REPORT OF A CASE
A 74-year-old man with a history of recurrent venous stasis ulcers presented to the clinic with a 1-month history of an enlarging, erythematous, tender, right pretibial wound. He recalled no trauma. Despite bedrest and oral dicloxacillin as prescribed, the patient returned to the clinic the following week with a larger wound, now described as a central black eschar with surrounding cellulitis. He was admitted for therapy with intravenous antibiotics (piperacillin and tazobactam) and frequent bedside surgical débridement. He did not tolerate a trial of hydrotherapy because of symptomatic hypotension. Plastic surgery consultants recommended split-thickness skin grafting after wound débridement; the wound was débrided two to three times weekly, limited primarily by the patient's pain and by concerns about the great depth of the wound and the patient's poor healing ability. Between débridements, his wound was dressed with hydrocolloid pads to aid in autolysis or with a
Sherman RA, Tran JM, Sullivan R. Maggot Therapy for Venous Stasis Ulcers. Arch Dermatol. 1996;132(3):254–256. doi:10.1001/archderm.1996.03890270026003
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