“Keep learning and great ideas will follow”

Fertram Sigurjonsson explains that his invention utilizes skin from fish that live in the freezing-cold waters around Iceland. Viruses in the skin and tissues from animals living in warmer climates can be transferred to humans, so heavy processing is required before these can be used in medical applications. In contrast, viruses present in cold-water fish become inactive at room temperature which allows the fish skin used by Kerecis to be processed gently. This gentler processing preserves the natural structure and the natural composition of the fish skin, which is why the product performs better in medical applications than highly processed tissues from other types of animals, describes Sigurjonsson.

“I like to believe that we have prevented amputations on hundreds of people because fish skin closes wounds faster than any other products,” he says.

Connecting experiences

Sigurjonsson says that the idea of using fish skin for wound healing essentially came from connecting his experience as a youngster in the fishing village of Isafjordur, in the northwest of Iceland, 20 miles south of the Arctic Circle, with the expertise he acquired in the medtech industry.

“As a boy, I worked in a fish factory and on a fishing boat during summer vacations. After finishing my studies I worked in the medtech industry, including prosthetics and amputation prevention. In 2007, I had the opportunity to set up as a consultant and it was between 2007 and 2010 that I realized that human skin and fish skin share similarities. This led to the innovative idea of using fish skin for medical applications,” he says.

It was a great feeling and meant a lot after years of hard work. It felt like a huge compliment. When you’re deeply involved in something, working hard, you don’t always notice the progress.

Sigurjonsson has also been nominated as a finalist in the European Inventor Award this year.

“It was a great feeling and meant a lot after years of hard work. It felt like a huge compliment. When you’re deeply involved in something, working hard, you don’t always notice the progress. This was a realization that things were going well,” he reveals and adds, “A success like this can only happen thanks to the contribution of many people. During the initial years of Kerecis I was very fortunate to be able to build a strong team that included many talented people who I had worked with over the years in prior jobs.”

How fish skin helps in skin healing

There is a key element in the manufacturing of the patented fish skin process; gentle cleaning and then removal of all the fish cells from the skin without causing damage. Human skin is primarily made up of fats, proteins, glycans, elastins, and a small number of cells, and fish skin has a similar composition.

This process gently cleans the skin and removes the fish cells from the skin, leaving behind tiny holes where the cells once were. Additionally, the scales are removed, and the product is sterilized before it is provided to doctors.

When treating a patient with a large wound, the doctor first cleans the wound and removes all dead tissue from the wound bed. The doctor then places the fish skin into the wound and covers it with a wound dressing. The healthy cells from the wound perimeter start to migrate into the fish skin, seeking to re-occupy the small holes left by the fish cells removed in the manufacturing process. Over time, the fish skin breaks down and is replaced by human tissue, ultimately becoming part of the patient’s own skin.

Kerecis’ journey and growth

Sigurjonsson began his career in the medtech industry at a prosthetics company. He describes that initially he thought limb loss was due to accidents, but quickly learned it was mostly required due to chronic wounds related to diabetes and other diseases.

“This insight turned into a strong interest in wound care and amputation prevention that still drives me today,” he says.

Transitioning Kerecis from a research and development (R&D) company in Iceland, a small market with only 300,000 people, to a sales and marketing company focused on the US was challenging.

After working at several medtech companies he founded his own business, initially as a consulting firm. In 2010 his focus shifted to the fish-skin technology, which received FDA approval in 2014. By 2016, Kerecis began selling its products on the US market, where thousands of patients have since been treated. The US market was chosen as the primary market due to its severe diabetes epidemic at the time, which had resulted in high rates of amputations and chronic wounds, describes Sigurjonsson.

“Transitioning Kerecis from a research and development (R&D) company in Iceland, a small market with only 300,000 people, to a sales and marketing company focused on the US was challenging. It required stepping out of our comfort zone, shifting from R&D to engaging directly with doctors, buyers, and procurement departments, and hiring salespeople with a different mindset. However, this strategic decision to focus on the US market was crucial to our success,” he says.

In 2023 Kerecis was named one of Europe’s fastest growing companies by the Financial Times. The firm’s revenue in its first year was USD 400,000, but by last year it had grown to over USD 100 million. The company was sold last year for USD 1.3 billion to the Danish firm Coloplast, making Kerecis one of Iceland’s first unicorns (a company valued at over a billion dollars).

From Isafjordur to global standard

“Now, as part of Coloplast, a company with 20,000 employees operating in 140 countries, we can think bigger,” says Fertram.

“My dream, and the mission of Kerecis, is to see the fish skin from Isafjordur available in all the 140 markets that Coloplast serves and becoming the global standard of care for severe life-threatening wounds,” he reveals. 

Kerecis received the President of Iceland Export Award 2024 for its outstanding results on international markets and the company won the Nordic ScaleUp Award last year.

“Startups face a difficult shift when transitioning from R&D to sales and marketing and this award highlights companies that are successful in making this leap, emphasizing the importance of bringing innovative products to the market,” concludes Sigurjonsson.

About the author

Paula Pérez González-Anguiano, M.Sc. in Scientific, Medical and Environmental Communication, is a Science Journalist and Illustrator based in Barcelona, Spain.