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Maggot Debridement Therapy

By Ronald A. Sherman, MD

The year 2019 began with a shadow over the field of biosurgery and a dark cloud over American health care: BioMonde, currently the largest producer of medicinal maggots in the world, just closed its American laboratory. Most famous for its dressing containing medicinal maggots within a net bag (BioBag™), BioMonde has been very profitable in Europe for years, where it operates two busy maggot-producing laboratories (in Wales and Germany). In 2014, with $5 million of dedicated investor funding, BioMonde opened a laboratory in Florida to serve the American market. Despite the popularity of their flagship product, BioMonde's US laboratory never turned a profit. Simply stated, sales were not high enough... but why?

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road blocks to maggot debridement therapy

by Ronald Sherman MD, MSC, DTM&H

Bob Hope and Bing Crosby starred in a series of films called "On the Road" in which the duo traveled around the globe, facing a variety of amusing obstacles and mishaps. Therapists and patients desiring maggot debridement therapy (MDT) for their non-healing wounds often face a variety of obstacles, too... though they may not seem quite as amusing. Let's consider some of these obstacles and examine ways to avoid or mitigate them.

We can organize the most likely obstacles chronologically:

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perspective

by Ron Sherman MD, MSC, DTM&H

Several months back, I suggested that we could better understand our patients' actions (for example, why patients do not adhere to their treatment plans) by looking at the situation from the patient's perspective. What I failed to discuss – largely because it is a topic worthy of its own discussion – is the fact that one of the best ways we can see the world from someone else's perspective is to ask that person to share their view with us.

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by Deboshree Roy, MSC and Ron Sherman MD, MSC, DTM&H

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by Ron Sherman MD, MSC, DTM&H

The Primary Issues with Systematic Reviews

My contribution to this column is very much overdue. Among other things, I have spent much of my time this past 12 months preparing to write my first "systematic review." The experience has been both illuminating and frustrating, and I am now feeling both respect for the art, and grief over its gross inadequacies.

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