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Increasing the options for management of large and complex chronic wounds with a scalable, closed-system dressing for maggot therapy.
J Burn Care Res. 2012 May-Jun; 33(3):e169-75.JB

Abstract

As reconstructive specialists, burn surgeons are often involved in managing large wounds of various etiologies. Such wounds can pose a management challenge, especially if they are chronic or occur in the setting of critical illness or multiple medical comorbidities. Medical maggots are an effective, selective, and low-risk method for wound debridement. However, their use in large and geometrically complex wounds is limited by the lack of scalability in currently available dressings, which are appropriate for smaller wounds but become cumbersome and ineffective in larger ones. This report describes a novel dressing designed for application of maggot debridement therapy in large and complex wounds. The authors then discuss how use of this dressing may create new management strategies for such wounds by allowing maggots to mechanically debride big, infected wounds. They describe the construction of a maggot containment dressing based on modified components from a negative pressure wound therapy system and provide a case report highlighting its successful clinical use in a large contaminated chronic wound resulting from Fournier's gangrene. In the case described, the novel dressing provided scalability, containment of maggots, control of secretions, and ease of use. The dressing created an environment suitable for maggot survival and allowed effective debridement of a heavily contaminated groin wound. The novel dressing described is shown to function appropriately, allowing controlled use of maggots for effective debridement of large, irregular wounds. Facilitating the use of maggots in such wounds may broaden the algorithm for their management.

Authors+Show Affiliations

Department of Plastic Surgery, Georgetown University Hospital, Washington, DC, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

21983646

Citation

Felder, John M., et al. "Increasing the Options for Management of Large and Complex Chronic Wounds With a Scalable, Closed-system Dressing for Maggot Therapy." Journal of Burn Care & Research : Official Publication of the American Burn Association, vol. 33, no. 3, 2012, pp. e169-75.
Felder JM, Hechenbleikner E, Jordan M, et al. Increasing the options for management of large and complex chronic wounds with a scalable, closed-system dressing for maggot therapy. J Burn Care Res. 2012;33(3):e169-75.
Felder, J. M., Hechenbleikner, E., Jordan, M., & Jeng, J. (2012). Increasing the options for management of large and complex chronic wounds with a scalable, closed-system dressing for maggot therapy. Journal of Burn Care & Research : Official Publication of the American Burn Association, 33(3), e169-75. https://doi.org/10.1097/BCR.0b013e318233570d
Felder JM, et al. Increasing the Options for Management of Large and Complex Chronic Wounds With a Scalable, Closed-system Dressing for Maggot Therapy. J Burn Care Res. 2012 May-Jun;33(3):e169-75. PubMed PMID: 21983646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increasing the options for management of large and complex chronic wounds with a scalable, closed-system dressing for maggot therapy. AU - Felder,John M,3rd AU - Hechenbleikner,Elizabeth, AU - Jordan,Marion, AU - Jeng,James, PY - 2011/10/11/entrez PY - 2011/10/11/pubmed PY - 2012/9/18/medline SP - e169 EP - 75 JF - Journal of burn care & research : official publication of the American Burn Association JO - J Burn Care Res VL - 33 IS - 3 N2 - As reconstructive specialists, burn surgeons are often involved in managing large wounds of various etiologies. Such wounds can pose a management challenge, especially if they are chronic or occur in the setting of critical illness or multiple medical comorbidities. Medical maggots are an effective, selective, and low-risk method for wound debridement. However, their use in large and geometrically complex wounds is limited by the lack of scalability in currently available dressings, which are appropriate for smaller wounds but become cumbersome and ineffective in larger ones. This report describes a novel dressing designed for application of maggot debridement therapy in large and complex wounds. The authors then discuss how use of this dressing may create new management strategies for such wounds by allowing maggots to mechanically debride big, infected wounds. They describe the construction of a maggot containment dressing based on modified components from a negative pressure wound therapy system and provide a case report highlighting its successful clinical use in a large contaminated chronic wound resulting from Fournier's gangrene. In the case described, the novel dressing provided scalability, containment of maggots, control of secretions, and ease of use. The dressing created an environment suitable for maggot survival and allowed effective debridement of a heavily contaminated groin wound. The novel dressing described is shown to function appropriately, allowing controlled use of maggots for effective debridement of large, irregular wounds. Facilitating the use of maggots in such wounds may broaden the algorithm for their management. SN - 1559-0488 UR - https://www.unboundmedicine.com/medline/citation/21983646/Increasing_the_options_for_management_of_large_and_complex_chronic_wounds_with_a_scalable_closed_system_dressing_for_maggot_therapy_ L2 - https://academic.oup.com/jbcr/article-lookup/doi/10.1097/BCR.0b013e318233570d DB - PRIME DP - Unbound Medicine ER -