Exploring the barriers and effectiveness of larvae therapy in chronic wound management in community nursing An integrative literature review

Main Article Content

Evgeniya Krotneva

Abstract

Aim: This paper critically evaluates the effectiveness of larvae therapy, also known as maggot debridement therapy, in managing chronic wounds and its potential for wider implementation within community nursing settings. Larvae therapy, as a biological method of debridement, has been used for centuries, with recent advancements renewing the interest due to its ability to cleanse necrotic tissue effectively.


Methodology: The methodological approach follows the PICO framework and includes an integrative literature review process based on the PRISMA guidelines.


Findings: Larvee therapy is clinically effective in improving wound healing and dissolving necrotic tissue, yet challenges persist, such as patient/clinician acceptance, stigma, lack of awareness, insufficient training and finances influencing nurse-led management.


Conclusion: Enhancing the integration of community nursing practice will require overcoming key barriers. These include, public, nurse and patient acceptance; clinical policy and evidence-based guidelines; continuing professional development; allocation of resources based on cost benefit analysis, while also prioritising further research into patient experience.

Article Details

Section

Review articles

Author Biography

Evgeniya Krotneva, University of Lancashire

Evgeniya is a registered nurse currently working as a Community Nurse within NHS England. She completed her Bachelor’s degree in Nursing at the University of Central Lancashire and later obtained a Master’s degree in Nursing, further developing her clinical and academic expertise. She has extensive experience in community healthcare, patient-centered care, and health promotion, supporting individuals with complex health needs through holistic, evidence-based practice. Her academic interests include public health, preventive healthcare, and the integration of clinical practice with research and education. She is committed to continuous professional development and aims to contribute to healthcare innovation through academic research and collaboration.

References

Reference List:

Akbarzadeh, K., Saghafipour, A., Jesri, N., Karami-Jooshin, M., Arzamani, K., Hazratian, T., & Afshar, A. (2018). Spatial distribution of necrophagous flies of infraorder muscomorpha in Iran using geographical information system. Journal of Medical Entomology, 55(5), 1071-1085. https://doi.org/10.1093/jme/tjy036

Akdis, C. A. (2021). Does the epithelial barrier hypothesis explain the increase in allergy, autoimmunity, and other chronic conditions? Nature Reviews Immunology, 21(11), 739-751. https://doi.org/10.1038/s41577-021-00558-6

Al-Jalodi, O., Serena, M., Breisinger, K., Patel, K., Harrell, K., & Serena, E. (2021). A novel debridement device for the treatment of hard-to-heal wounds: A prospective trial. Journal of Wound Care, 30(5), 32-36. https://doi.org/10.12968/jowc.2021.30.5.S32

Angel, D. (2019). Slough: What does it mean and how can it be managed? Wound Practice & Research: Journal of the Australian Wound Management Association, 27(4), 164-167. https://doi.org/10.33235/wpr.27.4.164-167

Azevedo, M., Lisboa, C., Cobrado, L., Pina-Vaz, C., & Rodrigues, A. (2020). Hard-to-heal wounds, biofilm and wound healing: An intricate interrelationship. British Journal of Nursing, 29(5), S6-S13. https://doi.org/10.12968/bjon.2020.29.5.S6

Bazaliński, D., Kózka, M., Karnas, M., & Więch, P. (2019). Effectiveness of chronic wound debridement with the use of larvae of Lucilia sericata. Journal of Clinical Medicine, 8(11), 36-41. https://doi.org/10.3390/jcm8111836

Bazaliński, D., Przybek-Mita, J., Pytlak, K., Kardyś, D., Bazaliński, A., Kucharzewski, M., & Więch, P. (2023). Larval wound therapy: Possibilities and potential limitations—a literature review. Journal of Clinical Medicine, 12(21), 60-66. https://doi.org/10.3390/jcm12216060

Bosanquet, C., & Harding, G. (2022). Wound healing: Potential therapeutic options. British Journal of Dermatology, 187(2), 149-158. https://doi.org/10.1111/bjd.21348

Brocke, T., & Barr, J. (2020). The history of wound healing. Surgical Clinics, 100(4), 787-806. https://doi.org/10.1016/j.suc.2020.04.004

