BIOSURGICAL NEWS                                                                            Volume 1, Issue 1
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VOLUME 1 , I S S U E 1                                                                                                    ...
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Noticias larvas


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Noticias larvas

  1. 1. BIOSURGICAL NEWS Volume 1, Issue 1 November 2002 Introduction to Biosurgery and the Biosurgical News Welcome to this the first gical Research Unit began to wounds, often in situations edition of the Biosurgical produce sterile maggots of the where traditional treatments News! green bottle, Lucilia sericata, un- had proved ineffective. der the brand name of LarvE. During the last five years Biosurgery is a term that has been coined specifi- maggot therapy has grown cally to describe the use in popularity and the use of of maggots in the treat- LarvE is now regarded by ment of infected and many as the treatment of necrotic wounds. choice for a variety of wound types. This ancient treatment was first used in Western Biosurgical News has medicine during the been introduced as a vehicle American Civil War, but to provide both new and came to prominence after existing users of LarvE with the First World War when information on recent devel- Baer, an American ortho- opments in this area and as a paedic surgeon, described forum for an exchange of the use of the technique ideas and experiences. for the treatment of Each edition will cover a osteomyelitis in the wide range of topics, some pre-antibiotic era. of which will be light- Following the discovery of The treatment attracted consid- hearted in tone whilst others Biosurgical News penicillin, the therapy was erable interest in the nursing will be more serious in nature. largely forgotten until it was press and media with the result Contributions are invited from resurrected in America by that, despite the somewhat un- all practitioners of maggot Sherman in the mid 1980s. conventional nature of the tech- therapy to future editions of Maggot therapy was reintro- nique, many hospitals around this newsletter. Please contact duced into the United King- the UK began to use maggots the editor at the address shown dom in 1995 when the Biosur- for the management of problem on page four. BIOSURGICAL RESEARCH UNIT LarvE: Produced by the NHS for the NHS LarvE are produced by the testing dressings and medical Biosurgical Research Unit, devices, and is believed to be the Inside this issue: part of the Bro Morgannwg only NHS laboratory accredited LarvE: An award winning product 2 NHS Trust, based in the Prin- by the United Kingdom Ac- cess of Wales Hospital in creditation Service (UKAS) for LarvE in veterinary practice 2 Bridgend. its work in this field . Spreading the word 2 The BRU is actually part of Staff from a variety of scientific Maggot therapy in the 2nd 3 the Surgical Materials Testing disciplines are involved in mag- World War Laboratory (SMTL), a depart- got production to ensure that ment that has been involved these are produced to the high- LarvE and the diabetic foot 3 in wound management for est possible standard as might Maggots in the treatment of 3 many years. be expected from an NHS-based pressure sores The laboratory specialises in organization. Become a registered maggot user! 4
  2. 2. Page 2 BIOSURGICAL NEWS LarvE: An award winning product The unique nature of the LarvE project This is not the first award that the BRU has received, for was recognized in 2001 when the Biosurgi- in 1999 the LarvE brand of maggots was granted Millen- cal Research Unit was granted a Queen’s nium Product Status. Award for Innovation. This was presented by His Royal Highness the Duke of Kent when he visited the SMTL earlier this year. During his visit the Duke was given a tour of the production unit including the fly room, where the adult insects are kept, the ‘nursery’ where the young maggots are raised prior to dispatch, and the clean room areas where the aseptic manipulations are carried out. The Duke was also shown the various pro cesses involved in the production of sterile maggots, and he later spoke to a pa- tient who had previously undergone a pro- longed course of maggot treatment which had prevented the amputation of his foot! The Duke also toured the rest of the SMTL to learn a little about the testing work of His Royal Highness, The Duke of Kent presenting the Queen’s Award to the department. Dr Steve Thomas, Director of the Biosurgical Research Unit. LarvE win