Tilapia Skin in Burn Injuries: A Narrative Review of Pathophysiology, Current Management, and Therapeutic Applications

Burn wounds are common worldwide and often require prolonged treatment and recovery time. Such injuries are associated with local and systemic changes, both of which require effective action to prevent deterioration and improve long-term outcomes. The most common division of burns is based on injury depth. Treatment differs depending on the extent of the injury. The social and financial burden of burns is heavy, with some survivors being excluded from society. Due to high treatment costs and restricted availability of some management options, patients in low-resource settings may not receive the most advanced care. Therefore, new cost-effective and easily accessible management options are desired to improve clinical outcomes and provide an alternative to traditional methods. Nile tilapia skin showed promising results in burn wound treatment in preclinical and clinical studies. Unique antimicrobial, anti-inflammatory, and molecular properties of tilapia skin, combined with a structure similar to human cutis, are associated with enhanced wound healing and faster re-epithelialization. In animals, tilapia skin showed promising results in wound healing of various depths. In humans, superficial partial-thickness burns were mostly examined. In comparison to conservative management, patients treated with tilapia skin experienced lower pain intensity, required fewer dressing changes, and decreased analgesic intake. Re-epithelialization was faster. Advantages over traditional methods include a lack of local adverse reactions, low infection risk, reduced pain, cost-effectiveness, ease in tilapia skin acquisition, and application. Clinical studies restricted to a small number of participants and a lack of research on humans in various burn depths limit the broader employment of tilapia skin. Data on long-term outcomes are scarce; therefore, more studies need to be performed in that area to create clear guidelines and standardized treatment protocols. However, the beneficial effects of tilapia skin on wound healing are very promising and have high potential for development. In the future, it might become a cornerstone of burn injury treatment and improve clinical outcomes, particularly in low-resource settings.