Successful Application of Maggot Debridement Therapy on Infants with Infected Wounds

Introduction: Neonates, hospitalized in the neonatal intensive care units (NICU) are exposed to higher risk of developing iatrogenic skin lesions due to the fragility of their skins and inexperience of some healthcare staff at the unit. Lesions due to intravenous fluid extravasation can cause pain, infection and lastly necrotic tissue, increased morbidity, prolong hospital stay and general increase in hospital costs. In order to provide correct treatment, nurses should eliminate or control the causative factors and provide a favorable environment for healing. The scarcity of information about skin lesions in newborn children was noted, which can generate insecurity in the nursing team and directly affect the quality of care. Maggot debridement therapy (MDT) is the therapeutic use of larvae of necrophagic/coprophagic flies cultured in a sterile manner for the debridement of wounds. MDT is an excellent choice as an alternative to conventional therapies for patients that do not have the resources to undergo surgical procedures; when the patient is at high-risk for surgical debridement; when preserving viable tissue is a goal; when there is a need to distinguish between living from dead tissue; while the patient is awaiting other types of more radical debridement; when patients cannot tolerate general anaesthesia or when the infected and/or necrotic tissue is difficult to assess surgically without extensively enlarging the wound. Maggot debridement therapy in recent years has obtained more attention and introduced as a complementary and one of the best method for treatment of various kinds of chronic wounds as well as debridement, disinfection, improve healing. The aim of this study was to treat wounds of infants and evaluate the effectiveness and safety of MDT for them.The fly most commonly used is Lucilia sericata but other species have been used with similar efficacy. Objectives: The aim of this study was to treat these infected wounds in infants using MDT and evaluate the effectiveness and safety on them. Method and material: The study was conducted on six infants (4 to 24 weeks old) with infected wounds (from intravenous fluid extravasation & burns with pulse oximetry sensor), having CRP of between 1 and 6 who could not withstand surgical debridement. Maggot debridement therapy was applied every 24hrs for 3 consecutive sessions along with other standard therapies (such as antibiotic, offloading, dressing). Result: The result of this study showed that maggot debridement therapy (MDT) is an effective biological debridement tool with good safety margin amongst infants. MDT removes all the necrotic tissue and stimulated granulation process within 1 week of application.Conclusion: MDT was seen to shorten the healing time, reduce pain, decreased consumption of antibiotics and the cost of treatment when compared to similar group without MDT

Keywords:

Infants , burns , maggot debridement therapy , skin lesions , Lucilia sericata