a veterinary award! Despite the widespread use of culitis, an infection of fatty tissue wound that progressed rapidly maggots in human wound man- on the flanks, which led to tissue to healing. agement, to date the use of mag- breakdown and the formation of This article was subsequently gots in veterinary medicine has a large necrotic wound. award the ‘William Hunting been somewhat limited. Repeated surgical debridement Award’ which is awarded annu- Nevertheless, in 2001, the Veteri- and antibiotic injections failed to ally for the best contribution to nary Record, the leading veterinary eliminate the problem, so mag- the Veterinary Record from journal in the United Kingdom, gots were used as a treatment of practitioners published an article that described last resort. the use of LarvE in the treatment The paper described how the Bell, N. J., Thomas, S. . Veterinary Record of an elderly female donkey1. maggots removed all the infected 2001; 149: 768-770 The donkey suffered from panni- material resulting in a clean Spreading the word The Biosurgical Research Unit has South West . ment to education and training, recently appointed three new a further series of training days All are very experienced in the members to its team. wound management field and has been arranged for 2003. These are based in different parts will undoubtedly prove be an These days are always oversub- of the United Kingdom to meet invaluable resource for practitio- scribed so early booking is local needs for education and ners of maggot therapy in their essential. training in the use of LarvE. respective areas. All three may be For further information and The three new staff members are contacted via the Biosurgical Re- registration forms contact Tony Clare McIver, who works in the search Unit. Fowler, Customer Services North East region, Pat Holman, Training Days Manager by phone or email who works in the North West, and As part of the BRU’s commit- ( Andy Carthew who covers the
  3. 3. VOLUME 1 , I S S U E 1 Page 3 Maggot therapy during the second world war Since Napoleonic times, the history of maggot therapy has been closely linked to military conflicts . Many soldiers with appalling battlefield injuries had their wounds infested with maggots, which may have actually saved their lives by preventing the development of septicaemia. Less familiar perhaps, are accounts of soldiers who, perhaps in the absence of more traditional medicines, were given maggot therapy during the Second World War. An insight into one officer’s experience was given in a letter that was recently written to the BRU in response to an article that appeared in a national newspaper and is reproduced her with his permission. Sir, I was interested to read the article which was less painful than using a Our poor diet and primitive liv- on Maggot Therapy in the Times scalpel (albeit a bamboo one) ing conditions in the jungle pre- Magazine of 31 August 2002 and otherwise shrieks of pain rent the vented normal healing. We never particularly about your work in air! had this problem in Singapore or this field. The next step was to sprinkle sul- Malaya. You might be interested to learn phonilamide powder (good old I am not sure where we got our that POWs working on the ‘Death M&B 693) on the wound and the maggots from - possibly fer- Railway’ in Thailand during the ulcer healed beautifully. mented rice - but we were not all Second World War used maggots Sometimes a skin graft was carried that curious to find out and the on their leg ulcers with great suc- out but this wasn't too popular kitchens were out of bounds for cess. though it did provide a protective us! After the maggots had done their coating on the wound. MHC Burns, Major (Retired), late work the ulcers were syringed out The slightest scratch from a bam- Indian Army. with Eusol or saline solution, boo and an ulcer formed rapidly. “Ancient dwellers in the land of Canaan chose Baal, LarvE in the treatment of the diabetic foot: an account of a new king of the flies, as application technique The management of foot ulcers multidisciplinary approach to the involved the use of a zinc their chief god.” in diabetic patients is both costly treatment of a patient with an impregnated stocking which and time consuming, and many extensive heel wound resulted in s u ccessfully prevented the patients are at risk of amputation. complete healing and prevented maggots from escaping and In a recent case history, that will an amputation. protected the surrounding skin be published in full on the web- The application of maggots from excoriation. site, Debbie