Maggot Debridement Therapy

Temple University School of Podiatric Medicine's picture

By 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
Leflap maggot dressing in action

By Ron Sherman MD, MSC, DTM&H

I have been avoiding the topic of addressing the differences between contained (bagged) versus confined (non-bagged or "free-range") maggot therapy because I haven't wanted to take a position in affairs that affect specific companies' products. In addition, I have a conflict of interest in that I run a laboratory that produces one type of dressing and not the other. Nevertheless, I have been dragged involuntarily into this conversation by the hoards of people who ask me about the data and information surrounding the application of maggots in containment bags. Indeed, I may even have an obligation to share my thoughts, given my role in the maggot therapy movement, and given that I have experience in testing and using both techniques. So with that understanding, let's begin by exploring the maggot dressing options currently available. The terminology can be a bit confusing so we should begin there.

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Laurie Swezey's picture
wound care 101 - wound debridement

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

There are four main types of debridement: mechanical, autolytic, enzymatic, and surgical. Each has its own advantages and disadvantages. Let’s take a look at each method individually:

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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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Michel Hermans's picture
google contact lens

By Michel H.E. Hermans, MD

The 2014 SAWC Fall conference took place in October in Las Vegas. As always, it was good to see colleagues, share thoughts and stories, stroll through the exhibition areas and attend the lectures. As usual, the meeting was well organized although given the size of the Vegas hotels, reaching it—even from your room within the conference hotel itself—provided enough walking exercise for a week.

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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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Aletha Tippett MD's picture

By Aletha Tippett MD

There was an inquiry a couple months ago for a blog about biotherapy. Biotherapy refers to the use of animals for treatment and therapy for humans. This is a topic of great interest to me and I hope to others. When I was preparing to do maggot therapy on a patient the other week she asked me if I watched Wild Kingdom. I told her no, I live Wild Kingdom. We laughed, but that is somewhat true. I use maggots and leeches routinely and have for ten or more years.

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Ron Sherman's picture

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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Aletha Tippett MD's picture

By Aletha Tippett MD

Understanding Pathergy and Pyoderma Gangrenosum

Pathergy is an aberration of the skin’s innate reactivity from a homeostatic reactive mode closely coupled to tissue healing to an abnormal destructive/inflammatory mode. Pathergy is not well understood and the cause is unknown. It is a diagnostic criteria for Behcet's disease and there is even a Skin Pathergy Test to help with diagnosis. Pathergy has also been reported in Sweet’s syndrome and it is a hallmark of pyoderma gangrenosum.

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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