Sanitas
Revista arbitrada de ciencias de la salud
Vol. 2(1), 1-8, 2023
https://doi.org/10.5281/zenodo.10606352
1
Tilapia skin occlusive dressing for the treatment of burns
Vendaje oclusivo de piel de tilapia en el tratamiento de quemaduras
Iván Pimienta-Concepción
ua.ivanpimienta@uniandes.edu.ec
Universidad Regional Autónoma de los Andes, Ambato, Tungurahua,
Ecuador
https://orcid.org/0000-0002-7623-7499
ABSTRACT
Detailed exploration of tilapia skin as a valuable resource in the treatment of burns has yielded
promising and revealing results. Aim: To analyse the use of tilapia skin occlusive dressing in the
treatment of second-degree burns. Method: Through an exhaustive immersion in the pages of 15
meticulously selected research studies published in PubMed, Scielo, Scopus. Results and
conclusion: Despite challenges in the gradual depletion of type I collagen during sterilisation and
clinical use, the ability of tilapia skin to maintain a significant amount of this essential component even
after burn treatment is highlighted.
Descriptors: drug therapy; skin; erythema. (Source: DeCS).
RESUMEN
La exploración detallada de la piel de tilapia como un recurso valioso en el tratamiento de
quemaduras ha arrojado resultados prometedores y reveladores. Objetivo: analizar el uso vendaje
oclusivo de piel de tilapia en el tratamiento de quemaduras de segundo grado. Método: A través de
una exhaustiva inmersión en las páginas de 15 investigaciones meticulosamente seleccionadas
publicadas e PubMed, Scielo, Scopus. Resultados y conclusión: A pesar de los desafíos en la
disminución gradual de colágeno tipo I durante la esterilización y el uso clínico, se destaca la
capacidad de la piel de tilapia para mantener una cantidad significativa de este componente esencial,
incluso después del tratamiento de quemaduras.
Descriptores: tratamiento farmacológico; piel; eritema. (Fuente: DeCS).
Received: 05/10/2022. Revised: 1810/2022. Approved: 05/11/2022. Published: 01/01/2023.
Original in brief
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 2(1), 1-8, 2023
Vendaje oclusivo de piel de tilapia en el tratamiento de quemaduras
Tilapia skin occlusive dressing for the treatment of burns
Iván Pimienta-Concepción
2
INTRODUCTION
On the exciting horizon of medical research, a flash of innovation is emerging that is
transforming the way skin burn challenges are addressed: the tilapia skin occlusive
dressing. In this scientific journey, the depths of applied biotechnology in medicine
are explored, dipping expectations into the waters of possibility and harnessing the
unique benefits of such an amazing resource as tilapia skin.
The narrative weaves between the intersection of ancient wisdom and cutting-edge
science, taking researchers beyond conventional approaches to a revolutionary
solution. Join the reader as they unravel the layers of a fascinating phase II study
exploring the potential of occlusive Nile tilapia (Oreochromis niloticus) skin xenograft
occlusion in the treatment of human burns.
1 2 3 4
By meticulously examining several variables, from healing time to pain management
and the need for dressing changes, the randomised controlled study sheds light on
the efficacy of tilapia skin as a promising alternative. The findings reveal not only
faster re-epithelialisation, a significant reduction in pain intensity and the need for
analgesics, but also a decrease in the frequency of dressing changes compared to
traditional approaches such as silver sulphadiazine.
The results presented not only support the promising efficacy of tilapia skin as an
occlusive xenograft, but also transcend the lines of conventional medical research.
This study paves the way towards more efficient and less invasive practices, marking
a milestone in the evolution of the approach to burn wounds.
14
In view of the above, the aim is to analyse the use of tilapia skin occlusive dressing
in the treatment of second-degree burns.
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 2(1), 1-8, 2023
Vendaje oclusivo de piel de tilapia en el tratamiento de quemaduras
Tilapia skin occlusive dressing for the treatment of burns
Iván Pimienta-Concepción
3
METHOD
Through an exhaustive immersion in the pages of 15 meticulously selected research
papers published in PubMed, Scielo, Scopus. This compendium, conceived as a
descriptive documentary research with bibliographic design, traces an illuminating
route towards a detailed understanding of the role of tilapia skin as an adjuvant in
the re-epithelialisation process of burn-injured tissues.
Each selected work stands as a critical piece in the complex jigsaw of scientific
evidence, making a unique contribution to the understanding of this fascinating
therapeutic perspective. Adopting an analytic-synthetic approach, the research not
only seeks to summarise existing findings, but also to synthesise the information to
extract patterns and understand the interconnectedness of the available data.
Through this foray into literature review, they not only cross the boundaries of
established knowledge, but also distil the essence of each study to shed new light
on the mysteries surrounding the application of tilapia skin in the skin wound healing
process. This analytical-synthetic approach will provide you with a comprehensive
and revealing insight into the contribution of tilapia skin in promoting re-
epithelialisation in burn cases.
RESULTS
Ten 0.5 × 0.5 cm tilapia skin samples were divided into four groups: skin in natura
(IN), chemical sterilisation (CH), additional irradiation (30 kGy) (IR) and skins used
in burn treatment (BT). Histochemical and immunohistochemical findings of collagen
quantity were compared and ultrastructural aspects were described by scanning
electron microscopy.
