“It eases the pain a lot and brings hope when we need it most”. That’s how welder Cleílton da Silva, 40, sums up what he felt, after having second degree burns treated with tilapia skin. The research, involving fish skin in the health area, was initiated at the Federal University of Ceará (UFC) in 2015. And culminated in a successful treatment for severe burns, benefiting more than 300 patients in Ceará and 500 in Brazil. Today, there are studies developed in 13 medical specialties such as otolaryngology (eardrum perforation) and cardiology (vessels).
Cleílton suffered burns on her arms and on the left side of her face, neck and chest when she worked, in May 2017. On the day, she used a torch to extract the screw from an aluminum piece. Due to the high pressure, the hose carrying the gas broke and a strong burst of fire hit the worker.
Because of the accident, he spent 13 days in the Burn Treatment Center (CTQ) of Instituto Doutor José Frota (IJF), where he was invited to volunteer in the research that used tilapia skin for burns. The proposal caused strangeness, but it soon became relief. “I was in doubt, but when they said it was going to ease the pain, I didn’t even think much and accepted it. They put the skin on my arm, forearm and chest and it was wonderful because it is very cold. I thought the result was very good”.
Less pain and costs
Without sequelae, he points out that little dressing change is the main advantage of the treatment. “Dressings (conventional) have to change more and cause more pain. The skin of tilapia, when it adheres, is dry and does not even need to be changed”.
According to the general coordinator of the research at UFC and president of the Burn Support Institute (IAQ), Edmar Maciel, the reduction of dressings eases pain and the use of anesthesia. As a result, the costs and work of medical teams also decrease.
Hope to live
The biological dressing became a synonym for relief for Fátima da Silva, 61. Cook at a hospital in the Messejana neighborhood, she suffered a burn while working two years ago. She was carrying a pot of boiling water in her hands when she tripped over the stove and burned her right forearm. Like Cleílton, she accepted to be a volunteer in the research. “It is a strange skin. It burns when they are put on, but it relieves in minutes. In 12 days, it was already very dry”.
The cook classifies the treatment as “great” because, in addition to promoting physical healing, she revived her “hope”. “My arm was perfect. And it made me want to continue living.”
Fátima estimates that the six-month treatment was quick. It still attributes the absence of burn marks to the skin of the tilapia. However, according to Edmar Maciel, the healing quality with the skin of the fish it is “practically the same” as the traditional treatment. The difference is in the healing time. “We did observe a reduction of one day in the healing time for superficial second degree burns. And two days for deep second degree burns.”
According to the coordinator, there are novelties in studies related to the skin of tilapia. The material has been tested in the treatment of Varicose ulcers, deep wounds on the skin, generated by poor blood circulation. Another novelty is the study of skin in humans for repair and protection of the palate, the tissue of the upper part of the mouth.
There is still an expectation of beginning – without a definite date – of sexual reassignment research at the University of São Paulo (USP). The sex change from man to woman is done only in Cali, Colombia. So far, more than 30 patients have been operated on. ” The aesthetic result is much better than that done with traditional methods. Besides the surgery being faster, it does not leave the stigma of taking skin from body parts to fill the vaginal canal”, evaluates Maciel.
Company must industrialize skin
With the end of studies on burns by the UFC, the offer of treatment to volunteer patients was also suspended at the IJF. According to the general coordinator of the research, Edmar Maciel, until the end of the first semester of this year, a tender must be opened that will select the company responsible for the industrialization of the tilapia skin. ” The university is participating in this. And it has several factors. One of them is to evaluate if the company has expertise to be able to produce. It is a negotiation that has been made and I believe that, until the middle of the year, this should happen”.
He points out that commercialization by the company will only occur when the product is released by the National Health Surveillance Agency (Anvisa).
Large-scale production, according to Maciel, aims to make the biological dressing available for treatment in the Unified Health System (THEIR). Above all, low-income people. He estimates that 97% of patients Burn victims have no health insurance. ” The anxiety of all of us, researchers, is that we can, in a quick way, make these products reach the Brazilian public network. Because they will benefit those who need it most. Besides, this will reduce the expenses of SUS itself” .
The commercialization of tilapia skin – previously discarded – as biological dressing it does not tend to lose its economic viability, because “it is the second largest fish in the world. It only loses to carp”, says the coordinator. In addition to having a large amount of type 1 collagen, the skin of the fish became a research bet because the risk of disease transmission in aquatic animals is “much lower”.
13 fun facts about tilapia skin:
1 – In Ceará, the tilapia skins used in the studies were taken from fish from the Castanho and Itarema reservoirs. Nile tilapia is a freshwater fish from captivity, easy to reproduce and abundant in Brazil, especially on the northeastern coast;
2 – In 2017, UFC researchers inaugurated the first animal fur bank in the country. At the moment, the material is designed for exclusive use in research and cannot be sold;
3 – Studies on tilapia skin have already resulted in the development of several products such as skin in glycerol (or glycerin), lyophilized (dehydrated) skin, dermal matrix and collagen extraction;
4 – Samples of lyophilized skin and dermal matrix were sent into space by the North American Space Agency (NASA) on two occasions. The biological material has been tested for possible use as a dressing in space missions;
5 – The skin has already been used in an unprecedented procedure for vaginal reconstruction of a transsexual woman, in São Paulo;
6 – In Ceará, vaginal reconstruction surgeries with the fish membrane have already been performed in women with Rokitansky syndrome, vaginal agenesis or pelvic cancer;
7 – More than 50 animals were benefited in various projects and in the missions carried out in fires that occurred in Pantanal (MT) and Uberaba (MG);
8 – The fish’s skin was also used to cure burns of bears that were victims of forest fires, in 2018, in California (USA). The application is already developed on dogs, cats and horses;
9 – Tilapia skin research today involves 242 researchers from Brazil, Colombia, Argentina, Ecuador, Guatemala, United States, Germany and the Netherlands. In Brazil, studies are already done in Ceará, São Paulo, Rio de Janeiro, Rio Grande do Sul, Goiás, Paraná, Pernambuco and Minas Gerais.
10 – The skin is the object of study in undergraduate, master, doctoral and postdoctoral studies in several countries around the world, adding up to 65 research projects and 25 published scientific articles;
11 – The research was already mentioned in the North American TV series “Grey’s Anatomy”, ” The Good Doctor”, ” The Resident” and “Vampires”;
12 – More than 700 journalistic articles about the research have already been published, in 17 languages, in more than 70 countries;
13 – The clinical application of the skin earned researchers 16 awards in the first place, granted in Brazil and abroad.