Saturday, July 27, 2019
The Role of Larval Therapy as an Alternative to Conventional Treatment Essay
The Role of Larval Therapy as an Alternative to Conventional Treatment for Acute or Chronic Wounds - Essay Example An official history of larval therapy started in the early 1930s when American surgeon William Baer introduced the maggot therapy into the clinical practice (SMTL, 2003). He and his followers used sterile maggots and proved the efficiency of larval therapy of purulent surgical infection. But in spite of the huge amounts of articles published before the Second World War, we cannot use them for current analysis of evidence. The medicine passed long distance since the first attempts to manage heavy wounds were made and simple methods of maggot sterilization were introduced. When the era of antibiotics started medical community forgot about larvae. When surgeons faced the problem of antibiotic resistance and nosocomial infections they thinks were turned back to the larval therapy. But is this medical technology evidence based? To answer this question there was performed information search in the modern electronic databases Medline, Ovid, Direct Science and CIHAHL. The used keywords are presented as follows: ââ¬Å"larval therapyâ⬠, ââ¬Å"wound healingâ⬠, ââ¬Å"maggotâ⬠, and ââ¬Å"evidence-based practiceâ⬠. Appropriate Boolean operands ââ¬Å"ORâ⬠, ââ¬Å"ANDâ⬠and ââ¬Å"NORâ⬠were used also. To optimize search results and increase their relevance and pertinence the MeSH (Medical Subject Headings) thesaurus was applied, e.g. subheadings ââ¬Å"Wound Healing/physiology"[MeSH] and "Larva"[MeSH]. The preferences were given to the systematic reviews, meta-analyses and primary data of randomized clinical trials, i.e. to the information sources of the I level of evidence, as well as to the clinical guidelines based on the best evidence. Evidence-based practice can be determined as the concept of integrating the most current scientific evidence in making decisions about the delivery of healthcare services. There are several levels of evidence depending on the qualitative characteristics and the design of study. The highest level of evidence is represented by meta-analyses and/or systematicà reviews.
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