15
During sterilisation and clinical use, the amount of type I collagen decreased due to
gradual reduction of immunostaining (anti-collagen-I) and thinning of collagen fibres
compared to type III (Picrosirius red polarised light). Collagen fibres reorganised at
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 2(1), 1-8, 2023
Vendaje oclusivo de piel de tilapia en el tratamiento de quemaduras
Tilapia skin occlusive dressing for the treatment of burns
Iván Pimienta-Concepción
4
each stage of sterilisation, showing a low percentage of collagen and structural
disorganisation in BT. After burn treatment, the amount of type I collagen was further
decreased (p<0.05).
15
Both methods of analysis showed no significant difference in the quantified values
(p = 0.247). A positive correlation was observed between them (r = 0.927; 95 % CI
= 0.720-0.983), demonstrating agreement in the quantification of collagen in similar
samples, with a low systematic error rate (Dalberg coefficient: 6.70). Despite
sterilisation, a significant amount of type I collagen remained, but its clinical
application further reduced this amount. Reliable quantification of collagen can be
performed by immunohistochemistry and/or Picrosirius Red.
15
In the search for effective alternatives for the treatment of burns, the collagen
composition in the skin of different species was examined, most notably Nautilus,
Grass Carp and Japanese sea bass. Although these have a high collagen
concentration, their geographical limitation to the Arctic Ocean poses challenges,
unlike Tilapia, whose global breeding allows wider access.
3
The process of preparing the tilapia skin proves to be a crucial step. After thorough
cleaning and stretching in a specialised press, the skin reaches dimensions of 10cm
x 20cm, acquiring flexibility and characteristics analogous to human tissue. Storage,
once processed and suitable for use, can extend up to 2 years in freezers at -4°C
4
.
Sterilisation, carried out by chemical and radiological methods, ensures its suitability
for medical applications.
5
Research reveals the richness of type I collagen in tilapia skin (Tsc), with
fluorescence-emitting properties in solid phase and in solution. This collagen, in a
highly concentrated or aggregated state, exhibits the AIE property, illuminating the
understanding of protein emission characteristics via the cluster-triggered emission
(CTE) mechanism.
6 7 8 9
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 2(1), 1-8, 2023
Vendaje oclusivo de piel de tilapia en el tratamiento de quemaduras
Tilapia skin occlusive dressing for the treatment of burns
Iván Pimienta-Concepción
5
A crucial finding is the durability of tilapia skin in its application as a dressing. Its
ability to remain attached to the wound for up to 10 days 10 11 reduces the need for
daily replacements and decreases secondary infections due to its outstanding
adhesion capacity
12 13
. In addition, a marked reduction in patient recovery time was
observed, offering economic and functional benefits, allowing for rapid reintegration
of the individual back into society with minimal visible physical injury. Importantly,
this treatment costs 75% less than the silver sulphadiazine cream conventionally
used in burn patients in Brazil.
13
The sustainable origin of tilapia skin is noteworthy. Sourced exclusively from waste
from the tilapia food trade, its production and application is economically viable. In
the case of setting up a pool specifically for skin production, the initial cost of
approximately 15,000 US dollars for a production of up to 5 years 13 is justified,
especially if the fish meat is used as additional income for the maintenance of the
pools. The profitability of a tilapia pool, whether as a tourist attraction or for medicinal
purposes, is supported by the high consumer demand for tilapia in the market,
demonstrating a comprehensive use of the product.
CONCLUSION
Detailed exploration of tilapia skin as a valuable resource in the treatment of burns
has yielded promising and revealing results. Through a thorough analysis of its
ultrastructural properties and changes in the amount of collagen during sterilisation
and clinical application, we have unravelled the mysteries of this exceptional
biomaterial.
Despite challenges in the gradual decrease of type I collagen during sterilisation and
clinical use, we highlight the ability of tilapia skin to maintain a significant amount of
this essential component, even after burn treatment. The durability of the skin as a
dressing, its ability to reduce the frequency of replacement and to reduce secondary
infections underlines its relevance in the medical field.
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 2(1), 1-8, 2023
Vendaje oclusivo de piel de tilapia en el tratamiento de quemaduras
Tilapia skin occlusive dressing for the treatment of burns
Iván Pimienta-Concepción
6
The process of skin preparation, from cleaning to specialised stretching, reveals the
importance of each step in giving tilapia skin characteristics similar to human tissue.
The application of chemical and radiological sterilisation methods ensures the safety
and efficacy of this biomaterial in clinical settings.
The study also highlights the richness of type I collagen, specifically tilapia skin
collagen (Tsc), with fluorescence-emitting properties that open new doors for its
application in various scientific fields.
In addition to its therapeutic properties, tilapia skin presents itself as a sustainable
and economically viable option. Its origin from waste from the tilapia food industry
and the possibility of generating additional income by selling the fish meat make this
approach an integral solution.
In short, tilapia skin emerges not only as an effective bandage in the treatment of
burns, but also as a shining example of how innovation can find solutions in the least
expected places. Its transformative potential in healthcare and its contribution to
sustainability make tilapia skin a therapeutic treasure to be fully explored and
harnessed.
FUNDING
Non-monetary
CONFLICT OF INTEREST
There is no conflict of interest with individuals or institutions involved in the research.
ACKNOWLEDGEMENTS
To the burn patients.
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Revista arbitrada de ciencias de la salud
Vol. 2(1), 1-8, 2023
Vendaje oclusivo de piel de tilapia en el tratamiento de quemaduras
Tilapia skin occlusive dressing for the treatment of burns
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Sanitas
Revista arbitrada de ciencias de la salud
Vol. 2(1), 1-8, 2023
Vendaje oclusivo de piel de tilapia en el tratamiento de quemaduras
Tilapia skin occlusive dressing for the treatment of burns
Iván Pimienta-Concepción
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doi:10.1016/j.acthis.2021.151762
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