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Medical fish skin pioneer aims to speed mastectomy recovery
Fish skin could be used to improve post-mastectomy breast reconstruction procedures
Iceland’s first billion-dollar ‘unicorn’ – which harnesses fish skin to treat wounds and burns – is now aiming to help women recovering from mastectomies.
Kerecis has disrupted the global market for wound, burn and trauma treatment in the last decade, thanks to a biproduct of one of Iceland’s biggest exports.
It utilises North-Atlantic cod skins to create a natural graft material that enables cellular therapy, tissue regeneration and protection.
Last year it became Iceland’s first unicorn after the Danish healthcare products multinational Coloplast acquired it for US$1.3bn.
To date its focus has been limited to chronic, acute and surgical wounds, burns and trauma. This is supported by growing body of clinical evidence for faster wound healing via its products.
But speaking to Femtech World in Reykjavik, CEO and founder Fertram Sigurjonsson reveals that the company’s research and development team is now working on applying fish skin to improve post-mastectomy breast reconstruction procedures.
“We have three avenues for growth,” he says. “The first is geographical expansion, and we will do that through the [parent] company. The second is to expand within the business we are already in, which is chronic wounds, burns and surgical wounds; so more features and products.
“The third avenue for expansion is new indications, including breast reconstruction.
“When women lose breasts after a mastectomy for cancer, there is a pocket that is put into the chest, stapled into the muscles. You can then put a silicone implant into the pocket. The silicone implant is heavy and so there is a sling that keeps the breast elevated normally. This sling is made of plastic. This means the woman has two foreign bodies, plastic and silicone.
“We are developing the use of fish skin as a sling that will keep the breast elevated over half a year to a year. This skin will eventually be replaced by the woman’s own tissues when they are strong enough to keep the breast elevated.”
Sigurjonsson says being part of a publicly listed company prevents him from sharing when the innovation may be available to women undergoing mastectomies; he also admits that a long road awaits in terms of building evidence and clinical data needed to reach that goal.
With Kerecis spending 10 to 15 per cent of revenue on research and development, including via investigations into hernia and ligament repair solutions, it is clearly committed to broadening the reach of medical fish skin to help more patients globally.
Sigurjonsson says: “We need new research, new trials and new regulatory submissions. Of course, now we are part of a bigger company and we have more money, this becomes more realistic.”
Bringing new medical applications to the fore is a notoriously cost-intensive, long-haul journey that requires patience among investors and shareholders; and an abundance of research funding.
Given the bright business outlook for Kerecis, however, the company seems to have these fundamentals in place as it looks to realise its mastectomy hypothesis and other new applications.
“I’ve raised money from shareholders four times and [each time] I was able to provide them a very good return on their investment,” says Sigurjonsson.
“We have very good market access in the United States, with 600 employees [there] and we are by far the fastest growing wound care company in the US.
“We are continuing to operate the Swiss unit and we are treating thousands of people every day with our products
“Coloplast has operations in 140 countries. I have the ability to work with them and over the next decade, make my invention from my hometown a global product around the world.”
Kerecis was conceived after a journey of discovery for Sigurjonsson as he sought a new and improved approach to wound care.
“I was an employee in several medtech companies and then came back to Iceland and had an opportunity to found Kerecis.
“I’m a specialist in wounds and wound treatment. Wounds are a huge global problem. People get diabetes, then lose the sensation their legs. They get a small wound and sometimes the wounds get bigger and bigger because of bad blood circulation in diabetics. Half a million people [every year] will have an amputation [in their lower extremities because of this].
“There are three generations of wound treatment products. Firstly gauzes, which keep the wound very dry. This is not very good for cells because they need to proliferate and need moisture and humidity. The second generation, emerging in the 50s, was moist wound dressings. Then in the first decade of this century, the third generation emerged, which is biologic material from animals or humans.”
The origins of such products developed to date include pigs and human foetal sacs.
Through fish, Sigurjonsson took this product class into entirely new territory.
