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Maggot Debridement Therapy Give the “tiny surgeons” a chance! History Ancient Civilizations – Maya, China, Australia Army War Surgeons – Napoleon, Civil War William Baer – John Hopkins Ronald Sherman House – Burn Victim Episode Importance to Healthcare Diversity of wound types Remove necrotic flesh Antimicrobial properties (MRSA) Promote Wound Healing Wound Types Any open purulent sore – Diabetic ulcers – Bed sores – Burns – Abscesses – Basal cell carcinoma – Vein and artery diseases – Many more Remove Necrotic Flesh Mouthhooks Excretory and secretory products – Enzymes liqification pH Antibiotic Resistance ES kill bacteria “Gut” test Identification of antimicrobial factors Evolution Healing factors E/S stimulate EGF and IL-6 Destroy fibrin cuffs Activate PAR system causing vasodilation Increase circulation thus oxygen to wound Maggot Biology Application of Use Make Pattern of Wound Place maggots inside Cover with mesh Place gauze bandage for drainage Cost and Insurance $70/ 1000 larvae Surgery Antibiotics – Vancomycin $138/day Results http://www.ucihs.uci.edu/com/patholo gy/sherman/cases.htm Results