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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 .
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.
An open wound after debridement. Debridement is an essential element of effective wound care. [7] Although this view is deeply rooted in practice it is nonetheless based on empirical observation. Bradley et al. have stated that it is "unclear whether wound debridement is a beneficial process that expedites healing". [8]
Debridement is a critical aspect of wound care because devitalized tissue, particularly necrotic tissue, serves as nutrients for bacteria thereby promoting infection. Additionally, devitalized tissue creates a physical barrier over a wound which limits the effectiveness of any applied topical compounds and prevents re-epithelialization.
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.
Maggot therapy has been shown to accelerate debridement of necrotic wounds and reduce the bacterial load of the wound, leading to earlier healing, reduced wound odor and less pain. The combination and interactions of these actions make maggots an extremely potent tool in chronic wound care.
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