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AMPUTEE WOUND CARE. LOUISE WEBBER AMPUTEE & REHAB CNC SSWAHS. AIMS OF POST-OP WOUND CARE. WOUND HEALING WITHOUT COMPLICATION POTENTIAL COMPLICATIONS: WOUND BREAKDOWN DEHISCENCE INFECTION. WOUND MANAGEMENT. NEED TO CLEAN THE WOUND BED – DEBRIDE NECROTIC TISSUE
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AMPUTEE WOUND CARE LOUISE WEBBER AMPUTEE & REHAB CNC SSWAHS
AIMS OF POST-OP WOUND CARE • WOUND HEALING WITHOUT COMPLICATION POTENTIAL COMPLICATIONS: • WOUND BREAKDOWN • DEHISCENCE • INFECTION
WOUND MANAGEMENT NEED TO CLEAN THE WOUND BED – DEBRIDE NECROTIC TISSUE DECREASE THE BACTERIAL BURDEN OF THE WOUND
METHODS OF WOUND DEBRIDEMENT • SURGICAL DEBRIDEMENT • AUTOLYTIC DEBRIDEMENT Advanced wound care products • BIOLOGICAL DEBRIDEMENT Maggot Debridement Therapy
Which fly? Maggots used are from the fly Lucilia sericata
Life Cycle of the Fly Egg Fly Fly Maggot Pupa
How do they work? Contrary to popular belief maggots do not have teeth, so they cannot bite or chew away dead tissue ( this is also why they cannot be felt in a wound)
How do they eat? They feed by extra-corporeal digestion, secreting collagenases, trypsin-like, & chymotrypsin-like enzymes that break down necrotic tissue into a semi-liquid form that the maggots can ingest. These enzymes are only effective on devitalised tissue
Problems with maggot therapy Potential “yuk” factor Run-away dressing Short shelf life
Perceived advantages of maggot therapy Rapid wound debridement Reduction in odour Control of infection Maggots take their oxygen from the air Stimulation of granulation tissue Highly cost effective
26/02/10 After 3 days VAC 23/02/10 VAC Applied
17/03/10 03/03/10