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Transcript of Maggot Therapy
Maggot therapy is a controlled therapeutic infestation of the body with a live mammal (maggot infestation on a live host).
It is controlled by:
selecting a safe and effective species and strain
by chemical disinfection to make the maggots germ-free
by containing the maggots within special dressings that prevent them from leaving the wound unescorted
Through quality control measures throughout the breeding and production processes.
Maggots are applied to the wound at a dose of 5–10 larvae per square centimeter of wound surface area and are left within their dressing for 48–72 h. At that point they are satiated, finished working, and can be removed (Sherman M.D., 2009)
What does the nurse have to consider regarding this therapy?
If the patient will benefit from the therapy?
Will the patient agree?
Is it safe for the patient?
What is the nursing evaluation for this therapy?
How do we know it was effective?
If the there is better healing quality than without the maggots.
If there is no infection in the wound.
What are the expected outcomes?
They debride the wound by dissolving dead and infected tissue
They disinfect the wound by secreting antimicrobial molecules, by ingesting and killing microbes within their gut, and by dissolving biofilm;
They stimulate the growth of healthy tissue
What is the nurse’s responsibility in documenting for this therapy?
What are important factors to include in the documentation?
How big the wound is before the maggots are applied
How many Maggots are being used
Type of dressing
How patient tolerated the process and over the time that the maggots are in the wound
Example of nursing documentation
The wound was 15cm. There were 50 maggots used in a "cage-dressing" over and around the maggots. This dressing will stay in place for 48 hours to give the maggots time to do their work. Patient tolerated the procedure with minimal pain and discomfort. (Monarch Labs, LLC , 2011)
Multiple choice questions
Who can order Maggots for this type of therapy?
Physician with a script
Patient with a script
Medicinal maggots are regulated by the Food and Drug Administration (FDA) as a Prescription Only medical device. This means that they must be ordered or prescribed by a licensed medical or veterinary therapist. They cannot be released without a prescription or an order to do so by an appropriately licensed health care provider. (BioTherapeutics, Education and Research Foundation , 2013)
What are the clinical indications for maggot therapy? (select all that apply)
Venous stasis ulcers
Neuropathic foot ulcers
Non-healing post surgical wounds
Non-healing traumatic wounds
Answer: All the above
How many maggots are used per square centimeter of wound surface area
Answer: 5-10 maggots
BioTherapeutics, Education & Research Foundation (2007, September 12). Part 1 of instructional video, illustrating the application of maggot therapy for wound healing.
BioTherapeutics, Education & Research Foundation (2007, September 12). Part 2 of instructional video, illustrating the application of maggot therapy for wound healing. Retrived from http://youtu,be/_C_k3322KcM.
BioTherapeutics, Education and Research Foundation . (2013). "The Better Foundation". Retrieved from Frequently Asked Questions about Maggot Debridement Thearpy : http://www.bterfoundation.org/faq_MDT#Is maggot therapy regulated by the FDA?
Labs, M. (2013). Monarch Labs Living Medicine. Retrieved from Medical Maggots :
Monarch Labs, LLC . (2011). Your Choice for Advanced Wound Care. Retrieved from Making Maggot Therapy Dressings : http://www.monarchlabs.com/support_dressing.htm
Sherman M.D., R. A. (2009). Journal of Diabetes Science and Technology . Retrieved from Maggot Therapy Takes Us Back to the Future of Wound Care: New and Imporved Maggot Therapy for the 21st Century : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771513/#!po=53.7037