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Art Bicnick

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If you’ve flown through Keflavík Airport lately, you might have noticed that it’s always changing — shops are constantly being shuffled around and construction never seems to end. But for years, one thing that remained unchanged was a long ad of a man holding a baby that said in bold, “Someday I will tell my grandson the story / how Icelandic fish skin saved my life.”

Recently, the man was replaced by an eagle, also saved by the same miraculous fish skin, but the company behind the ad stayed the same. “We signed the agreement for that billboard during Covid. It’s very cheap to keep that,” Fertram Sigurjónsson tells me matter-of-factly, as if money were an issue.

Fertram is the founder and CEO of Kerecis, a medical device company that develops wound-healing products made from sustainably sourced fish skin. Just last week, it was announced that this autumn Kerecis will pay a lump sum of 40 billion ISK [290 million USD] in tax to the Icelandic treasury, effectively turning a projected government deficit into a surplus. The tax comes from the 2023 1.3 billion USD deal in which Kerecis was acquired by Danish healthcare giant Coloplast.

I’d walked past that airport ad dozens of times, but a few weeks ago, I finally sat down with Fertram to ask what had prompted him to look at cod. 

Nobody thought of the fish

The story of Kerecis actually begins earlier, with another Icelandic success story: Össur, one of the world’s leading prosthetics companies. That’s where Fertam, a chemist from the Westfjords, began his career in medtech in the early 2000s. It was also there that he first confronted the grim reality of diabetic amputation.

“There are about 100,000 Europeans that get amputated every year because of diabetic wounds, 100,000 Americans, probably 500,000 around the world,” Fertram says. “I always thought that prosthetics were being fitted on people who had a motorbike accident or something like that, but I quickly found out that people were being amputated because a chronic wound wasn’t healing and was getting bigger and bigger.”

Fertram carried the tragedy behind every amputation with him through his career. After working at several other medtech companies, he established himself as a consultant in 2007, advising other companies in innovation and product management.

“In my naivete, I thought that people all around the world would be waiting for the fish skin. That was not exactly the case.”

Around the same time, new wound-healing products began appearing on the market, developed from amniotic membranes donated after childbirth, as well as cadaver and pig skin (the latter two carrying a risk of disease transmission). Fertram thought back to his youth in the Westfjords and the fish processing factory he used to work at. 

“There was always a big pile of scales underneath the deskinning machine,” he recalls. “I was thinking about if I could use the scales, but then the idea transitioned to just using the fish skin.” 

The first breakthrough came when Fertram realised how similar fish skin is to human skin. “I found out that fish skin is identical to human skin — it has an epidermis, a dermis and connective tissue. These are all the same types of cells and chemicals, elastins, glycans, soluble collagens, insoluble collagens and fats. But fish looks so different that I and everybody else had never really made the connection that the similarity of the fish skin to human skin could actually be utilised.”

That’s how the foundation of Kerecis was born. In 2010, the company’s focus shifted from consultancy to product development. With a few former colleagues, a patent lawyer, and two medical doctors, it took Fertram four years to ready the product he now proudly displays on the table.

Photo by Art Bicnick

From trash to treatment

So what exactly does Kerecis offer? Do they just transplant fish skin onto humans and hope for the best? The reality is a bit more complicated. 

“There are sporadic fish cells in the tissue, and within the fish cells, there’s fish DNA,” Fertram explains. “So if you take just a fresh fish skin and put it into a wound, you’re going to get an allergic reaction.”

The company spent years developing methods to remove fish cells from the skin without damaging its three-dimensional structure, creating an intact graft. It took two attempts to get FDA approval, a period when funds were running out, and everyone, including Fertram, had to find new jobs. They pressed on because Fertram was convinced from the start Kerecis was onto building a product that could save — and improve — lives.  

Every morning, Kerecis collects a few thousand leftover cod skins from a fish factory in Ísafjörður. While the factory would typically just dispose of them, because Kereris interferes with the factory’s usual processes, “We pay them a little,” Fertram says. The oldest fish are normally processed first, but Kerecis needs fresh ones, since there’s a lesser risk of bacteria. 

The first step is removing the scales from the fish. This is done by hand in a clean room with purified air. Once descaled, the fish is submerged in a special saline solution, which causes the cells — including the fish cells — to swell and burst. The skin is then washed in clean water, flushing out the fish DNA, before being dried in a special steel chamber that sucks out the water molecules without using heat. Finally, the product is packed for sterilisation — the only step not currently done in Iceland. There are just a few medical-device sterilisation contractors in the world, and Kerecis currently sterilises its products in the U.K. and the U.S. 

“You never remove our material that goes in the wound. It becomes your own body.”

