Atlantic cod skin grafts cut hospital stays for severe burn patients

Severe burn patients treated with a biological graft made from Atlantic cod skin recover significantly faster than those receiving synthetic alternatives. The findings suggest a shift in how clinicians manage temporary wound coverage before permanent skin graft surgery.

According to a study of 465 adults across 49 burn centers conducted between 2019 and 2025, patients treated with GraftGuide—a product developed by the Icelandic company Kerecis—were discharged from the hospital after an average of 23 days. In contrast, patients treated with synthetic substitutes spent an average of 35 days in the hospital, representing a reduction in stay of 12 days. The study participants had burns affecting an average of 13% of their bodies, consisting primarily of mixed or third-degree burns.

The biological alternative

Severe burns are typically managed using temporary wound coverage, such as biosynthetic collagen scaffolds, to stabilize the area before a permanent graft can be applied. Kerecis developed GraftGuide using wild Atlantic cod (Gadus morhua) as a biological alternative to these synthetic materials. The company utilizes cod skin because it provides large surface areas per fish and contains collagen and omega-3 fatty acids.

John Lantis of the Icahn School of Medicine at Mount Sinai noted that fish skin closely resembles human skin under microscopic examination, which may contribute to its efficacy. Because few fish viruses affect humans, the skin requires less aggressive processing than other biological materials, allowing the beneficial omega-3 fatty acids to remain intact.

Clinical implications

Reducing hospital stays by nearly two weeks represents a substantial improvement in burn care, potentially lowering healthcare costs and reducing the window of vulnerability for patients. The use of a biological scaffold that mimics human skin structure may provide a more compatible environment for healing than traditional synthetic options.

Regulatory status and next steps

GraftGuide is currently FDA-approved in the United States via the 510(k) pathway. While the study highlights a clear advantage in recovery speed, clinicians continue to monitor the long-term outcomes of biological grafts compared to synthetic standards. Further research is expected to clarify the exact mechanism by which the omega-3 fatty acids in the cod skin accelerate the healing process.