Biologic Wound Debridement

PATIENT EDUCATION

Biologic Wound Debridement

Elsevier Patient Education © 2023 Elsevier Inc..
Last revised: September 27, 2023.

Biologic wound debridement is a treatment to remove dead tissue from a wound. This helps the wound heal. This treatment uses live maggots (fly larvae) to eat away at the dead tissue. Before the maggots are used for the procedure, they are cleaned of germs (sterilized).

The maggots eat away at only dead tissue. They do not eat healthy tissue. The maggots also eat harmful bacteria and leave antibacterial substances in the wound. These natural substances help the wound heal.

Biologic debridement is for wounds that are long-term (chronic) or keep coming back (recurring). This method may also be used for wounds that are new (acute). The procedure usually takes 24–72 hours; depending on the size of the wound, the amount of dead tissue, and how many maggots are used. It is usually done in a hospital or clinic.

Tell a health care provider about:

  • Any allergies you have. If you have a history of allergy to fly larvae or ingredients used in their manufacture (brewer’s yeast, soy) notify your health care provider.

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

  • Any blood disorders you have.

  • Any medical conditions you have.

  • Any surgeries you have had.

  • Whether you are pregnant or may be pregnant.

  • Any concerns or anxiety you may have about receiving maggot therapy.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.

  • Bleeding.

  • Pain.

What happens before the procedure?

  • You may be given antibiotic medicine to help prevent infection.

  • You may have imaging tests done, such as an MRI.

  • Depending on your wound, you may need to have some surgery before this procedure. The surgery helps the body to restore blood flow and carry fluid to the wound (revascularization).

What happens during the procedure?

A person applying a gauze bandage to another person's left leg just above the ankle.
  • To lower your risk of infection, your health care team will wash or sanitize their hands.

  • The skin around the wound will be wiped with a substance that allows a bandage (dressing) to easily stick to the skin.

  • A dressing will be applied around the edge of the wound (periwound) to prevent breakdown of the wound edge skin due to moisture (maceration).

  • Maggots may be placed directly inside the wound using a clean cotton swab. Or, the maggots may be contained in a mesh bag that will be placed in the wound. The number of maggots that will be used depends on the size of the wound.

  • Moist gauze will be placed over the wound and the maggots. The gauze will be moistened with a saline solution, which is made of salt and water.

  • A dressing will be wrapped around the whole wound. The dressing will be kept moist with a saline solution.

  • The maggots and the dressings will be kept in place between 24–72 hours. You may stay in the hospital or clinic during the treatment.

    • The wound dressings may be checked every few hours.

    • You may be given medicine to help with pain.

  • After 24–72 hours, the dressings and maggots will be removed.

  • The wound will be rinsed out with a saline solution.

  • The wound will be covered with a clean, open weave dressing that allows for air flow.

  • If some of the dead skin was not cleared out, the procedure may be repeated.

This procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • You may be given medicine for pain.

  • You may be given antibiotic medicine. If antibiotic medicine was started before your procedure, you may continue to receive it.

Summary

  • Biologic wound debridement is a treatment to remove dead tissue from a wound.

  • This treatment uses live maggots (fly larvae) to eat away at dead tissue in the wound. The maggots do not eat healthy tissue.

  • Maggots will be placed inside the wound. The number of maggots that will be used depends on the size of the wound.

  • The procedure usually takes between 24–72 hours, and it is usually done in a hospital or clinic.

  • Depending on your wound, you may need to have some surgery before this procedure. The surgery helps the body to restore blood flow and carry fluid to the wound.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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