localization at the level of the thigh (n = 2), the distal calf (n = 7), the forefoot (n = 14) and the hand (n = 2). The time to heal varied between 9 and 41 weeks and between 3 and 26 wound matrices were applied per wound. Interestingly, a reduction of analgesics intake was noted when the treatment with the Omega3 Wound matrix was initiated.

Conclusion: The novel Omega3 Wound matrix in this study represented an effective treatment option in 25 complicated wounds. Further studies are necessary to evaluate the impact of the wound matrix on stimulation of granulation tissue and re-epithelialization as well as the potential antinociceptive and analgetic effects.

Einleitung: Die Omega-3-Wundmatrix (Kerecis®) stellt eine innovative Wundauflage dar, die aus der Haut des Kabeljaus durch entsprechende Verfahren wie Dezellularisierung gewonnen wird und seit Kurzem in Deutschland verfügbar ist. Die Intention der vorliegenden Studie ist die Zusammenstellung der Behandlungserfahrungen aus 3 gefäßchirurgischen Zentren mit dem Einsatz der Omega-3-Wundmatrix bei selektierten Wundpatienten.

Material und methoden: In einem multizentrischen Erfahrungsbericht haben wir die Ergebnisse von insgesamt 23 Patienten mit 25 vaskulären und diabetes- bzw. vaskulitisassoziierten Problemwunden zusammengestellt. Bei mehreren Patienten war zuvor eine konventionelle Wundbehandlung mit Vakuumtherapie teils über mehrere Wochen ohne durchgreifenden Erfolg durchgeführt worden. Die Erstapplikation der Omega-3-Wundmatrix erfolgte im OP unter stationären Bedingungen, danach wurden die Patienten nach Möglichkeit einmal wöchentlich ambulant versorgt.

Ergebnisse: Insgesamt behandelten wir 25 Problemwunden sowohl nach Amputationen als auch bei primärer Wunde (Oberschenkel n = 2, Unterschenkel n = 7, Fuß n = 14, Hand n = 2). Die Abheilungszeiten variierten von 9 bis 41 Wochen, die Anzahl der pro Wunde verwendeten Omega-3-Wundmatrizes von 3 bis 26. Zusätzlich war im Rahmen der Behandlung mit Omega-3-Wundmatrizes eine Verminderung der lokalen Wundschmerzen zu verzeichnen.

Schlussfolgerung: Die Behandlung mit der innovativen marinen Omega-3-fettsäurehaltigen Wundmatrix stellt in dieser Untersuchung einen wirksamen Ansatz in der Behandlung von 25 Problemwunden dar. Weitere Untersuchungen sind notwendig, um die Granulations- und Reepithelialisierungsfunktion sowie die zusätzlich vorhandene analgetische bzw. antinozizeptive Wirkung dieses Präparates genauer zu evaluieren.

Keywords: Amputation; Arterial occlusive disease; Diabetic ulcer; Wound healing; Wound matrix.

PubMed Disclaimer

Conflict of interest statement

Compliance with ethical guidelinesH. Diener has received lecture fees from Kerecis. B. Dorweiler, T.T. Trinh, F. Dünschede, C.F. Vahl, E.S. Debus and M. Storck declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Ultrastructure of the matrix. a, b Acellular dermal matrix derived from fish skin (a) and decellularized amnion matrix (b) compared under a scanning electron microscope (SEM). c, d Stem cells were cultured for 12 days in an acellular dermal matrix derived from fish skin (c) and amnion (d). The stem cells stained blue (marked with arrows) have migrated into the fish skin matrix, while the stem cells on the amniotic matrix have settled on the surface of the matrix. (Used with kind permission from Kerecis®. This content is not part of the Open Access Licence)
Fig. 2
Fig. 2
An example of treatment course at the Mainz center. a Initial finding involving wound necrosis following forefoot amputation in patient 5. b Intraoperative finding following debridement (wound area 29 cm2). c Interim result after 8 weeks of Omega3 wound matrix therapy. d Healed wound following a total treatment duration of 33 weeks (material used: 22 wound matrices à 3 × 7 cm)
Fig. 3
Fig. 3
Healing kinetics of the first seven wounds at the Mainz center. a Normalized curves of the healing kinetics of seven wounds in five patients, in which the wound size was related to the baseline value and the time related to the total time to healing. b A polynomial trend curve was adapted to the individual data matrix in a (Pat patient). This clearly shows that on average a 50% reduction in wound area could be seen as early on as after 20% of the treatment duration
Fig. 4
Fig. 4
Placement of the omega-3-wound matrix. The size of the wound (a) is measured with a plastic sheet (b, c) and the matrix is shaped accordingly (d). After hydration, the matrix is placed on the wound and covered with a polyurethane foam (f). During treatment, the wound is progressively remodeling (g) until final healing (reepithelialization) is achieved (h)
Fig. 5
Fig. 5
Healing rates/wound reduction in the 10 patients at the Hamburg center. The figure shows the treatment rates of patients in Hamburg, taking treatment days into account
Fig. 6
Fig. 6
Emergency necrectomy with ray resection of D1 and D2 in the case of intensive catecholamine therapy for sepsis (a, b). Following Omega3 wound matrix therapy, successful conditioning and mesh graft with virtually complete skin coverage over the course of treatment with the exception of a protruding bone edge in the middle hand (c). Hand function can be improved by means of plastic surgery if necessary
Fig. 7
Fig. 7
Chronic mixed ulcer involving abscess formation and subsequent persistent long intramuscular soft tissue channel, which was primarily treated with negative pressure wound therapy (NPWT) (a). The matrix is introduced as a roll into the channel, while another matrix is placed to cover the surface (b–e). Multiple NPWT (f); following removal, the wound was protected using a silicone gauze. Successful wound conditioning for a subsequent mesh graft (g–i) with healing of the mesh graft (j) followed by compression therapy
See this image and copyright information in PMC

References

    1. Heyer K. Versorgungsepidemiologie des Ulcus cruris in Deutschland. Erkrankungshäufigkeit, Versorgungsqualität und Prädiktoren der Wundheilung. Wiesbaden: Springer; 2016.
    1. Rüttermann M, Maier-Hasselmann A, Nink-Grebe B, Burckhardt M. Clinical practice guideline: Local treatment of chronic wounds in patients with peripheral vascular disease, chronic venous insufficiency and diabetes. Dtsch Arztebl Int. 2013;110(3):25–31. - PMC - PubMed
    1. Elraiyah T, Domecq JP, Prutsky G, Tsapas A, Nabhan M, Frykberg RG, Hasan R, Firwana B, Prokop LJ, Murad MH. A systematic review and meta-analysis of débridement methods for chronic diabetic foot ulcers. J Vasc Surg. 2016;63(2 Suppl):37S–45S. doi: 10.1016/j.jvs.2015.10.002. - DOI - PubMed
    1. Elraiyah T, Tsapas A, Prutsky G, Domecq JP, Hasan R, Firwana B, Nabhan M, Prokop L, Hingorani A, Claus PL, Steinkraus LW, Murad MH. A systematic review and meta-analysis of adjunctive therapies in diabetic foot ulcers. J Vasc Surg. 2016;63(2 Suppl):46S–58S. doi: 10.1016/j.jvs.2015.10.007. - DOI - PubMed
    1. Ubbink DT, Westerbos SJ, Nelson EA, Vermeulen H. A systematic review of topical negative pressure therapy for acute and chronic wounds. Br J Surg. 2008;95:685–692. doi: 10.1002/bjs.6238. - DOI - PubMed