{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:14:39Z","timestamp":1791389679086,"version":"4.3.3"},"reference-count":22,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,7,22]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Chronic skin defects in the head, face and neck pose challenges for closure, especially after multiple surgeries or radiation therapy. We report the case of a woman in her 70s with a chronic occipital wound following squamous cell carcinoma resections, resulting in exposed skull bone. Despite various options, we successfully treated the 4 cm x 5\u2009cm wound with a Kerecis fish skin graft (FSG), observing significant improvement within a week. The FSG promoted granulation tissue formation, enabling subsequent full-thickness skin grafting from the patient\u2019s groin. Complete wound closure was achieved within 2\u2009weeks, indicating FSG\u2019s efficacy in complex wound management. Our experience highlights FSG\u2019s potential as a valuable tool in wound healing and reconstruction, particularly in challenging cases involving the head and neck.<\/jats:p>","DOI":"10.1136\/bcr-2024-261172","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T13:01:53Z","timestamp":1722690113000},"page":"e261172","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Resolution of a chronic occipital wound with exposed skull bone with a fish skin graft: a successful treatment approach"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-3089","authenticated-orcid":false,"given":"Alexander B","family":"Veitinger","sequence":"first","affiliation":[{"name":"Otorhinolaryngology, Head and Neck Surgery, Plastic Surgery, SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burkard M","family":"Lippert","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology, Head and Neck Surgery, Plastic Surgery, SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9319-8260","authenticated-orcid":false,"given":"Lukas S","family":"Fiedler","sequence":"additional","affiliation":[{"name":"Heidelberg University Medical Faculty Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"key":"2025082709455805000_17.8.e261172.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198167020-00007"},{"key":"2025082709455805000_17.8.e261172.2","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.3390\/medicina58121775","article-title":"Intact fish skin graft vs. standard of care in patients with neuroischaemic diabetic foot ulcers (kerefish study): an international, multicentre, double-blind, randomised, controlled trial study design and rationale","volume":"58","author":"Dardari","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"2025082709455805000_17.8.e261172.3","doi-asserted-by":"crossref","unstructured":"Choi AM , Brenner MJ , Gorelik D , et al . New medical device and therapeutic approvals in otolaryngology: state of the art review of 2021. OTO Open 2022;6. doi:10.1177\/2473974X221126495","DOI":"10.1177\/2473974X221126495"},{"key":"2025082709455805000_17.8.e261172.4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s00772-018-0428-2","article-title":"The marine omega3 wound matrix for treatment of complicated wounds: amulticenter experience report","volume":"23","author":"Dorweiler","year":"2018","journal-title":"Gefasschirurgie"},{"key":"2025082709455805000_17.8.e261172.5","doi-asserted-by":"crossref","first-page":"567","DOI":"10.17992\/lbl.2015.12.54","article-title":"Decellularized fish skin: characteristics that support tissue repair","volume":"101","author":"Magn\u00fasson","year":"2015","journal-title":"Laeknabladid"},{"key":"2025082709455805000_17.8.e261172.6","doi-asserted-by":"publisher","DOI":"10.1177\/1534734615573661"},{"key":"2025082709455805000_17.8.e261172.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.plipres.2012.10.003"},{"key":"2025082709455805000_17.8.e261172.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2009.00466.x"},{"key":"2025082709455805000_17.8.e261172.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdermsci.2013.07.008"},{"key":"2025082709455805000_17.8.e261172.10","doi-asserted-by":"crossref","first-page":"383","DOI":"10.7205\/MILMED-D-16-00142","article-title":"Regenerative and antibacterial properties of acellular fish skin grafts and human amnion\/chorion membrane: implications for tissue preservation in combat casualty care","volume":"182","author":"Magnusson","year":"2017","journal-title":"Mil Med"},{"key":"2025082709455805000_17.8.e261172.11","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/wrr.12761","article-title":"Fish skin grafts compared to human amnion\/chorion membrane allografts: a double-blind, prospective, randomized clinical trial of acute wound healing","volume":"28","author":"Kirsner","year":"2020","journal-title":"Wound Repair Regen"},{"key":"2025082709455805000_17.8.e261172.12","doi-asserted-by":"crossref","first-page":"39","DOI":"10.22467\/jwmr.2020.01228","article-title":"The utility of novel fish-skin derived acellular dermal matrix (kerecis) as a wound dressing material","volume":"17","author":"Kim","year":"2021","journal-title":"J Wound Manag Res"},{"key":"2025082709455805000_17.8.e261172.13","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.ijbiomac.2022.02.055","article-title":"Wound healing ability of acellular fish skin and bovine collagen grafts for split-thickness donor sites in burn patients: characterization of acellular grafts and clinical application","volume":"205","author":"Yoon","year":"2022","journal-title":"Int J Biol Macromol"},{"key":"2025082709455805000_17.8.e261172.14","first-page":"262","article-title":"Acellular fish skin graft use for diabetic lower extremity wound healing: a retrospective study of 58 ulcerations and A literature review","volume":"31","author":"Michael","year":"2019","journal-title":"Wounds"},{"key":"2025082709455805000_17.8.e261172.15","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22031010"},{"key":"2025082709455805000_17.8.e261172.16","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1093\/rb\/rbz036","article-title":"A comparative study of two porous sponge scaffolds prepared by collagen derived from porcine skin and fish scales as burn wound dressings in a rabbit model","volume":"7","author":"Shi","year":"2020","journal-title":"Regen Biomater"},{"key":"2025082709455805000_17.8.e261172.17","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3390\/ebj3010006","article-title":"The use of intact fish skin as a novel treatment method for deep dermal burns following enzymatic debridement: a retrospective case-control study","volume":"3","author":"Wallner","year":"2022","journal-title":"EBJ"},{"key":"2025082709455805000_17.8.e261172.18","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/milmed\/usy280","article-title":"Acellular fish skin grafts for management of split thickness donor sites and partial thickness burns: a case series","volume":"184","author":"Alam","year":"2019","journal-title":"Mil Med"},{"key":"2025082709455805000_17.8.e261172.19","doi-asserted-by":"crossref","first-page":"124","DOI":"10.4236\/ojmn.2015.54021","article-title":"Use of acellular fish skin for dura repair in an ovine model: a pilot study","volume":"05","author":"Kjartansson","year":"2015","journal-title":"OJMN"},{"key":"2025082709455805000_17.8.e261172.20","doi-asserted-by":"crossref","DOI":"10.3390\/medicina58070912","article-title":"The use of acellular fish skin grafts in burn wound management-a systematic review","volume":"58","author":"Luze","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"2025082709455805000_17.8.e261172.21","doi-asserted-by":"crossref","first-page":"169","DOI":"10.25270\/wnds\/2021.169177","article-title":"A multicenter, blinded, randomized controlled clinical trial evaluating the effect of omega-3-rich fish skin in the treatment of chronic, nonresponsive diabetic foot ulcers","volume":"33","author":"Lullove","year":"2021","journal-title":"Wounds"},{"key":"2025082709455805000_17.8.e261172.22","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13082389","article-title":"The use of fish skin grafts in children as a new treatment of deep dermal burns-case series with follow-up after 2 years and measurement of elasticity as an objective scar evaluation","volume":"13","author":"Staubach","year":"2024","journal-title":"J Clin Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:46:06Z","timestamp":1756313166000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":22,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,3]]},"published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1136\/bcr-2024-261172"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261172","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8]]}}}