Study led by WVU professor Dr. John Nguyen finds alternative source for periocular skin grafts

Study led by WVU professor Dr. John Nguyen finds alternative source for periocular skin grafts

A new study led by West Virginia University Department of Ophthalmology and Visual Sciences professor John Nguyen, M.D., could provide patients with a less invasive alternative to periocular skin grafts.

Dr. Nguyen’s study examined the outcomes of utilizing decellularized fish skin for periocular repair on patients who had skin removed following skin cancer treatment. Nguyen explained that decellularized fish skin is skin tissue taken from a fish host that has undergone biomedical engineering to be used in artificial tissue regeneration processes such as skin grafts.  He said that having additional options for traditional skin graft alternatives will widely benefit patients, as well as ophthalmic plastic surgeons as a whole.

“The addition of decellularized fish skin as an alternative source of tissue for periocular reconstruction further expands the surgical armamentarium for surgeons, while simultaneously providing a less invasive option for our patients,” Nguyen said.

Specifically, his study examined the use of decellularized fish skin in periocular skin grafts following a procedure known as Mohs surgery, performed by Vlad Codrea, M.D., Ph.D., an assistant professor and the director of Mohs microscopic surgery and dermatologic oncology for the Department of Dermatology. Dr. Codrea explained that Mohs surgery is a highly specialized technique for treating skin cancer that involves the surgical removal of thin layers of skin one layer at a time. The layers of skin are then examined under a microscope to determine if the presence of any cancer remains.

Nguyen said the repair of the areas where the skin was removed during Mohs surgery typically requires the patient to either undergo an autologous skin graft or the presence of an allogenic skin donation from a separate patient. He explained that autologous skin grafts require skin to be transported from one area of the patient’s body to another, while an allogeneic skin graft requires a separate patient to have skin removed and donated to the host. He added that both of these options are considered rather invasive, which is where the concept of xenografts comes into play.

A xenograft involves the transplantation of animal skin and can be a common practice due to the invasive nature of harvesting one’s skin or the availability of donated human skin tissue, according to Nguyen. Nguyen’s study explored the application of a new potential source of tissue for xenografts, decellularized fish skin, on four patients who recently underwent Mohs surgery. At the conclusion of the pilot study, all four of the xenografts were completed successfully and no post-operative complications were observed.

Nguyen served as the principal investigator for this project, which was conducted by various WVU Health Sciences team members. The research was also assisted by students and residents, including 2023 M.D. graduate Omar Sadat, M.D., who is now a first-year resident in the Department of Ophthalmology and Visual Sciences Residency Program at WVU and Janice Hernandez, M.D., a third-year resident in the Department of Ophthalmology Residency Program at George Washington University.

Sadat worked alongside Nguyen primarily in the areas of data gathering and manuscript preparation. Additionally, Nguyen presented the findings from his study at the American Society of Ophthalmic Plastic and Reconstructive Surgery Spring Scientific Symposium in Quebec, Canada on June 23.

To learn more about the research opportunities within the Department of Ophthalmology and Visual Sciences, visit