[dspring]

Awsome topic people. I must say it has really sparked an interest. Also does anyone elsr have the creepy crawloes after reading this? LOL I just read this from National Geographic;

I call them microsurgeons," said Edgar Maeyens, Jr., a doctor in Coos Bay, Oregon, who employs maggot treatment. "They can do what we can't do with scalpels and lasers."

Only a few species of fly larvae, primarily blowflies, are suitable for such duty. Five to ten maggots are placed on each square centimeter (0.2 square inch) of a wound, which is then covered with a protective dressing that allows the maggots to breath. For the next 48 to 72 hours, the maggots dissolve dead tissue by secreting digestive juices and then ingesting the liquefied tissue and bacteria. The maggots grow from about two millimeters (0.08 inch) to nearly ten millimeters (0.4 inch) while doing the doctor's dirty work.

"I'm just a supporting actor here," Maeyens said. "The maggots are marvelous.

http://news.nationalgeographic.com/n...edicine_2.html

[teeituptom]

I love maggots

I love Politicians

I love lawyers

I love news reporters<paparazzi all>

Only the first statement is true, maggots can be very beneficial to wounds

the other 3 maggots feed on, what does that tell you

[flightnurse2b]

Originally Posted by billsnurse

Hi Everyone,

Does anyone have any experience with patients coming into the ED with maggots on them? What do you use to remove them?
Just thinking about it gives me the willies and I want to be prepared if it comes my way.

Thanks

oh god yes. and the funny thing is that some of the skin underneath looks really good! i think theres a couple different types of larvae.. some beneficial to wound healing, and some that eat healthy tissue.

anyway, i find the best way to remove them is with a suture removal kit.. the mini forceps work well.

the smell is forgettable and to be honest-- if they arent moving, they kinda dont look like bugs.. maybe little orzo pastas or something...

[wibobr]

Had one just a few weeks ago. Homeless/alcoholic, s/p tib/fib fx in a cast. non compliant as they get. The patient actually had them crawling out of her vagina and the wound on her cast. Cast removed, wound i+d'd to high heaven, betadine douches. Not pretty,actually made one of our more seasoned rn's a bit sick.

[edmia]

Originally Posted by RNontheroad

The patient had severed 3 of his fingers and they were using leeches to help revascularize the digits. Apparently they excrete something in their saliva that helps improve blood flow to the re-attached part.

Maggot and leech therapy have great clinical results. Maggots only consume dead tissue, so all the stories about maggots actually helping preserve a wound from more rapid deterioration are true.

Leeches are really great for wounds that need revascularization. I've seen it on post-op head & neck surgery patients. They're used to maximize the chances that flaps will take.

There's no need to worry about removing the leeches; they fall off by themselves when they're nice and full. It's a very cool thing to see. Most patients grow very fond of their leech friends .

[NRSKarenRN]

Procedure for Removal of Maggots
http://rnceus.com/mag/procremov.html

Depending on location, followup patient soak in Hubbard tank ideal to remove community acquired non-sterile maggots.

[EMT-2-RN]

Working in the ER I took care of a patient who was a burn victim 2 years prior. He was homeless and his legs had horrible wounds all over with dressings that looked like they had been there for at least a month. The smell was terrible. When taking of the patients socks and shoes, there were not only maggots but ants and small spiders crawling around. I had seen maggots in wounds before, but not like this. There were thousands. I tried soaking his wounds, flushing with betadine and Hydrogenperoxide. Nothing worked. As soon as you could scrape the maggots off and out of his wounds more would crawl out from. We did the best we could but I believe this man ended up having to have his legs amputated. It was certainly something to see.

[Ninaer]

7 years ago, I had a pt with the exact same thing. She lived with her husband and did not know anything about it. The reason why she had come to the hospital was that she became very lethargic. Too make the long story short, she had a rotting left breast/gangrenous/with strong odor/ and was very jaundiced.

[DoubleblessedRN]

Originally Posted by Hellllllo Nurse

Pt was a lady in her 40s- well dressed and appeared clean. She had a fungating CA of the breast. She kept it covered all the time at home, and never looked at it, even when bathing.
Well, we convinced her to let us take the dressing off- and there were maggots in her rotting breast.

EEEEWWWWW!! I once saw the EXACT same thing.

[northshore08]

bringing back memories....
I agree that the smell is usually related to "other things" about the patient, not the maggots. My biggest memory about this subject was a morbidly obese bed-bound pt with tunnelling bedsore; you could see them under the skin. I believe she went off for debridement...I remember brushing the little buggers off the bed while cleaning up, and thinking how they looked like soft grains of rice.
I, for one, am grateful for decon showers.