Brożyna, M., Dudek, B., Kozłowska, W., Malec, K., Paleczny, J., Detyna, J., & Junka, A. (2024). The chronic wound milieu changes essential oils' antibiofilm activity—An in vitro and larval model study. Scientific Reports, 14(1), 22-31. https://doi.org/10.1038/s41598-024-21079-z

Bryant, A., Moore, E., & Iyer, V. (2021). Clinical profile of the SEM scanner—modernizing pressure injury care pathways using sub-epidermal moisture (SEM) scanning. Expert Review of Medical Devices, 18(9), 833-847. https://doi.org/10.1080/17434440.2021.1975321

Bucekova, M., Sojka, M., Valachova, I., Martinotti, S., Ranzato, E., Szep, Z., & Majtan, J. (2017). Bee-derived antibacterial peptide, defensin-1, promotes wound reepithelialisation in vitro and in vivo. Wound Healing Southern Africa, 10(2), 25-35. https://doi.org/10.33235/whsa.10.2.25-35

Bugeja, L., Low, K., McGinnes, A., Team, V., Sinha, S., & Weller, C. (2018). Barriers and enablers to patient recruitment for randomised controlled trials on treatment of chronic wounds: A systematic review. International Wound Journal, 15(6), 880-892. https://doi.org/10.1111/iwj.12962

Burian, E. A., Karlsmark, T., Franks, P. J., Keeley, V., Quéré, I., & Moffatt, J. (2021). Cellulitis in chronic oedema of the lower leg: An international cross-sectional study. British Journal of Dermatology, 185(1), 110-118. https://doi.org/10.1111/bjd.2021.16821

Chandrasekaran, R., Krishnan, M., Bupesh, G., Chacko, S., Gawade, O., Hasan, S., & Sagadevan, S. (2023). Prospective features of functional 2D nanomaterial graphene oxide in the wound healing process. Journal of Drug Delivery Science and Technology, 82,(1), 116-121. https://doi.org/10.1016/j.jddst.2023.103757

Chen, L., Cheng, L., Gao, W., Chen, D., Wang, C., & Ran, X. (2020). Telemedicine in chronic wound management: Systematic review and meta-analysis. JMIR mHealth and uHealth, 8(6), 115-157. https://doi.org/10.2196/18199

Coelho, A., Secretan, H., Tortolano, L., Charvet, L., & Yagoubi, N. (2023). Evolution of the chronic venous leg ulcer microenvironment and its impact on medical devices and wound care therapies. Journal of Clinical Medicine, 12(17), 56-63. https://doi.org/10.3390/jcm12175636

Dalgleish, L., Campbell, J., Finlayson, K., & Coyer, F. (2020). Acute skin failure in the critically ill adult population: A systematic review. Advances in Skin & Wound Care, 33(2), 76-83. https://doi.org/10.1097/01.asw.0000650195.70299.44

Dissemond, J., Gerber, V., Lobmann, R., Kramer, A., Mastronicola, D., Senneville, E., & Strohal, R. (2020). Therapeutic index for local infections score (TILI): A new diagnostic tool. Journal of Wound Care, 29(12), 720-726. https://doi.org/10.12968/jowc.2020.29.12.720

Dryden, M. S. (2020). Reactive oxygen species treatment in the management of wounds. In Burns, Infections and Wound Management, 13(2), 285-294. Retreived from: https://wounds-uk.com/wp-content/uploads/2023/02/3bd66abc881d9e8119d372464db2c754.pdf

Eckert, A., Fife, E., & Carter, J. (2023). The impact of underlying conditions on quality-of-life measurement among patients with chronic wounds, as measured by utility values: A review with an additional study. Advances in Wound Care, 12(12), 680-695. https://doi.org/10.1089/wound.2023.1001

Falanga, V., Isseroff, R., Soulika, M., Romanelli, M., Margolis, D., Kapp, S., & Harding, K. (2022). Chronic wounds. Nature Reviews Disease Primers, 8(1), 50-56. https://doi.org/10.1038/s41572-022-00472-0

Fernández-Araque, A., Martinez-Delgado, M., Jiménez, M., López, M., Castro, J., & Gila, C. (2024). Assessment of nurses' level of knowledge of the management of chronic wounds. Nurse Education Today, 134(1), 66-69. https://doi.org/10.1016/j.nedt.2024.105741

Firlar, I., Altunbek, M., McCarthy, C., Ramalingam, M., & Camci-Unal, G. (2022). Functional hydrogels for treatment of chronic wounds. Gels, 8(2), 127-131. https://doi.org/10.3390/gels8020127

