What is Biological Debridement of Bed Sores?

Biological DebridementA bed sore, or pressure ulcer, is an injury that arises when the skin does not receive adequate blood flow in one area, typically due to prolonged pressure on the skin. People who spend most of their time in bed or in wheelchairs are most at risk of developing bed sores. Doctors can use several approved methods to treat bed sores. The most appropriate one will depend on the needs of the patient. One method the Food and Drug Administration (FDA) approved in 2004 is biological debridement.

About This Treatment Method

Debridement is the medical term for the removal of damaged or decayed tissue from a wound. It is a common type of treatment for burn injury, frostbite, and bed sore cases. Any injury where necrotic (dead) tissues or cells begin to overrun the wound area may require debridement. It is a method of preparing the wound for speedy healing. Without debridement, dead tissues may impede the body’s ability to develop new skin to heal a bed sore injury. Different ways to debride a bed sore include autolytic, mechanical, chemical, surgical, sharp, and biological.

Biological debridement refers to the use of maggots to eat and eliminate decayed tissue in a bed sore or other wound. Biological debridement of bed sores can be highly effective at removing decayed tissue while preserving healthy tissues, without the patient needing surgery. It is also an effective means of eliminating harmful bacteria from the bed sore that could otherwise cause an infection. Infections are serious potential complications of bed sores, and serious cases could be fatal. Using maggots significantly reduces the risk of infection and sepsis.

Another name for biological debridement is larval therapy. During larval therapy, a physician places maggots or maggot larvae on the bed sore site. The maggots will eat all the dead tissue within the wound, making it clean. It is similar to conventional surgical debridement in that it removes dead tissues; however, it does not put the patient on an operating table. Maggots yield the added benefit of disinfecting a bed sore wound as well, naturally releasing substances that kill bacteria and facilitate a healthy healing process.

Perks of Biological Debridement

Although many patients may hesitate at the idea of placing maggots on a bed sore, physicians have been using the biological debridement method for decades with great success. The FDA approved the use of “medical maggots” to debride nonhealing dead skin tissues, not only for pressure ulcers, but also for other ulcers and post-surgical wounds that have trouble healing. Medical maggots must comply with high safety and sanitation standards for use on patients in the U.S. Larval therapy comes with many benefits for patients, namely it is:

  • Non-surgical. There is no need for anesthesia, going under the knife, or recovery time with biological debridement.
  • Effective. Within 48 to 72 hours, the maggots can remove a large percentage of dead flesh without any intervention from the physician.
  • Enhanced wound healing. Maggot therapy is more thorough than other types of debridement in terms of sanitation, bacteria removal, and infection prevention.

Biological debridement is a form of controlled wound myiasis. A physician will apply maggots or their larvae directly on a bed sore in a dose of five to eight creatures per square centimeter. The maggots know exactly how to clean a bed sore wound, using mouth hooks to eliminate dead tissues and releasing sanitizing digestive enzymes at the same time. Once a physician determines the maggots have successfully done their job, the physician will remove the maggots in a controlled environment. Most cases require multiple debridement cycles for complete wound cleaning and care.


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