Axolotl Xenograft Shows Potential in Small Case Series

The use of animal tissue such as fish or frog skin as an adjunct or primary wound treatment has shown encouraging results so far in a number of case studies and series. And at this year’s Symposium on Advance Wound Care (SAWC) Fall, held in Las Vegas, Nevada, a new potential contender was introduced: the salamander.

Specifically, one poster examined xenograft tissue derived from Ambystoma mexicanum, the axolotl, in the context of patients who had undergone metatarsal amputation as a result of osteomyelitis. These amphibians are unique for both their presentation of neoteny (that is, maintaining juvenile features even once reaching sexual maturity) and their extensive healing capabilities—axolotl have been known to regenerate everything from lost tails or eyes to limbs and even portions of their brains, which has understandably made them a subject of great medical interest.

In this poster, the authors retrospectively reviewed the medical records for 3 patients with diabetes. All 3 patients developed infections that resulted in osteomyelitis and eventually metatarsal amputation.

After their amputations, the patients had axolotl dermis patches placed on the amputation site, which resulted in complete wound closure for all 3 patients. These results are particularly encouraging in light of the comorbidities the poster’s authors noted: 2 patients had type 2 diabetes while the third had type 1 diabetes, 2 patients had peripheral neuropathy, and 2 patients had renal failure. Despite this, all of the wounds treated with the xenograft dermis patches achieved closure and did not reopen in 3 months of follow-up.

Equally impressive is the fact that the axolotl patches succeeded where negative pressure wound therapy (NPWT) did not—one patient had their amputation wound treated with “a wound vacuum” for 2 months while another underwent NPWT for 7 weeks, and neither achieved wound closure.

All patients achieved wound closure within 9 to 12 weeks. As noted in the poster, patient 1, whose wound size measured 4.0 cm x 3.8 cm x 4 cm, required 7 patch applications and saw 20% closure by week 1, 36% by week 2, and 100% wound closure by week 10. Patient 2 (wound size: 0.5 cm x 1.2 cm x 0.5 cm) required 7 applications, demonstrating 25% wound closure by week 1, 85% by week 3, and 100% wound closure by week 9. Patient 3 required 6 patch applications and saw 35% closure at week 1, 96% by week 9, and 100% wound closure by week 12.

Given the encouraging results, the poster’s authors are advocating for additional clinical evaluation of this xenograft alternative in wound management.

-Wounds editorial staff

Poster Reference: Initial Observational Evaluation Using Naturally Neotenic Salamanders Ambystoma Mexicanum as Clinical Device for Wound Management of Toe Amputations Resulting from Osteomyelitis. Poster presented at Symposium on Advanced Wound Care Fall; October 2-5, 2024; Las Vegas, NV.