(CS-083) Successful Use of Decellularized Piscine Graft in a Pediatric Extensive Wound Reconstruction

Closing large wounds in children can be difficult. Plastic surgeons may need to use different techniques to achieve final closure. In this case, two forms of fish skin graft (FSG) were used to help fill a significant, resected defect in a pediatric patient.

Methods:

A 5-year-old boy with giant cell fibroblastoma had a surgical defect after an extensive resection of his right shoulder, neck, and chest. FSG was applied to fill the large areas of resected muscle and soft tissue. The reconstruction involved first approximating edges using a closure-assisted device and negative pressure wound therapy (NPWT). The meshed FSG was stacked to fill the defect, and a mixture of FSG particulate and medical-grade honey was used along with NPWT. The patient returned to the operating room for each dressing change until appropriate granulation was achieved for the final split-thickness skin graft (STSG).

Results:

The FSG was incorporated into the wound, and granulation increased with each dressing change. The FSG allowed the filling of muscle and soft tissue defects to achieve final closure with STSG.

Discussion:

Closing extensive wounds can be challenging and may require several techniques. The use of FSG in this case shows its benefits in filling large complex wounds and contouring defects in pediatric patients. Decellularized piscine skin grafts can be used in different forms to fill complex wounds and reconstruct defects in pediatric patients.