AMPUTEE WOUND CARE

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AMPUTEE WOUND CARE

• LOUISE WEBBER
• AMPUTEE REHAB CNC
• SSWAHS

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AIMS OF POST-OP WOUND CARE

• WOUND HEALING WITHOUT COMPLICATION
• POTENTIAL COMPLICATIONS
• WOUND BREAKDOWN
• DEHISCENCE
• INFECTION

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WOUND MANAGEMENT

• NEED TO CLEAN THE WOUND BED DEBRIDE NECROTIC
  TISSUE
• DECREASE THE BACTERIAL BURDEN OF THE WOUND

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METHODS OF WOUND DEBRIDEMENT

• SURGICAL DEBRIDEMENT
• AUTOLYTIC DEBRIDEMENT
• Advanced wound care products
• BIOLOGICAL DEBRIDEMENT
• Maggot Debridement Therapy

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Which fly?

• Maggots used are from the fly Lucilia sericata

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Life Cycle of the Fly
Egg
Fly
Fly
Maggot
Pupa
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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)

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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
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Problems with maggot therapy

• Potential yuk factor
• Run-away dressing
• Short shelf life

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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

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6 weeks post op 22/01/10
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12/02/10 Pre MDT
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15/02/10 Post 1st Application
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19/02/10 Post 2nd application
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26/02/10 After 3 days VAC
23/02/10 VAC Applied
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17/03/10
03/03/10
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QUESTIONS?????
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