Debridement

Ron Sherman's picture

by Ron Sherman MD, MSC, DTM&H and Lynn Wang, BA

William Shakespeare wrote: "That which we call a rose, by any other name, would smell as sweet" (Romeo and Juliet, Act 2, Scene 2). William Baer reportedly said the same thing when asked why he used the name "maggot therapy" to describe the use of fly larvae (maggots) to treat osteomyelitis and soft tissue wounds.

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Ron Sherman's picture

by Ron Sherman MD, MSC, DTM&H and Lynn Wang, BA

Warning: Information ahead. Read responsibly. Consume with caution.

In this age of information technology, we all have ready access to an abundance of information and data. But not all the "facts" are true, and some of what is true might be skewed to support an author's agenda. I was reminded of this while reading the Wikipedia entry for "Maggot Therapy."

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Aletha Tippett MD's picture

by Aletha Tippett MD

Once the individual has been thoroughly assessed for palliative care and his or her objectives and needs have been discussed, the wound care provider must determine the wound management strategy to follow. This strategy will depend upon the type of wound being treated for palliation. A summary of each type of wound and an appropriate palliative strategy are listed below, including factors such as removal of the wound cause, pain and drainage management, and odor control:

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Ron Sherman's picture

by Ron Sherman MD, MSC, DTM&H

Like Rodney Dangerfield, maggot therapy sometimes gets no respect. Take, for example, the following comment which appeared on the WoundSource Facebook page, in response to a post by the publication’s editors about my blog discussing palliative maggot therapy use on a necrotic tumor.

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Aletha Tippett MD's picture

by Aletha Tippett MD

Does wound care need to be expensive? In the U.S. over a billion dollars per year is spent on wound care. When dealing on an individual basis, the cost of treating a pressure ulcer, our most common type of wound, has been computed to be $1600/patient/month, adjusted for CPI.1 What is driving this trend? It is expensive, high tech equipment such as pressurized beds, vacuum assisted closure, surgical techniques for debridement and skin grafting, and high priced dressings such as some of the foams, alginates and collagen dressings. Additionally, costs are increased when care is ineffective or counter-productive, prolonging the need for care.

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Ron Sherman's picture

by Ron Sherman MD, MSC, DTM&H

This week I was asked about using maggot therapy for treating a tumor that eroded through the skin, causing a foul-smelling, necrotic draining wound. This is not an uncommon question, and it touches upon several important elements of biotherapy, as well as palliative wound care in general. This is also a timely subject because of the upcoming (third) Annual Palliative Wound Care Conference.