Kerecis and Recell in Patients with Necrotizing Fasciitis: Report of Our First Experience in Three Patients

Necrotizing soft tissue infections (NSTI) are serious infections that are typically treated with aggressive debridements. Coverage of those extensive full-thickness integumentary defects requires complex reconstructions of both the dermal and epidermal layers with the goal of achieving close to normal pliability. A key determinant factor in the development of scar tissue is the time to create a graftable surface and curtail inflammatory reactions. A second limiting factor is the extent of donor skin needed for coverage. Kerecis, a fish skin-derived regenerative tissue matrix, is a novel product that has shown good promise in the rapid generation of a graftable, pliable dermal matrix in burn patients. Additionally, it decreases the inflammatory reaction through its Omega-3 polyunsaturated fatty acids content. The ReCell system produces a regenerative skin cell suspension of a patient's own skin, with a reduction in the size of the skin graft needed for coverage. The combined use of Kerecis and ReCell provides a promising reconstructive approach that may speed up definitive coverage while reducing donor-site morbidity and pain.