Managing and monitoring maggots
“When a patient receives MDT, staff are really curious and excited about it … usually,” Axelrod says. Care is primarily observational. Significant drainage requires that the outer gauze be changed, according to Axelrod, and whoever does it can expect to see the squirming maggots at work. Although they start out about the size of an eyelash and are white-beige in color, they look more like a big, fat, puffy piece of brown rice when finished, usually after about 48 to 72 hours.
“Sometimes patients can have bleeding, but it’s rare,” Fuller says. “It probably means the maggots are getting down to live tissue. If there’s discomfort, she adds, the dressing should be removed and the patient assessed. Complaints can range from feeling the maggots moving to severe pain usually associated with ischemic wounds. Unless pain can be adequately controlled with analgesics or the patient’s anxiety relieved, treatment is terminated early.