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Maggot therapy (also known as larval therapy) is a type of biotherapy involving the introduction of live, disinfected maggots (fly larvae) into non-healing skin and soft-tissue wounds of a human or other animal for the purpose of cleaning out the necrotic (dead) tissue within a wound (debridement), and disinfection.
Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. [ 2 ] [ 3 ] Removal may be surgical , mechanical, chemical, autolytic (self-digestion), or by maggot therapy .
During this process, facial muscles might be tightened, while facial fat might be removed or redistributed. Sometimes, a jaw lift is performed in the same surgery by making an incision under the chin and tightening the skin of the jaw and neck. Immediately after the surgery, a drainage tube is used to remove excess fluid from the wound. [23] [24]
The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure. The wound is purposely left open. Examples: healing of wounds by use of tissue grafts. If the wound edges are not reapproximated immediately, delayed primary wound healing transpires. This type of healing may be desired in the case of contaminated wounds.
Wound bed preparation (WBP) is a systematic approach to wound management by identifying and removing barriers to healing. The concept was originally developed in plastic surgery. [1] [2] It includes wound assessment, debridement, moisture balance, bacterial balance, and wound cleaning.
An increasingly common aid to both pre-operative wound maintenance and post-operative graft healing is the use of negative pressure wound therapy (NPWT). This system works by placing a section of foam cut to size over the wound, then laying a perforated tube onto the foam. The arrangement is then secured with bandages.
At some point before surgery a health care provider conducts a preoperative assessment to verify that a person is fit and ready for the surgery. [ 1 ] [ 2 ] For surgeries in which a person receives either general or local anesthesia, this assessment may be done either by a doctor or a nurse trained to do the assessment. [ 2 ]
It also plays an additional role in autolytic debridement (removal of dead tissue) which is less painful when compared to manual wound debridement inside the operating theater. It is highly elastic and flexible, thus is closely adhered to the skin. As the dressing is transparent, wound inspection is possible without removing the dressing.