Maggot Debridement
Therapy
Give the “tiny surgeons” a chance!
History
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Ancient Civilizations
– Maya, China, Australia
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Army War Surgeons
– Napoleon, Civil War
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William Baer
– John Hopkins
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Ronald Sherman
House
– Burn Victim Episode
Importance to Healthcare
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Diversity of wound
types
Remove necrotic
flesh
Antimicrobial
properties (MRSA)
Promote Wound
Healing
Wound Types

Any open purulent sore
– Diabetic ulcers
– Bed sores
– Burns
– Abscesses
– Basal cell carcinoma
– Vein and artery diseases
– Many more
Remove Necrotic Flesh
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Mouthhooks
Excretory and
secretory products
– Enzymes
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 liqification
 pH
Antibiotic Resistance
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ES kill bacteria
“Gut” test
Identification of antimicrobial factors
Evolution
Healing factors
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E/S stimulate EGF and IL-6
Destroy fibrin cuffs
Activate PAR system causing
vasodilation
Increase circulation thus oxygen to
wound
Maggot Biology
Application of Use
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Make Pattern of
Wound
Place maggots
inside
Cover with mesh
Place gauze
bandage for
drainage
Cost and Insurance

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$70/ 1000 larvae
Surgery
Antibiotics
– Vancomycin $138/day
Results
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http://www.ucihs.uci.edu/com/patholo
gy/sherman/cases.htm
Results