Biotherapy Flashcards
What is the most common fly used in MDT and what are its features?
The greenbottle
Larvae produce proteolytic enzymes such as collagenase (breaks down dead tissue), reabsorbed and digested
Come in large groups and feed head down - have pair of hooks for locomotion and attachment
Describe doctor fish
Grassberger and Hoch, 2006
Use of cyprinidae fish in treating psoriasis - may soften plaque
91% improvement observed
Risks - fish may act as pathogenic vectors - could be ruled out if sterilisation undertaken
What were the findings of nordstrom et al 2009 ?
Gangrene
Gangrene in 69 y/o man
Larval therapy can remove necrotic tissue/bacteria
5-10 larvae /cm2 applied to necrotic ulcers, showed increase in granulation tissue / new epithelial growth
Larvae separate healthy / necrotic tissue
What were the findings of macdougall et al 2004?
Compartmental syndrome
Larval therapy common before antibiotics
Mr B (77) - compartmental syndrome in leg - wound wouldn’t heal - pain/expenses
Larvae don’t ingest healthy tissue but secretions may irritate healthy tissue - use template to protect skin and secure larvae
how are larvae prepared for clinical use?
contaminated larvae removed/killed to ensure remaining larvae are sterile
wound tracing cut out and placed on dressing
first instar larvae (2mm) introduced to wound
recommended 10 larvae/cm2
larvae removed after 2 days
what are the properties of the medicinal leech? (Hirudo medicinas)
sucker at both ends - anterior creates bite wound for feeding - posterior maintains attachment
What is the therapeutic benefit of the leech?
salivary secretions produce an anaesthetic, anticoagulant (hirudin), local vasodilator (histamine) and hyaluronidase
what was the case of mr thomas|? (MDT) jones et al 1998
developed squamous cell carcinoma
chemo/radiotherapy but infection/odour remained
MDT reduced slough/odour but painful
NOT a cancer treatment but may be able to manage malignancy
