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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 .
This is an important distinction, as most other major varieties of myiasitic fly larvae attack both live and dead wound tissue indiscriminately, effectively negating their benefit in non-harmful wound debridement. Medicinal maggots are placed on the wound and covered with a sterile dressing of gauze and nylon mesh.
Since the year 2000, the wound bed preparation concept has continued to improve. For example, the TIME acronym (Tissue management, Inflammation and infection control, Moisture balance, Epithelial (edge) advancement) has supported the transition of basic science to the bedside in order to exploit appropriate wound healing interventions [6] and has not deviated from the important tenets of ...
For skin cancer surgeries, most wounds are relatively small. After removal of the dressing, the wound can be cleaned by washing with clean soapy water, and should be kept moist. It is also suggested to apply prescribed antibiotic ointments or any other medications to the wound, and protect the scar formed. [30]
Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: reducing the course of treatment needed (and time in the hospital), and improving the function and appearance of the area of the body which receives the skin graft. There are two types of skin grafts:
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.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.