A research proposal
Title MAGGOTS; WHAT EFFECT DOES CONTAINMENT
OF MAGGOTS HAVE REGARDING THE EFFECTIVNESS OF TREATMENT AND TOLARANCE OF PATIENTS? Author: Natalie Merrick Student nurse yr3
Declaration of interest: I have chosen to investigate this topic as I have only worked with one patient using lave therapy treatment (contained) and was often designated the task of redressing and watering the lave, this particular gentleman did not mind the therapy and referred to the lave as “his little friends” I could not help but wonder if he wound have been so compliant if they were loose in his wound and if this would have made any difference to the healing process. Abstract: This article plans to compare the use of contained or caged maggots to those placed directly onto the wound bed itself (referred to in this research proposal as free range). All care has been taken to ensure that patient safety comes first and if at any point a healthcare professional feels that the treatment is not affective for the patient they will be excluded from the research and commenced on a more suitable or preferred treatment. I expect to find in my results that free range maggots are more effective, however patient tolerance will be better with contained lave due to fear of lave escaping the dressing and sensation if overlapped onto healthy skin.
Introduction Maggots, many recent articles comparing debridement versus maggot therapy. less information available on the application of maggots and how that effects the treatment and effectiveness of the maggots ability to debride, disinfect and stimulate healing. traditional method of free range maggots Vs. contained maggots in gauze or muslin bags. Validaty and reliability
“Accounts of maggots used on open wounds date back to the Old Testament.” (Baer 1931; Pechter and Shermanm 1983)
Bear 1931, treated a WW1 soldier on a battlefield using maggots for a femur fracture and abdominal wound. observed that the wounds were covered in maggots, after cleaning the wounds noticed that the wound bed consisted of healthy granulating tissue. due to this he began studying maggots and there effect on open wounds in detail and pionered the international treatment of skin infections with colliphorid fly larvae in 1931 it was deemed safe, effective and economical at this time and was widely used untill 1950 when antibiotics and surgical debridment therapys became more popular treatment option as suggested by; (BioTherapeutics
Education & Research Foundation [BTER], 2003; Fleischmann, Grassberger, & Sherman, 2004;
Maggots on wounds have been used for Debridment, disinfection, stimulation of healing and biofilm inhibitation and eradication. Although these benafits have use on any wound area or infected skin tissue research has proven maggots to be preticularly useful in pressure ulcer treatment and diabetic foot ulcers. as suggested by Bear (1931), Horn Cobb and Gates (1976) Sherman (2002), Steenvoorde (2004) and Tantawi (2007)
Research has been condicted into the sub-spieces of maggots that is most effective by: REFRANCE And also research has been conducted into patient tolerance of the treatment by: REFRANCE However, less research has been done to see if patient tolerance and containment are directly related, and the extent that containment hinders the debridment process. Sample Inclusion and exclusion: No participant’s with servicer sepsis or gangrene and need amputation (due to the risk of patient) none of the sample group shall be diabetic as this will affect the rate of healing and cause results to be skewed. For the same reason the wounds on each patient must be about the same size and depth with equal quality of tissue (5x5x0.5cm 70% slough, for example). To keep my research fair and ethical I intend to select clients of similar age and health for a fair opportunity for contained and free ranged maggots. Due to the nature of this research in intend to...
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