| Sumario: | Aim: Treatment of some wound defined "hard to heal" due to their aetiology and characteristics is at times limited due to the absence of biomaterials able to provide correct stimulation for healing. In this case series, we demonstrate the potential of acellular fish skin to re-start the tissue repair process. Method: Use of an acellular skin graft of fish origin, in the regenerative treatment of 20 wounds, both acute and chronic, which are considered to be "hard to heal" (Pyoderma Gangrenoso, digital ischemia, sternal surgical dehiscences, scalp wounds with bone exposed, necrotising fasciitis, chronic decubiti). Results / Discussion: All the wounds treated showed strong re-start of the healing process, with a rapid response, and in 75% of cases, complete healing, with the resulting new tissue stable and with characteristics totally similar to the native one. Conclusion: Bio-stimulation with acellular fish skin grafts proved to be effective even when treating "hard to heal" wounds, with optimal response timing and excellent regenerative outcome, both from a functional and an aesthetic point of view.
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