The use of larvae therapy to debride full thickness burns in the anaesthetically unfit patient: The Nottingham experience

Akhtar, Nadeem; Abdel-Rehim, Shady; Rodrigues, Jeremy; Brooks, Peter

doi:10.1016/j.burns.2011.04.005

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…39 In contrast, a significant better graft take (82, 85% vs 65, 61%) in chronic-colonized burn wounds could be shown in an intra-individual comparison (n ¼ 49) after wound cleansing with 2% hydrogen peroxide compared with conventional debridement with curetting and lavage with saline (LoE 3). 40 Several case reports describe miscellaneous topics such as topical anesthesia for wound debridement, 41 larvae therapy to debride full-thickness or infected burn wound, [42][43][44] burn wound debridement via erbium: YAG laser, 45 the equipment of a cautery knife with an air spray to maintain better sight on bleeding wound areas, 46 or wound dyeing with methylene blue to facilitate adequate debridement 47 (LoE 4 or lower).…”

Section: Miscellaneous Debridement Methodsmentioning

confidence: 99%

Evidence and Trends in Burn Wound Debridement: An Evidence Map

et al. 2020

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Treatment of the burn wound is crucial in care of severely burned patients. Surgical strategies differ in technique and timing of wound excision and are considered to have an impact on morbidity and mortality of burn patients. Most techniques and strategies have been established during the last century and are still standard of care. Nonetheless, several newer techniques have been presented and evaluated recently. To summarize the evidence and trends for eschar removal by burn wound debridement currently available, an evidence map as variant of the systematic review, was prepared. For this purpose, a systematic literature search was performed in the PubMed databases until December 2016. While overall evidence in this domain is low, recent publications focus on optimal timing of wound excision, enzymatic debridement, and hydrosurgery. Several studies report the benefit of an early wound excision in terms of shorter hospital stay, lower wound infection rate, and reduction of postburn metabolic changes. Enzymatic debridement has been shown to be an effective tool for early eschar removal and in addition reduces the need for autografting of the debrided burn wound with a relatively high level of evidence (LoE 2-). Wound debridement by means of hydrosurgery is more precise compared to conventional wound excision and preserves viable dermis, but a positive effect on wound healing or scar formation could not been shown (LoE 2). Furthermore, rarely reported techniques comprise larvae therapy, debridement by laser, and other technical adjuncts, but the level of evidence is limited (LoE 4-/5).

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Section: Miscellaneous Debridement Methodsmentioning

confidence: 99%

Evidence and Trends in Burn Wound Debridement: An Evidence Map

et al. 2020

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“…Likewise, Namias and colleagues achieved remarkable recovery of fourth degree burns to both legs with MDT 82 . In China, MDT has been used to treat a patient with horrendous hot-crush injuries, 85 where Li and colleagues used Musca domestica, a species of fly not normally used in MDT, but achieved good results with complete debridement and wound closure.…”

Section: Report/discussionmentioning

confidence: 99%

“…[81][82][83] The ability of maggots to perform extensive debridement equal to surgical intervention has been demonstrated by Akhtar and colleagues who had success in debriding full thickness burns in patients that were not fit for anaesthesia and surgery. 84 Likewise, Namias and colleagues achieved remarkable recovery of fourth degree burns to both legs with MDT. 82 In China, MDT has been used to treat a patient with horrendous hot-crush injuries, 85 where Li and colleagues used Musca domestica, a species of fly not normally used in MDT, but achieved good results with complete debridement and wound closure.…”

Section: Technological Disastersmentioning

confidence: 97%

Maggot Debridement Therapy in Disaster Medicine

Stadler

Shaban

Tatham

2015

Prehosp. Disaster med.

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“…This work has been driven by the appearance of multiple drug resistant strains of various bacteria and the need to treat a range of wounds that are refractory to the more usual treatments (18). The maggots are placed in the wound either directly or more usually contained in fine net bags and their secretions clean out the eschar and reduce the bacterial load to encourage healing (19). The success of this approach has resulted in a more detailed analysis of the larval secretions and an analysis of the site of application on the host to better understand the cleaning and healing response.…”

Section: Introductionmentioning

confidence: 99%

The immunobiology of myiasis infections – whatever happened to vaccination?

Sandeman

Bowles

Colwell³

2014

Parasite Immunology

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The current state of myiasis vaccine technologies are reviewed mainly in the primary research genera of Lucilia and Hypoderma. The importance of myiasis flies as primary causes of morbidity and mortality in agricultural species and man has not diminished despite the existence of good control strategies. However, the development of vaccines against myiasis infections has been relatively quiescent for more than 10 years despite the rapid development of genomic and proteomic analysis and of skills in data interpretation. The value of vaccine research in an era of chemical primacy is analysed. In fact, recent findings of drug resistance and the impact of animal welfare concerns should mean a renewed interest in alternative controls. The reasons that this has not been true to date are explored and new possibilities discussed.

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The use of larvae therapy to debride full thickness burns in the anaesthetically unfit patient: The Nottingham experience

Cited by 11 publications

References 14 publications

Evidence and Trends in Burn Wound Debridement: An Evidence Map

Evidence and Trends in Burn Wound Debridement: An Evidence Map

Maggot Debridement Therapy in Disaster Medicine

The immunobiology of myiasis infections – whatever happened to vaccination?

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