Patient walking on a pier

News | one year ago

A New Tool to Prevent Unnecessary Amputations: Fish Skin (Really)

This creative technique has saved limbs of soldiers on the battlefield and now patients in Charlotte can experience its benefits. Using fish skin to promote wound recovery prevents unnecessary amputations and Atrium Health Sanger Heart & Vascular Institute is a national leader.

Chris Cawley was on an Alaskan cruise with his wife, Debbie, when he suffered a foot infection that deteriorated rapidly. He was quickly rushed to a nearby hospital in Seattle, where he had to undergo a foot amputation.

Chris’ recovery did not go as smoothly as expected. Due to complications, he was facing another amputation above the knee – which typically requires more challenging prosthetics. To seek another option that might prevent an amputation higher on his leg, the Seattle hospital referred Chris to Dr. Hector Crespo Soto, a vascular surgeon at Atrium Health Sanger Heart & Vascular Institute. Crespo Soto was the first doctor in the world to use an innovative tool in a commercial setting that could prevent unnecessary amputations. That tool? The North Atlantic cod. (Yes, the fish.)

“Dr. Crespo Soto took one look at my leg and said, ‘I think we can save it below the knee. I’ve got this thing called cod.’ And I looked at him and said, ‘What are you talking about?’” Chris recalls with a laugh. “That’s how Dr. Crespo Soto saved my leg under the knee.”

A Leader in Preventing Amputations

The idea is as surprising as it is revolutionary: Fish skin can help wounded human tissue regenerate and heal. Crespo Soto first used it in a commercial setting in 2019. Now, Atrium Health doctors have used the new technology on about 300 patients, including those with chronic ischemic ulcers and diabetic foot alterations. Hundreds of Sanger Heart & Vascular Institute patients have avoided amputations, thanks to the skin of North Atlantic cod.

“Our team at Sanger Heart & Vascular Institute has created the standards to teach other physicians and wound care doctors how to use this technology to treat their patients,” Crespo Soto says. “Sanger Heart & Vascular Institute is at the front end of the use of this technology.”

This isn’t the first time Atrium Health introduced the latest innovations to help patients avoid amputation. With each adoption of new technologies, the limb salvage program has become one of the best in the country. Since it began in 2012, this program at Atrium Health has saved 150% more limbs, including for patients who had been referred for amputation.

How it Works

Surgeons place fish skin on top of the patient’s wound to form a kind of scaffolding. This allows the tissue underneath to receive the oxygenation and nutrition needed to heal the human tissue. For patients who have wounds that aren’t healing well, fish skin can prevent an amputation. For those who’ve had previous amputations that haven’t healed fully, this can prevent a re-amputation to an upper level.

“The product is intended for implantation to reinforce soft tissue where weakness exists, such as in patients requiring soft tissue repair or reinforcement in plastic or reconstructive surgery,” Crespo Soto says.

Adapting Leading-Edge Military Techniques for Civilian Patients

Crespo Soto used this technology before coming to Atrium Health. He served as a surgeon in the military, deploying to Afghanistan in 2013. There, Crespo Soto used fish skin to treat soldiers who had been wounded or burned on the battlefield, helping to save their limbs from amputation. As soon as the FDA approved the use of fish skin for civilian use, Crespo Soto brought this technology to Sanger Heart & Vascular Institute.

This isn’t the first time a former military surgeon introduced military technology to Atrium Health patients. Dr. Joseph Hsu, a former U.S. Army trauma surgeon who is now an orthopedic trauma surgeon and the vice chair of quality at Atrium Health Musculoskeletal Institute, created the Return to Performance Pathway Program at Atrium Health. The program, based on one that helped soldiers recover from limb-threatening injuries and return to the battlefield, now serves civilians here in Charlotte and helps them return to the lives they love.

It's all part of Atrium Health’s commitment to bring the latest proven technologies to patients. The result is that it has become a leader in limb salvage, caring for patients around the Charlotte region as well as around the country.

“Our team takes great effort to care for patients in a holistic fashion, and this technology helps us give patients a better quality of life by allowing wounds to heal faster than the standard of care,” Crespo Soto says.

This holistic care allowed Chris to avoid that second amputation – which changed the trajectory of his life. 

“I was as happy as can be to avoid that next amputation,” Chris says. “I was so grateful that first, I had the doctor that I had. Second, that I had the hospital that I had. And third I had the technology. The combination of those three made this really work.”

Learn more about the innovative vascular medicine offered at Atrium Health Sanger Heart & Vascular Institute.