What is the Role of Fish Skin Graft in Combat Injuries in Austere Conditions?

Training was endorsed by field clinicians at the four other hospitals that the physicians visited in the region.4 This supports other literature which has reported the ease of use of FSG.

Pain levels were not assessed, which must be addressed with further investigation; however, no infections were reported.4

While the current intention of treatment in military field-like hospitals is to temporize wounds until better treatment can be sought, the use of FSG marks a shift in this strategy. FSG not only temporizes the wound but actively accelerates the healing process, and in some circumstances can be used in place of an alternative graft.3,4,6 This has the potential to make permanent treatment more portable, easily stored, and accessible in field-like military hospitals and other austere environments. The use of FSG in the cases provided above is, however, an unusual clinical application of the product and there are some limitations to the evidence produced. Given the environment, the study was not controlled and there is no welldocumented assessment of each wound prior to the application of FSG. Sufficient follow-up of each patient is also lacking. NPWT was also used which is the accepted treatment of wounds. It is therefore difficult to ascertain the true efficacy of FSG for each individual case.4

Changes in war tactics, such as the use of drones and targeted air strikes, inevitably produces more burn and complex blast injury victims. The need for a strategy to treat these injuries is woefully unmet by current approaches which are impractical in such austere environments and when local military field hospitals become overwhelmed. FSGs offer an opportunity to