| Sumario: | Aim: Case 1: 88-year-old female with chronic venous insufficiency on both sides (CEAP C3 right, C6 left) with arterial hypertension and hypercholesterolemia presented with a non-healing venous leg ulcer 18 months of age. Case 2: 76-year-old patient with well-controlled Type 2 diabetes mellitus, well controlled arterial hypertension, and chronic heart disease presented with a chronic wound of 11 months which was identified as pyoderma gangrenosum. Case 3: A 53-year-old male patient with a history of systemic scleroderma presented with a chronic wound on the right hand MCP joint with exposed tendon dorsally. The wound was 12 weeks old on presentation. Method: Infections were treated as appropriate then wounds were debrided using a sharp debridement technique. Intact fish skin graft (Kerecis Omega3 Wound, Kerecis, Iceland) was used as recommended by the manufacturer. Results / Discussion: Notably, all patients reported a drop in pain when the fish skin was applied. Almost immediately in all cases, the wounds began to improve, and healthy granulation tissue was observed. All 3 wounds successfully healed, in as little as one treatment of fish skin in one patient, and wounds were aesthetically and functionally pleasing upon follow up. Conclusion: Intact fish skin graft is an effective solution for chronic, non-responding wounds of varying etiologies and should be used when standard procedure fails to initiate wound healing.
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