“I came back here looking for a new project that inspired me, with a material that Iceland has a lot of. Of course we have fish all around the country, we have small fishing towns everywhere and there is a lot of fish export.
“I started to think about using scales from the fish, but then when I was studying more about the anatomy of fish skin, I found out that it is identical to human skin. You might think that human skin is very different from fish. We used to be fish two million years ago, but actually evolution has focused on the brain, the fingers and the feet. The epidermis, dermis, subcutaneous tissue are identical, except we have developed hairs out of scales.”
Furthermore, because there is no known risk of viral disease transmission, fish skin needs only minimal processing by Kerecis, preserving its structure and components.
“When I discovered these things, the first person I talked to about it, apart from my wife, was a patent attorney.”
Today, the Kerecis product journey starts with fish caught in the North Atlantic, off the township of Isafjordur, on Iceland’s northwest coast. Skins that would otherwise have been thrown away are sent to the company’s processing plant in the same town – where products are made for the rest of Europe, the US and other jurisdictions.
The continued presence of Kerecis in its homeland has helped to draw attention to the country’s growing prowess in health innovation. Sigurjonsson believes its emergence as the country’s first unicorn has also helped to change the mindset of investors.
“Iceland does not have a very developed investor community. Most investments in the past have been in real estate and traditional businesses. Companies on the Icelandic stock exchange have their values based on multiples of EBITDA [earnings before interest, taxes, depreciation, and amortisation].
“There has not been a big history of venture investments in Iceland. But, because people can see others making money now, there is now substantially more investment interest in start-ups.”
Femtech World was speaking to Kerecis CEO and founder Fertram Sigurjonsson at an event organised by Business Iceland on behalf of Reykjavik Science City.
The Scottish government has launched a national review into whether NHS IVF access should be extended to single women.
The review will also consider whether wider access should be offered to couples who have children from previous relationships.
Health secretary Angela Constance said: “Access to NHS IVF treatment should be fair, timely and reflect the way people’s lives and families look today.”
Most single women are not currently eligible for NHS IVF treatment in Scotland.
Campaigners have welcomed the review.
Katie Rollings of Fertility Action said: “It’s an essential and long-awaited decision that will impact a huge number of people who are struggling to grow their families.
She said there is “no evidence” that having two parents rather than one determines whether a child will thrive.
She added: “What matters is whether a child is loved, safe, supported and has stable, positive relationships around them.”
Figures from the Human Fertilisation and Embryology Authority show Scotland is the only UK nation where NHS-funded IVF cycles outnumber privately funded cycles.
In 2024, more than 6,000 cycles of fertility treatment were carried out among more than 4,000 patients in Scotland. Both figures were slightly lower than the record highs recorded in 2022.
The past 20 years have also seen a rise in the number of same-sex female couples and single women receiving fertility treatment.
In 2024, 625 IVF cycles were carried out for women in same-sex couples in Scotland, with more than one third funded by the NHS.
There were 330 cycles involving single women, of which 50 were NHS-funded.
In England, single women can access IVF through the NHS, although eligibility varies according to the local health trust’s policy.
Current Scottish rules state that couples are eligible if they have been living in a stable relationship for two years and neither partner has been sterilised.
Couples where one partner already has a child can be eligible, but those where both partners have children from previous relationships are not.
Eligibility rules also require a body mass index above 18.5 and below 30, and state that couples must not smoke, drink alcohol or take drugs during treatment. The mother must be under 42.
The Scottish government said the review would also examine consistency of access to fertility preservation, including during cancer treatment, as well as reducing waiting times for donor eggs and sperm.
Same-sex female couples already have access to NHS IVF, but they can face long waits for donor eggs or sperm, as can heterosexual couples who require donor treatment.
The National Fertility Group will lead the review and make “costed, demand-modelled recommendations”, which are due to be published by early summer 2027.
The group will include fertility experts from Scotland’s four NHS-assisted conception units in Glasgow, Edinburgh, Aberdeen and Dundee.