Galluzzi, L., Bravo-San Pedro, M., Levine, B., Green, R., & Kroemer, G. (2017). Pharmacological modulation of autophagy: Therapeutic potential and persisting obstacles. Nature Reviews Drug Discovery, 16(7), 487-511. https://doi.org/10.1038/nrd.2017.58

Gethin, G., Probst, S., Stryja, J., Christiansen, N., & Price, P. (2020). Evidence for person-centred care in chronic wound care: A systematic review and recommendations for practice. Journal of Wound Care, 29(9), 1-22. https://doi.org/10.12968/jowc.2020.29.9b.S1

Ghaly, P., Iliopoulos, J., & Ahmad, M. (2021). The role of nutrition in wound healing: An overview. British Journal of Nursing, 30(5), S38-S42. https://doi.org/10.12968/bjon.2021.30.5.S38

Gieroń, M., Słowik-Rylska, M., & Kręcisz, B. (2018). Effectiveness of maggot debridement therapy in treating chronic wounds—Review of current literature. Medical Studies/Studia Medyczne, 34(4), 325-331. https://doi.org/10.5114/ms.2018.77413

Graves, N., Phillips, J., & Harding, K. (2022). A narrative review of the epidemiology and economics of chronic wounds. British Journal of Dermatology, 187(2), 141-148. https://doi.org/10.1111/bjd.21344

Gray, R., & Sanders, C. (2020). A reflection on the impact of COVID-19 on primary care in the United Kingdom. Journal of Interprofessional Care, 34(5), 672-678. https://doi.org/10.1080/13561820.2020.1794432

Guest, J. F., Fuller, G. W., & Vowden, P. (2020). Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: Update from 2012/2013. BMJ Open, 10(12), 165-170. https://doi.org/10.1136/bmjopen-2020-037042

Guimarães, I., Baptista-Silva, S., Pintado, M., & Oliveira, A. L. (2021). Polyphenols: A promising avenue in therapeutic solutions for wound care. Applied Sciences, 11(3), 66-69. https://doi.org/10.3390/app11030669

Gulumbe, B. H., & Abdulrahim, A. (2023). Pushing the frontiers in the fight against antimicrobial resistance: The potential of fecal and maggot therapies. Future Science OA, 9(10), 166-171. https://doi.org/10.2144/fsoa-2023-0048

Guo, X., Liu, Y., Bera, H., Zhang, H., Chen, Y., Cun, D., & Yang, M. (2020). α-Lactalbumin-based nanofiber dressings improve burn wound healing and reduce scarring. ACS Applied Materials & Interfaces, 12(41), 45-48. https://doi.org/10.1021/acsami.0c12671

Harman, R. M., Theoret, L., & Van de Walle, R. (2021). The horse as a model for the study of cutaneous wound healing. Advances in Wound Care, 10(7), 381-399. https://doi.org/10.1089/wound.2020.1143

Hazlehurst, M., Logue, J., Parretti, M., Abbott, S., Brown, A., Pournaras, J., & Tahrani, A. (2020). Developing integrated clinical pathways for the management of clinically severe adult obesity: A critique of NHS England policy. Current Obesity Reports, 9(1), 530-543. https://doi.org/10.1007/s13679-020-00383-w

Hearn, H., Rohn, J., & Monden, R. (2022). Isolated and anxious: A qualitative exploration of the impact of the COVID-19 pandemic on individuals living with spinal cord injury in the UK. The Journal of Spinal Cord Medicine, 45(5), 691-699. https://doi.org/10.1080/10790268.2022.2079049

Hofmeyer, A., & Taylor, R. (2021). Strategies and resources for nurse leaders to use to lead with empathy and prudence so they understand and address sources of anxiety among nurses practising in the era of COVID‐19. Journal of Clinical Nursing, 30(1-2), 298-305. https://doi.org/10.1111/jon.15262

Holloway, S., Pokornà, A., Janssen, A., Ousey, K., & Probst, S. (2020). Wound curriculum for nurses: Post-registration qualification wound management–European qualification framework level 7. Journal of Wound Care, 29(7), 1-39. https://doi.org/10.12968/jowc.2020.29.7.S1

