Standardized Algorithm for Peri- and Postoperative Wound Management Using Fish Skin Grafts and Octenidine in Head-Neck Surgery

Background: Complex reconstructions are often required in head and neck tumor resections, especially for wounds after radiation therapy and in areas with exposed bone. This study is the first to evaluate the effectiveness of fish skin grafts (FSG) as a reconstructive option combined with octenidine-based antiseptics, focusing on efficacy, granulation and wound healing. Methods: Six patients with eight defects of different etiology, located on head and neck, received FSGs, Defects ranged from 2x2 cm (endonasal) to 7x6 cm (parietooccipital). Time to granulation were observed, with irradiated and non-irradiated cases analyzed separately. As octenidine already showed beneficial results in split-thickness skin transplantation in high-risk patients, we added this molecule in our treatment regimen. Results: Four patients achieved full granulation of wounds; five defects required additional full-thickness skin grafting. Non-irradiated wounds tend to take less time for granulation (median 14 days) than irradiated wounds ( median 48 days; U = 0.33, p = 0.083). Individuals treated with octenilin® gel showed favourable healing outcomes, including quicker granulation time. Conclusions: Despite the poor prognosis for uncomplicated wound healing in all patients in the study, both treatment protocols — using either Flaminal® forte or octenilin® gel — achieved highly satisfactory results when combined with FSG transplantation. This approach therefore appears to be a promising reconstructive method.