Prof Sarah Martins Da Silva, an NHS consultant and chair of fertility medicine at Dundee University, said there were questions to be answered in a resource-stretched NHS.
“As a fertility specialist I’m never going to be disappointed if the criteria is widened,” she said.
“But with single people, as an NHS clinician looking at the competing demands we have, I’d ask the question about whether being single is a health condition that needs to be funded.”
Da Silva said NHS waiting lists were full of couples who require donated eggs or sperm because of medical conditions including cancer and could face longer waits.
“It’s slightly a disservice to them,” she said.
“There would need to be a real investment and resource without making everybody wait an extraordinary long time.
“With the current financial environment we work in, if you’re talking about new money, where would that come from?”
She said she would welcome changes that encouraged more people to donate eggs or sperm and questioned whether arguments about children needing two parents were necessarily relevant to the debate.
“On the one hand bringing up a child is quite an expensive process, and if you don’t have that support, it can be very difficult.
“But on the other hand, many people start off as a couple and divorce.”
Da Silva also welcomed plans for the review to consider eligibility for couples who already have children, describing the move as “fantastic”.
The FDA has granted accelerated approval to AstraZeneca drug Etcamah for certain adults with advanced breast cancer carrying an ESR1 mutation.
Etcamah, also known as camizestrant, was approved in combination with a CDK4/6 inhibitor, either abemaciclib, palbociclib or ribociclib.
The treatment is for adults with hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer when an estrogen receptor-1 (ESR1) mutation is detected during aromatase inhibitor and CDK4/6 inhibitor therapy using an FDA-authorised test.
ESR1 mutations are acquired resistance mutations that tumours may develop during treatment with aromatase inhibitors, a type of endocrine therapy commonly used as a front-line treatment for locally advanced or metastatic breast cancer.
Fewer than 5 per cent of patients have the mutation when HR-positive metastatic breast cancer is diagnosed, according to the FDA. After disease progression on an aromatase inhibitor, nearly 40 per cent have the mutation.
Acting FDA commissioner Kyle Diamantas said: “Women living with metastatic breast cancer face an uphill battle as their tumors continuously evolve to escape treatment.
“We owe them every weapon in our arsenal.
“Today’s approval delivers a win to these patients by granting them a targeted therapy designed specifically to overcome resistance, giving them more time before their disease progresses.”
The accelerated approval programme allows earlier approval of drugs that treat serious conditions and fill an unmet medical need based on surrogate or intermediate endpoints.
For Etcamah, approval was based on how long patients lived without their disease worsening, measured from when the resistance mutation was first detected in their blood.
The FDA said it has not yet been confirmed whether intervening when the mutation is detected, rather than waiting until disease progression is confirmed, results in a clinically meaningful benefit. Confirmatory studies are therefore required to verify and describe clinical benefit.
Angelo de Claro, director of the FDA’s Oncology Center of Excellence, said: “I commend both the FDA and the sponsor for their commitment to advancing cancer care and securing this accelerated approval.
“This marks the first FDA approval of a cancer therapy guided by the detection of a resistance mutation in circulating tumor DNA (ctDNA) before imaging tests show that the disease is progressing.
“But additional evidence is needed to confirm clinical benefit.”
Circulating tumour DNA, or ctDNA, consists of small pieces of tumour DNA released into the blood and can allow earlier molecular detection of resistance mutations.
The FDA also authorised the Guardant360 CDx assay as a companion diagnostic to identify patients with breast cancer who have ESR1 mutations for treatment with camizestrant.
Efficacy was assessed in a clinical trial comparing a switch to Etcamah plus a CDK4/6 inhibitor with continued treatment using an aromatase inhibitor plus a CDK4/6 inhibitor.
Estimated median progression-free survival was 16 months in the Etcamah group, compared with 9.2 months in the aromatase inhibitor group.
Etcamah’s prescribing information includes a boxed warning about the risk of irregular heart rhythm when taken with certain other medicines. It also includes warnings about an abnormally slow heart rate and potential harm to an unborn baby.