The finished product looks basically like a band-aid — a thin, flexible white sheet that is nothing like the fish it once was. When a doctor applies the fish skin graft to a prepared wound, the body’s own cells migrate into the holes in the dressing. They don’t recognise it as foreign; they see a scaffold full of holes that used to be populated by fish cells but have been removed. The body’s cells move into these tiny holes, gradually filling and reinforcing them with new tissue.

“Over time, the fish skin is replaced by normal human tissue,” Fertram explains. “You never remove our material that goes in the wound. It becomes your own body.”

A billion-dollar catch 

“In my naivete, I thought that people all around the world would be waiting for the fish skin. That was not exactly the case,” Fertram admits. 

In reality, when Kerecis finally got FDA approval, hospitals weren’t lining up to buy the product. In 2015, the company shifted from R&D to commercialisation, moved sales and marketing to the U.S. and focused on convincing sceptical doctors that the product was effective and completely safe. They found early adopters in the U.S., and that same year Kerecis secured Medicare reimbursement approval, opening the product to a vast majority of the American elderly population.

By 2022, Kerecis had reached 100 million USD in revenue and was approaching profitability. This caught the attention of KIRKBI, the holding company behind the LEGO group. KIRKBI led a 100 million USD investment round that valued Kerecis at 650 million USD.

At that point, there were about 200 shareholders in the company. Once the news about the KIRKBI investment got out, many started doing Excel calculations and wanted to convert their shares into cash — they wanted out. “There are two ways of creating liquidity for shareholders,” Fertram says. “You can either list the company or you can sell it.”

When a formal inquiry came from Coloplast, one of Europe’s largest medical companies, Kerecis wasn’t planning to sell. In fact, it was preparing for an IPO. 

Then a billion-dollar offer landed on Fertram’s desk. 

“We saw in that company that it was a platform to take the fish skin global,” Fertram says. 

Headquartered in Denmark, Coloplast is known for inventing the stoma bag in 1957. Today, the company’s portfolio includes dozens of products — from catheters to wound dressings — that doctors use daily around the world. “Coloplast is a really good company. It has changed the lives of millions of stoma patients all around the world, and it has offices basically everywhere. Everywhere where people have a stoma, you can buy their products,” Fertrams says. “Our mission now, in Kerecis, is to repeat that.”

In 2023, Coloplast acquired Kerecis for a whopping 1.3 billion USD, making it Iceland’s first unicorn. 

Photo by Art Bicnick

Becoming the standard of care

This brings us to today. Nearing three years after its acquisition, Kerecis now produces fish skin grafts in various sizes for different medical needs: wound management, surgical success, burn management, and animal care. They have 700 employees globally, including 150 in Iceland, direct sales in over 20 countries, and success stories from around the globe. Expansion and helping more people in need remain top priorities. 

Beyond being one of Iceland’s most successful and most innovative companies, Kerecis has also built a reputation for rapid response to mass casualty events.

When a fire broke out at a bar in the Alpine resort of Crans-Montana, Switzerland, on New Year’s Day 2026, killing 41 people and injuring 116 others (with 83 being treated for severe burns), Kerecis reacted immediately. Within hours, the company’s two sales representatives in the region, both on Christmas break, had cancelled their plans and drove to hospitals with whatever was in stock.

“We just put everything in overdrive and decided to donate material initially, so the patients could be treated immediately, without negotiating prices or supply,” Fertram says.  

The company’s Swiss inventory, stocked mostly with the smaller sheets used for diabetic wounds, was depleted within days. A burn wound covering a significant portion of the body requires roughly 4,000 times more material than a typical diabetic wound. Kerecis put its Ísafjörður operatios into emergency mode, reconfiguring production to prioritise the larger grafts burn doctors needeed. When the product was ready to ship, the roads out of the Westfjords were impassable. The Icelandic Coast Guard came to rescue and agreed to transport the product to the U.K. for sterilisation. 

“I’m not sure exactly what the English word for is, but it’s a bit of a special feeling when you sense all this human tragedy — that people are suffering, that parents are losing their children — yet you know that you have an invention or product that can actually help offset that pain a little bit,” Fertram explains. “It gives you a very special feeling, because we control our manufacturing. It’s from the fish in the ocean. Then making decisions to participate and help offset tragedies like that is easy and just comes automatically.”

Kerecis has done this before: supporting burn victims from fires in California, tourists affected by the eruption on White Island in New Zealand, victims from two Nagorno-Karabakh wars, and their ongoing aid to Ukraine.

What the company gains, Fertram says, is straightforward: impact. “We have an impact on people that are suffering,” he explains — improving not only patient survivability but the quality of recovery itself, with less scarring and faster healing. It also strengthens the connection with the doctors treating these patients. 

“Fortunately, severe burns are not very common around the world,” Fertram adds. “There are maybe three or four hundred doctors all around the world that specialise in burns, and by donating and making our material available in incidents like this now it starts to become the standard of care. That’s, of course, what we want. We want the fish skin from Ísafjörður to become the standard of care around the world.”