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Maggots in medical packaging. Maggot therapy improves healing in chronic ulcers. [1] In diabetic foot ulcers there is tentative evidence of benefit. [3] A Cochrane review of methods for the debridement of venous leg ulcers found maggot therapy to be broadly as effective as most other methods, but the study also noted that the quality of data was poor.
A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness focused on polyhexamethylene biguanide solution, Ringer's solution or saline in 112 venous leg ulcer patients. [31] The study group received the polyhexamethylene biguanide solution (n=59) and the control group received either Ringer's solution or saline (n=53).
Pressure ulcers can trigger other ailments, cause considerable suffering, and can be expensive to treat. Some complications include autonomic dysreflexia, bladder distension, bone infection, pyarthrosis, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation (Marjolin's ulcer – secondary carcinomas in chronic wounds).
It recommended that concentration be adopted as a "modified Dakin's solution" for wound dressing. [20] Currently, various concentrations are sold for wound cleansing including Anasept (0.057%), [ 21 ] 1/4 strength Dakin's (0.125%), and Di-Dak-Sol or Dakin's Wound Cleanser (0.0125%) which is 1/40 strength.
The dressing delivers absorption or hydration as needed over each independent wound area and aids in the natural process of autolytic debridement. It effectively removes liquefied slough and necrotic tissue, disintegrated bacterial biofilm as well as harmful exudate components, known to slow the healing process. [ 41 ]
Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. [ 2 ] [ 3 ] Removal may be surgical , mechanical, chemical, autolytic (self-digestion), or by maggot therapy .
The vacuum may be applied continuously or intermittently, depending on the type of wound being treated and the clinical objectives. Typically, the dressing is changed two to three times per week. [3] The dressings used for the technique include foam dressings, sealed with an occlusive dressing intended to contain the vacuum at the wound site. [1]
A 2013 Cochrane systematic review aimed to determine the effectiveness of foam dressings for helping to heal venous leg ulcers. The authors concluded that is uncertain whether or not foam dressings are more effective than other dressing types and that more randomized controlled trials are needed to help answer this research question. [ 53 ]