Ruff, Vascular played an important part of this For full details of this and other Nurse, Pennine Acute Hospitals treatment as they rapidly cleansed case histories see: NHS Trust, and Melanie the wound which in turn allowed Stephens, Lecturer Adult Nurs- the process of granulation to take ing, Department of Nursing, place. University of Salford have The treatment was enhanced by a described how a structured new application technique that Maggots in the treatment of pressure sores Sherman, the leading exponent treated and 49 conventionally n o n-maggot-treated wounds of maggot therapy in the United, treated wounds. (p<0.001). States has recently published the Eighty percent of maggot treated The area of conventionally- results of an analysis of the treat- wounds were completely treated wounds increased by ment of 103 patients with 145 debrided, while only 48% of 1.2cm 2/week, but the area of- pressure ulcers. Fifty of these wounds were completely debrided maggot-treated wounds decreased patients, with a total of 61 using conventional treatment by 1.2cm 2/week. wounds, received maggot therapy alone (p=0.021). at some point during their treat- Within three weeks maggot Sherman,R.A. Maggot versus conserva- ment. treated wounds contained one- tive debridement therapy for treatment of Debridement and wound healing pressure ulcers, Wound Repair and Regenera- third the necrotic tissue (p=0.05) tion, 1992, 10:(4), 208-214. were quantified in 43 maggot- and twice the granulation tissue of
  4. 4. Page 4 Become a ‘registered maggot user’ As part of the Biosurgical Research to register simply send an email to Name Unit’s commitment to promoting with the education and training in all aspects word ‘register’ in the subject line. ………………………… of maggot therapy, we are setting up Alternatively complete the details Position a database of maggot users. in the panel below and return it in ………………………… Individuals whose details are an envelope to the BRU at the Address included in this database will receive address shown below. ………………………… a personal copy of each edition of By registering in this way you can ………………………… Biosurgical News as well as informa- ensure that you are kept up-to-date ………………………… tion on other publications or events in this interesting and developing Phone related to maggot therapy. area of wound management. ………………………… Membership of the group is free. Email ………………………… Maggots on the ‘net’ Few would dispute the value of will shortly be relaunched. the internet as a source of infor- In the coming months, this new site Key web addresses mation on virtually any topic and will develop into a freely available maggot therapy is no exception. resource for anyone who has an Biosurgery Home Page: The SMTL first established an interest in biosurgery. internet presence in 1996, then, in One important section will consist of 1997, the laboratory introduced case studies on maggot therapy that “Maggots the World Wide Wounds: ‘World Wide Wounds’, the illustrate the use of the technique in a larvae of flies, world’s first peer-reviewed variety of wound types. electronic wound management Some of these case studies will also caterpillars are the journal. be summarised in this and future Email: larvae of butterflies Although the SMTL web site has editions of Biosurgery News. or moths, and had a Biosurgery section for many The first of these new case studies is years, this is being updated and summarised on page 3. grubs are the larvae of beetles.” On a lighter note …. I’ve come to help that job you do I do not munch nor bite nor chew A maggot’s year: November I liquefy slough and take it away With all nasty bugs-even MRSA. Please help me to do a really good job Like you, I’m not cheap, I cost a few bob If you cover me well – so that I can’t breathe I won’t take the food, but any small chance to leave. If you leave me too wet, I’ll choke and I’ll drown And you’ll never find me, you’ll think I’ve left town If you leave me too dry, I’ll shrivel away ‘I’ll need two more pots’ to Mary you’ll say. The moral here told is simple and fact Biosurgical Research Unit Read my instructions and don’t be a prat. SMTL Some moistened fresh gauze and change every Princess of Wales Hospital day… Coity Road I’ll be worth every penny that you’ve had to pay Bridgend Remember, if I leave a bloody red trail CF31 1RQ That shows I’m working and not that I’ve failed ‘Guy Forks’ thought he had found a way of Phone: 01656 752820 Fax: 01656 752830 If in any doubt ring the contact that’s given removing slough faster than usual! Email: So I can do well in this short life I’m living. Mair Fear 2002