TY  - BOOK
AU  - Jeng, James C
AU  - Jordan, Marion H
TI  - Increasing the options for management of large and complex chronic wounds with a scalable, closed-system dressing for maggot therapy. [Review]
SN  - 1559-047X
KW  - *Bandages
KW  - *Debridement/mt [Methods]
KW  - *Diabetes Mellitus, Type 2/co [Complications]
KW  - *Negative-Pressure Wound Therapy/mt [Methods]
KW  - *Skin Ulcer/th [Therapy]
KW  - *Wound Infection/th [Therapy]
KW  - Animals
KW  - Anti-Bacterial Agents/tu [Therapeutic Use]
KW  - Combined Modality Therapy
KW  - Follow-Up Studies
KW  - Humans
KW  - Larva
KW  - Male
KW  - Middle Aged
KW  - Risk Assessment
KW  - Severity of Illness Index
KW  - Skin Ulcer/et [Etiology]
KW  - Skin Ulcer/pp [Physiopathology]
KW  - Treatment Outcome
KW  - Wound Healing/ph [Physiology]
KW  - Wound Infection/et [Etiology]
KW  - Wound Infection/pp [Physiopathology]
KW  - MedStar Washington Hospital Center
KW  - Surgery/Burn Services
KW  - Case Reports
KW  - Journal Article
KW  - Review
N1  - Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present
N2  - As reconstructive specialists, burn surgeons are often involved in managing large wounds of various etiologies. Such wounds can pose a management challenge, especially if they are chronic or occur in the setting of critical illness or multiple medical comorbidities. Medical maggots are an effective, selective, and low-risk method for wound debridement. However, their use in large and geometrically complex wounds is limited by the lack of scalability in currently available dressings, which are appropriate for smaller wounds but become cumbersome and ineffective in larger ones. This report describes a novel dressing designed for application of maggot debridement therapy in large and complex wounds. The authors then discuss how use of this dressing may create new management strategies for such wounds by allowing maggots to mechanically debride big, infected wounds. They describe the construction of a maggot containment dressing based on modified components from a negative pressure wound therapy system and provide a case report highlighting its successful clinical use in a large contaminated chronic wound resulting from Fournier's gangrene. In the case described, the novel dressing provided scalability, containment of maggots, control of secretions, and ease of use. The dressing created an environment suitable for maggot survival and allowed effective debridement of a heavily contaminated groin wound. The novel dressing described is shown to function appropriately, allowing controlled use of maggots for effective debridement of large, irregular wounds. Facilitating the use of maggots in such wounds may broaden the algorithm for their management
UR  - http://dx.doi.org/10.1097/BCR.0b013e318233570d
ER  -