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Maggot Debridement Therapy in Disaster Medicine

Published online by Cambridge University Press:  09 December 2015

Frank Stadler ,
Ramon Z. Shaban  and
Peter Tatham
Frank Stadler*
Affiliation:
Department of International Business and Asian Studies, Griffith University, Gold Coast, Queensland, Australia
Ramon Z. Shaban
Affiliation:
Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia Department of Infection Control and Infectious Diseases, Gold Coast University Hospital and Health Service, Gold Coast, Australia
Peter Tatham
Affiliation:
Department of International Business and Asian Studies, Griffith University, Gold Coast, Queensland, Australia
*
Correspondence: Frank Stadler, BSc Hon Griffith Business School Department of International Business and Asian Studies Gold Coast Campus Griffith University Queensland, Australia 4222 E-mail: f.stadler@griffith.edu.au
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Abstract

Background

When disaster strikes, the number of patients requiring treatment can be overwhelming. In low-income countries, resources to assist the injured in a timely fashion may be limited. As a consequence, necrosis and wound infection in disaster patients is common and frequently leads to adverse health outcomes such as amputations, chronic wounds, and loss of life. In such compromised health care environments, low-tech and cheap wound care options are required that are in ready supply, easy to use, and have multiple therapeutic benefits. Maggot debridement therapy (MDT) is one such wound care option and may prove to be an invaluable tool in the treatment of wounds post-disaster.

Discussion

This report provides an overview of the wound burden experienced in various types of disaster, followed by a discussion of current treatment approaches, and the role MDT may play in the treatment of complex wounds in challenging health care conditions. Maggot debridement therapy removes necrotic and devitalized tissue, controls wound infection, and stimulates wound healing. These properties suggest that medicinal maggots could assist health care professionals in the debridement of disaster wounds, to control or prevent infection, and to prepare the wound bed for reconstructive surgery. Maggot debridement therapy-assisted wound care would be led by health care workers rather than physicians, which would allow the latter to focus on reconstructive and other surgical interventions. Moreover, MDT could provide a larger window for time-critical interventions, such as fasciotomies to treat compartment syndrome and amputations in case of life-threatening wound infection.

Recommendations

There are social, medical, and logistic hurdles to overcome before MDT can become widely available in disaster medical aid. Thus, research is needed to further demonstrate the utility of MDT in Disaster Medicine. There is also a need for reliable MDT logistics and supply chain networks. Integration with other disaster management activities will also be essential.

Conclusions

In the aftermath of disasters, MDT could play an important role facilitating timely and efficient medical treatment and improving patient outcomes. Existing social, medical, and logistic barriers will need to be overcome for MDT to be mainstreamed in Disaster Medicine.

StadlerF, ShabanRZ, TathamP. Maggot Debridement Therapy in Disaster Medicine. Prehosp Disaster Med. 2016;31(1):79–84.

Keywords

disasterinfectioninjurymaggot debridement therapywound care
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 1 , February 2016 , pp. 79 - 84
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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