Hopkins, R. C., Williams, S., Brown, A., Humphreys, I., Clifford, R., & Nigam, Y. (2022). Evaluating nursing opinion and perception of maggot therapy for hard-to-heal wound management. Journal of Wound Care, 31(10), 846-863. https://doi.org/10.12968/jowc.2022.31.10.846

Jordan, A., Khiyani, N., Bowers, R., Lukaszczyk, J., & Stawicki, P. (2018). Maggot debridement therapy: A practical review. International Journal of Academic Medicine, 4(1), 21-34. https://doi.org/10.4103/IJAM.IJAM_51_17

Kenawy, A., & Abdel-Hamid, M. (2020). Maggot therapy “Use of fly larvae for treatment of wounds”-A review. Egyptian Academic Journal of Biological Sciences, E. Medical Entomology & Parasitology, 12(2), 1-10. https://doi.org/10.21608/eajbsa.2020.164937

Kerr, A. (2022). Cutting costs and caseloads with a monofilament debridement pad. Journal of Community Nursing, 36(6), 22-24. https://doi.org/10.12968/jocn.2022.36.6.22

Khalid, A., Nawi, M., Zulkifli, N., Barkat, A., & Hadi, H. (2022). Aging and wound healing of the skin: A review of clinical and pathophysiological hallmarks. Life, 12(12), 66-69. https://doi.org/10.3390/life12120669

Kolluri, R., Lugli, M., Villalba, L., Varcoe, R., Maleti, O., Gallardo, F., & Beckman, J. A. (2022). An estimate of the economic burden of venous leg ulcers associated with deep venous disease. Vascular Medicine, 27(1), 63-72. https://doi.org/10.1177/1358863X211059707

Laurano, R., Boffito, M., Ciardelli, G., & Chiono, V. (2022). Wound dressing products: A translational investigation from the bench to the market. Engineered Regeneration, 3(2), 182-200. https://doi.org/10.1016/j.engreg.2022.05.002

Li, M., Dilley, D., Carson, A., Twelftree, J., Hutchinson, J., Belli, A., & Greenwood, R. (2021). Management of traumatic brain injury (TBI): A clinical neuroscience-led pathway for the NHS. Clinical Medicine, 21(2), e198-e205. https://doi.org/10.7861/clinmed.2020-0610

Lo, Z. J., Lim, X., Eng, D., Car, J., Hong, Q., Yong, E., & Heng, H. (2020). Clinical and economic burden of wound care in the tropics: A 5‐year institutional population health review. International Wound Journal, 17(3), 790-803. https://doi.org/10.1111/iwj.13354

Lumbers, M. (2018). Wound debridement: Choices and practice. British Journal of Nursing, 27(15), 16-20. https://doi.org/10.12968/bjon.2018.27.15.S16

Lumbers, M. (2020). New tools in wound care to support evidence-based best practice. British Journal of Community Nursing, 25(3), 26-29. https://doi.org/10.12968/bjcn.2020.25.3.S26

Maben, J., & Bridges, J. (2020). COVID-19: Supporting nurses' psychological and mental health. Journal of Clinical Nursing, 29(15-16), 2742-2744. https://doi.org/10.1111/jon.15373

Maben, J., Conolly, A., Abrams, R., Rowland, E., Harris, R., Kelly, D., & Couper, K. (2022). ‘You can't walk through water without getting wet’ UK nurses’ distress and psychological health needs during the Covid-19 pandemic: A longitudinal interview study. International Journal of Nursing Studies, 131 (1), 216-221. https://doi.org/10.1016/j.ijnurstu.2022.103764

Maheswary, T., Nurul, A., & Fauzi, B. (2021). The insights of microbes’ roles in wound healing: A comprehensive review. Pharmaceutics, 13(7), 79-86. https://doi.org/10.3390/pharmaceutics13070779

Mahmood, F., Hussain, A., & Akingboye, A. (2020). Pilonidal sinus disease: Review of current practice and prospects for endoscopic treatment. Annals of Medicine and Surgery, 57(1), 212-217. https://doi.org/10.1016/j.amsu.2020.06.014

Mahmoudi, M., & Gould, J. (2020). Opportunities and challenges of the management of chronic wounds: A multidisciplinary viewpoint. Chronic Wound Care Management and Research, 2020(7), 27-36. https://doi.org/10.2147/CWCMR.S260136

