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Bagged larval therapy

H Čičková, M Kozánek, P Takáč
Maggot debridement therapy has become a well-established method of wound debridement. Despite its success, little information is available about the optimum duration of the treatment cycle and larval growth in wounds. This study examines the development of Lucilia sericata (Diptera: Calliphoridae) larvae under two containment conditions (bagged and free range) under simulated wound conditions and assesses the impact of transport and further storage of larvae on their survival and growth. There was no significant difference in size between bagged and free-range larvae over the 72-h experimental period...
December 2015: Medical and Veterinary Entomology
Helena Cičková, Marek Cambal, Milan Kozánek, Peter Takáč
Maggot debridement therapy (MDT) is an established method of debridement of nonhealing wounds. Despite intense clinical research about its efficacy and effects of substances produced by the larvae, growth and development of maggots in the wounds remain largely unexplored. In the present study, the bags with larvae (n = 52), which had been used to debride traumatic, ischemic, diabetic and venous ulcers, were collected and examined. Survival, length, width and larval instar of the maggots within each bag were recorded and analyzed with respect to the wound type and duration of the treatment...
2013: Evidence-based Complementary and Alternative Medicine: ECAM
Linda Rafter
This article is a review of larval therapy and includes a case study that uses larval therapy in the treatment of complex leg ulcer wounds. Complex wounds require careful management from the multidisciplinary team and present clinicians with intricate challenges to save the limb. Wound-bed preparation and debridement needs to be as effective and non-traumatic as possible for the patient. Larval therapy removes the devitalised tissue effectively with minimal tissue trauma. This case study reports on a patient with a non-progressing, full-thickness wound with exposed tendon following reconstructive surgery at a local vascular unit...
March 28, 2013: British Journal of Nursing: BJN
Gwendolyn Cazander, Mariëlle C van de Veerdonk, Christina M J E Vandenbroucke-Grauls, Marco W J Schreurs, Gerrolt N Jukema
BACKGROUND: Biofilm-associated infections in trauma surgery are difficult to treat with conventional therapies. Therefore, it is important to develop new treatment modalities. Maggots in captured bags, which are permeable for larval excretions/secretions, aid in healing severe, infected wounds, suspect for biofilm formation. Therefore we presumed maggot excretions/secretions would reduce biofilm formation. QUESTIONS/PURPOSES: We studied biofilm formation of Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella oxytoca, Enterococcus faecalis, and Enterobacter cloacae on polyethylene, titanium, and stainless steel...
October 2010: Clinical Orthopaedics and related Research
J C Dumville, G Worthy, M O Soares, J M Bland, N Cullum, C Dowson, C Iglesias, D McCaughan, J L Mitchell, E A Nelson, D J Torgerson
OBJECTIVES: To compare the clinical effectiveness and cost-effectiveness of larval therapy with a standard debridement technique (hydrogel). DESIGN: A pragmatic, three-arm, randomised controlled trial with an economic evaluation. SETTING: Community nursing services, community leg ulcer clinics and hospital outpatient leg ulcer clinics. A range of urban and rural settings. PARTICIPANTS: Patients with venous or mixed venous/arterial ulcers (minimum ankle brachial pressure index of 0...
November 2009: Health Technology Assessment: HTA
Marta O Soares, Cynthia P Iglesias, J Martin Bland, Nicky Cullum, Jo C Dumville, E Andrea Nelson, David J Torgerson, Gill Worthy
OBJECTIVE: To assess the cost effectiveness of larval therapy compared with hydrogel in the management of leg ulcers. DESIGN: Cost effectiveness and cost utility analyses carried out alongside a pragmatic multicentre, randomised, open trial with equal randomisation. Population Intention to treat population comprising 267 patients with a venous or mixed venous and arterial ulcers with at least 25% coverage of slough or necrotic tissue. INTERVENTIONS: Patients were randomly allocated to debridement with bagged larvae, loose larvae, or hydrogel...
2009: BMJ: British Medical Journal
Jo C Dumville, Gill Worthy, J Martin Bland, Nicky Cullum, Christopher Dowson, Cynthia Iglesias, Joanne L Mitchell, E Andrea Nelson, Marta O Soares, David J Torgerson
OBJECTIVE: To compare the clinical effectiveness of larval therapy with a standard debridement technique (hydrogel) for sloughy or necrotic leg ulcers. DESIGN: Pragmatic, three armed randomised controlled trial. SETTING: Community nurse led services, hospital wards, and hospital outpatient leg ulcer clinics in urban and rural settings, United Kingdom. PARTICIPANTS: 267 patients with at least one venous or mixed venous and arterial ulcer with at least 25% coverage of slough or necrotic tissue, and an ankle brachial pressure index of 0...
March 19, 2009: BMJ: British Medical Journal
Karen Spilsbury, Nicky Cullum, Jo Dumville, Susan O'Meara, Emily Petherick, Carl Thompson
OBJECTIVES: To explore patient preferences and acceptability of two forms of larval therapy ('bagged' and 'loose'). BACKGROUND: Larval therapy is frequently used to treat patients with leg ulcers. However, patient preferences and acceptability of larval therapy when compared with other treatments is not established. DESIGN: A survey of patient preferences between larvae and standard therapy (hydrogel) using randomized allocation of two questionnaires ('bagged' or 'loose' questionnaire)...
June 2008: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
E S Petherick, S O'Meara, K Spilsbury, C P Iglesias, E A Nelson, D J Torgerson
BACKGROUND: A trial was commissioned to evaluate the effectiveness of larval therapy to debride and heal sloughy and necrotic venous leg ulcers. Larval therapy in the trial was to be delivered in either loose or bagged form. Researchers were concerned that resistance to larval therapy may threaten the feasibility of the trial. Additionally there was concern that the use of larval therapy may require a larger effect size in time to healing than originally proposed by the investigators...
2006: BMC Medical Research Methodology
Pauline Raynor, Jo Dumville, Nicky Cullum
The VenUS II trial is the first large, prospective clinical study to investigate the effect of larval therapy and hydrogel on both the bacteriology and healing of leg ulcers. This trial will compare the clinical and cost effectiveness of two types of larval therapy (loose and bagged) with a standard debridement intervention (hydrogel) in terms of effects on time to complete healing, time to debridement, wound microbiology, cost of treatment and health-related quality of life. This paper describes the aims and design of the trial, outlines the eligibility criteria for patients and discusses the nurses' role in the study...
July 2004: Journal of Tissue Viability
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