Can Medical Larval Effectively Debride Necrotic Tissue in Spinal Cord Injury Veterans with Wounds?

Background

Pressure injury is a common complication in the spinal cord population, (SCI). When chronic wounds develop they can be difficult to treat due to lack of sensory perception and other comorbidities. Maggot debridement therapy , (MDT) is an effective debriding agent and is currently being piloted at Hines Veterans Hospital in the SCI units.

Problem

Usual debridement methods which include sharp, enzymatic, mechanical and autolytic failed to prevent a reformation of slough and necrotic tissue. MDT was piloted in this population in an effort to obtain a clean wound base.

Method

In this quality improvement study, 20 veterans with 24 wounds in the SCI units received MDT after standard debridement methods had failed. Wounds were evaluated at baseline and 6 days after MDT application using the PUSH wound scoring system

Outcome

Of the 24 applications, MDT demonstrated improvement with a 74% decrease in the PUSH score. Although six patients demonstrated no change in PUSH scores due to larval non viability, there were no adverse effects due to the treatment.

Conclusion

MDT therapy can be a successful debridement treatment in the SCI population to obtain a necrotic free wound base in the SCI population. The failures of MDT were addressed with increased nursing education and improved site selection.

National Pressure Ulcer Advisory Panel (NPUAP). Retrieved October 2, 2018, from http://www.npuap.org/resources/educational-and-clinical-resources/push-tool/