Biotherapy

James McGuire's picture
Frequently Asked Questions

By James McGuire, DPM, PT, LPed, FAPWHc

In my recent WoundSource webinar, I discussed the topic of debridement strategies and chronic wounds. The webinar is still available for viewing on WoundSource.com. Wound debridement is the foundation for healing in chronic wounds. Excessive debridement is a detriment to healing, whereas proper removal of accumulated non-viable tissue or foreign material from the wound bed maintains a healthy progressive healing trajectory and avoids wound chronicity.

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Ron Sherman's picture
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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Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

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Ron Sherman's picture
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.

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Aletha Tippett MD's picture
Leech Therapy

By Aletha Tippett MD

People from across the country call or email me asking about using leeches for a loved one. Usually, I tell them to try to find someone close to them to administer therapy. Often, the problem is not something a leech could help. I have written about leech therapy before, but maybe it’s time to review how leeches can be used in wound management.

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Aletha Tippett MD's picture
medical leech therapy

By Aletha Tippett MD

Sometimes when we think back on the things that have we have done for a patient it gives us a feeling of great satisfaction. Sometimes, however, these past reflections give us feelings of sadness and futility.

Ron Sherman's picture
determining when to use contained maggot therapy

By Ronald Sherman MD, MSC, DTM&H

In a previous post, we learned that all clinical studies to date and all but one laboratory study indicate that contained ("bagged") maggots are effective in wound debridement, but less so than "free-range" (or "non-bagged") larvae. Why, then, are they used? What are the attributes of contained maggots that make them worth sacrificing the efficacy and efficiency of conventional "free-range" maggots?

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Aletha Tippett MD's picture
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medicinal leeches

By Aletha Tippett MD

I have written about biotherapy in the past, primarily about maggot therapy, but today I would like to discuss leech therapy. In the U.S., leeches are used frequently by plastic surgeons to save a surgical flap that is in danger of dying. Leeches in the U.S. are provided by Leeches USA and they keep leeches ready at the New York airport to ship out in an emergency 24/7. The leeches used actually come from France and are FDA approved. Monarch Labs in the U.S. is working to develop a U.S. leech, but has a ways to go to get FDA approval.

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Aletha Tippett MD's picture
Maggots

By Aletha Tippett MD

Recently I had a discussion with several other physicians and a topic that came up was why maggots were not more widely received. I was not aware that maggots were not widely received since I have used them regularly for 15 years. So, the question is, why not use maggots?

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Ron Sherman's picture

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

Most wound care therapists are well acquainted with the benefits of maggot debridement therapy (MDT) by now, but may not be as informed about its adverse events. As an intern with the BTER Foundation, one of my projects was to review records of adverse events and potential complications by examining data from published studies, regulatory documents, and the quality control files shared by one producer of medicinal maggots, Monarch Labs (Irvine, California). Now nearing the end of my 6-month study, who better to share my discoveries with than the wound care experts that visit the WoundSource blog?

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