The FDA convened its Oncologic Drugs Advisory Committee for the application on 30 April 2026.
Entrepreneur
Last chance to save on Women’s Health Week and Women’s Sport Summit: Early Bird pricing ends 11 September
Early bird pricing for W Group’s two flagship October summits – Women’s Health Week Europe 2026 and Women’s Sport Summit Europe 2026 – closes on 11 September.
Both events take place at Emirates Stadium, London, bringing together founders, investors, corporates, and industry leaders shaping the future of women’s health and sport.
Women’s Health Week Europe 2026
7-8 October | Emirates Stadium, London
This year’s edition will be Women’s Health Week Europe biggest one yet: with 700+ attendees, 80+ speakers, and 20+ sponsors, it will also feature two stages – a Global Stage covering market trends and policy, and a Scale Stage focused on company-level growth and commercialisation. WHW takes place across two days of content, business matchmaking, and dealmaking.
Agenda highlights include:
- Where Capital Flows: Funding Trends in Women’s Health – with Merete Clausen (EIF), Ekaterina Gianelli (Calm/Storm), Henriette Hessen (Verdane), Jemma Day (British Business Bank), Ravit Warsha Dor (Telus Global Ventures), Tim Davis (LSEG)
- Six Feet Under-funded: Surviving the Valley of Death in Women’s Health – with Patric Stenberg (Gesynta Pharma), Valentina Milanova (Daye), Amber Vodegel (28x)
- The Women’s Health Label – Gift or Curse? · Live Debate – with Juan Camilo Arjona Ferreira (organon), Marissa Fayer (DeepLook Medical), Christian Lautner (Heal Capital), Annie Theriault (CBIV), Ida Tin (Clue)
- Passport to Scale: Taking Your Women’s Health Business Global – with Vanessa Carpenter (Femtech Across Borders), Annie Theriault (CBIV), Victorine Lançon (Daya Ventures), Dr Mridula Pore (Peppy)
Early bird pricing (ends 11 September):
| Ticket type | Early bird | Standard |
| Startups, Scaleups, Investors, Non-Profits, Government | £599 + VAT | £699 + VAT |
| Corporates, Payors & Providers | £1,799 + VAT | £1,999 + VAT |
| Service Providers & Consultants | £3,299 + VAT | £3,499 + VAT |
Register for Women’s Health Week Europe | See the full agenda for WHW
Women’s Sport Summit Europe 2026
6 October | Emirates Stadium, London
The first-ever Women’s Sport Summit expands W Group’s expertise in connecting key decision-makers to the sports industry.
WSS brings together rights holders, brands, investors, athletes, and media to accelerate commercial growth across the sector.
Agenda highlights include:
- From capital to crowd: the women’s sport cycle at scale – with Omar Shaikh (Arsenal FC), Nicole McWilliams (Google), Kerstin Lutz (Mercury13), Jo Currie (BBC Sport)
- Women’s sport through the investor lens: what gets funded – and why – Hugo Sever (APEX Capital)
- Rethinking ROI: what are we measuring that doesn’t actually matter? – Fi Watherston (Metro Bank), Silvia Keiser (Billie Jean King Cup), Gabriel Akin-Odujobi (Crux Football), Tammy Parlour (WST)
- Beyond the 90 minutes: matchday as a commercial product, not just a fixture – Maggie Murphy (Aston Villa Women FC), Sam Feasey (Diageo/Guinness), Molly Miller (OneFootball), Megan Feringa (The Athletic/The New York Times)
Early bird pricing (ends 11 September):
| Ticket type | Early bird | Standard |
| General Pass | £299 + VAT | £399 + VAT |
| Service Providers & Consultants | £1,799 + VAT | £1,999 + VAT |
Register for Women’s Sport Summit Europe | See the full agenda for WSS
Attending both events?
For group tickets or to attend both summits this October, contact Callum, W Group’s Client Success Lead, at [email protected].
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