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WORKSHOP: MEET THE EXPERTS IN MAGGOT THERAPY
Workshop: Meet the Experts in Maggot Therapy
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Maggots for treatment of trauma injuries
Wim Fleischmann 1
1 Department of Trauma and Reconstructive Surgery, Bietigheim Hospital (Freiburg,
Germany).
Century old experiences with maggot infestation of wounds have suggested:
1. Maggots on war wounds may prevent infection and death
2. Maggots are effective in the treatment of orthopedic infections.
Interestingly both indications, namely prevention and therapy of wound infection have
been more or less reduced to a mere debridement of chronic wounds.
Anyhow latest research has shown that maggot secretions possess distinct
immunomodulatory properties and are able to break down biofilms of S. aureus and
P. aeruginosa spec.
These findings offer an explanation for the efficiency of MDT in septic wounds in spite of
the difficulty to provide evidence of a bactericidal effect of clinical importance.
So far a genuine breakthrough of MDT seems to be hampered – at least In Germany –
by:
1. The classification of MDT as a finished medicinal product. Tedious and expensive
certification procedures for maggot products look like a never ending story and
prevent its reimbursement.
2. The yuk or disgust factor withholding doctors and nurses from applying maggots to
wounds.
3. Difficult logistics.
Nevertheless, MDT is simple, safe and efficient – given that indication and application
are correct. Some case studies will be discussed in this presentation.
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Workshop: Meet the Experts in Maggot Therapy
Changes in the surrounding skin when treating with maggots
Tonny Karlsmark 1
1 Copenhagen Wound Healing Center Department of Dermato- venereology, Bispebjerg
University Hospital (Copenhagen, Denmark).
Introduction: Skin surrounding chronic ulcers can bee affected by wound flood or
materials from dressings reducing the skin barrier and introducing a contact dermatitis.
-Irritant or allergic.The treatment effect of the maggots is a combination of a mechanical
and an enzymatic process for debridement of the ulcers. In this process an increased
amount of enzyme rich wound flood will be produced. Protection of the surrounding skin
is because of this phenomenon very important.
Methods: The treatment modality from the Wound Healing Center using both free range
and biobag technique will be presented.
Conclusion: Using an efficient protection of the ulcer near skin reduce the risk of skin
problems.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
69