Ether for Wound Debridement of Wild Maggots

Abstract

<jats:p> Myiasis is defined as an infestation of the organs or tissues of live vertebrates (humans or animals) by dipterous larvae, commonly referred to as maggots. Wound myiasis is a common presentation in the emergency department. The presence of wild maggots and larvae in wounds is concerning for subsequent myiasis-induced infections and complications. Proper extraction of wild maggots and larvae is required to avoid complications that may occur with wound myiasis. Surgical debridement is often utilized to extract wild maggots and larvae, but can be painful and time-consuming. There is limited literature available on alternative approaches for removal of wild maggots and larvae. We present a case of lower extremity wound myiasis that had wild maggots and larvae successfully removed with no complications using ether. This procedure is a novel, noninvasive, and pain-free way to extract wild maggots and larvae from wound myiasis. </jats:p>

A convocation of worms: a case report and literature survey of treatments for wound myiasis

“…Surgical removal alone can be effective but tends to be difficult, time‐consuming, and painful. Surgical or mechanical methods may benefit from supplemental therapies due to the possibility of remaining larvae as well as an infection caused by rupture of larvae 4 . Mechanical removal of maggots using Yankauer suction, where a suction tip is applied directly to the wound to remove superficial maggots, has been described in a case report in conjunction with wound care and oral antibiotics.…”

“…Occlusive agents cause asphyxiation and emergence of maggots, allowing for subsequent mechanical removal. Ether followed by normal saline irrigation was described in one case report; there were no side effects reported and no evidence of local or systemic infection nor recurrence of maggots 4 . Turpentine oil was described in a similar fashion, but this treatment was associated with slower maggot shedding time and incomplete maggot resolution compared with administration of systemic therapy, ivermectin, along with mechanical extraction 2 …”

“…Surgical or mechanical methods may benefit from supplemental therapies due to the possibility of remaining larvae as well as an infection caused by rupture of larvae. 4 Mechanical removal of maggots using Yankauer suction, where a suction tip is applied directly to the wound to remove superficial maggots, has been described in a Occlusive agents cause asphyxiation and emergence of maggots, allowing for subsequent mechanical removal. Ether followed by normal saline irrigation was described in one case report; there were no side effects reported and no evidence of local or systemic infection nor recurrence of maggots.…”

“…Ether followed by normal saline irrigation was described in one case report; there were no side effects reported and no evidence of local or systemic infection nor recurrence of maggots. 4 Turpentine oil was described in a similar fashion, but this treatment was associated with slower maggot shedding time and incomplete maggot resolution compared with administration of systemic therapy, ivermectin, along with mechanical extraction. 2 Among wound-cleansing agents, the effects of Dakin's solution (0.5% sodium hypochlorite), 70% isopropyl alcohol, povidone-iodine, and 3% hydrogen peroxide on maggot mortality were comparatively evaluated when applied daily to maggots in vitro for a total of 14 days.…”