Introduction: This study will explore the effectiveness of fish skin grafts (FSG) in ulcer healing in diabetic foot
disease compared to standard of care (SOC).
Methods: The systematic review and meta-analysis were performed following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) standard. The electronic databases of PubMed, EMBASE, and
Web of Science (WoS) internet were searched for the outcome rate of complete ulcer healing. The risk of bias
assessment was conducted using the tool recommended by the Cochrane Collaboration. Statistical analysis
included the individual and combined result of the studies, heterogeneity test, the effect size, sensitivity analysis,
and publication bias tests.
Results: Five randomised controlled trials (RCTs) with a total of 411 patients were included in this study. This
meta-analysis showed a higher rate of complete ulcer healing in groups receiving fish skin grafts (OR = 3.34,
95% CI 2.14–5.20, p < 0.01, I
2 = 0%) compared to control groups.
Conclusion: Fish skin grafts have been shown to be more effective for achieving complete ulcer healing compared
to current conventional treatments in diabetic foot disease.