Mahoney, K. (2020). Part 2: Wound cleansing and debridement. Journal of Community Nursing, 34(3), 26-31. https://doi.org/10.12968/jocn.2020.34.3.26

Markiewicz-Gospodarek, A., Kozioł, M., Tobiasz, M., Baj, J., Radzikowska-Büchner, E., & Przekora, A. (2022). Burn wound healing: Clinical complications, medical care, treatment, and dressing types: The current state of knowledge for clinical practice. International Journal of Environmental Research and Public Health, 19(3), 113-122. https://doi.org/10.3390/ijerph19031013

McDonald, M., Bailey, R., & Birch, E. (2020). Improving wound care services through a shared care pathway. Journal of Community Nursing, 34(5), 26-29. https://doi.org/10.12968/jocn.2020.26.6.26

McLoone, P., Tabys, D., & Fyfe, L. (2020). Honey combination therapies for skin and wound infections: A systematic review of the literature. Clinical, Cosmetic and Investigational Dermatology, 13(1), 875-888.

McNamara, A., Hirt, A., Weigelt, A., Nanda, S., de Bedout, V., Kirsner, S., & Schachner, A. (2020). Traditional and advanced therapeutic modalities for wounds in the paediatric population: An evidence-based review. Journal of Wound Care, 29(6), 321-334. https://doi.org/10.12968/jowc.2020.29.6.321

Melguizo-Rodríguez, L., de Luna-Bertos, E., Ramos-Torrecillas, J., Illescas-Montesa, R., Costela-Ruiz, J., & García-Martínez, O. (2021). Potential effects of phenolic compounds that can be found in olive oil on wound healing. Foods, 10(7), 45-49. https://doi.org/10.3390/foods10010045

Milne, J., Searle, R., & Styche, T. (2020). The characteristics and impact of hard-to-heal wounds: Results of a standardised survey. Journal of Wound Care, 29(5), 282-288. https://doi.org/10.12968/jowc.2020.29.5.282

Moore, K., & Baxter, E. (2021). ‘Wound preparation’ using a 2-in-1 cleansing and debridement tool. Wounds UK, 17(3), 82-86. Retreived from: https://wounds-uk.com/journal-articles/wound-preparation-using-2-1-cleansing-and-debridement-tool/

Morris, D., Flores, M., Harris, L., Gammon, J., & Nigam, Y. (2023). Larval therapy and larval excretions/secretions: A potential treatment for biofilm in chronic wounds? A systematic review. Microorganisms, 11(2), 457-469. https://doi.org/10.3390/microorganisms11020457

Moya-López, J., Costela-Ruiz, V., García-Recio, E., Sherman, R. A., & De Luna-Bertos, E. (2020). Advantages of maggot debridement therapy for chronic wounds: A bibliographic review. Advances in Skin & Wound Care, 33(10), 515-525. https://doi.org/10.1097/01.ASW.0000683465.42306.19

Mudjahid, M., Nainu, F., Utami, N., Sam, A., Marzaman, F., Roska, P., & Permana, D. (2022). Enhancement in site-specific delivery of chloramphenicol using bacterially sensitive microparticles loaded into dissolving microneedles: Potential for enhanced effectiveness treatment of cellulitis. ACS Applied Materials & Interfaces, 14(51), 560-565. https://doi.org/10.1021/acsami.2c18275

Mumford, Z., & Nigam, Y. (2024). Maggots in medicine: A narrative review discussing the barriers to maggot debridement therapy and its utilisation in the treatment of chronic wounds. Journal of Clinical Medicine, 13(22), 67-72. https://doi.org/10.3390/jcm13223672

Murphy, C., Atkin, L., Hurlow, J., Swanson, T., & de Ceniga, V. (2021). Wound hygiene survey: Awareness, implementation, barriers, and outcomes. Journal of Wound Care, 30(7), 582-590. https://doi.org/10.12968/jowc.2021.30.7.582

Murphy, C., Atkin, L., Swanson, T., Tachi, M., Tan, K., de Ceniga, M. V., ... & Wilson, P. (2020). Defying hard-to-heal wounds with an early antibiofilm intervention strategy: Wound hygiene. Journal of Wound Care, 29(3), 1-26. https://doi.org/10.12968/jowc.2020.29.Sup3b.S1

Naik, G., & Harding, G. (2017). Maggot debridement therapy: The current perspectives. Chronic Wound Care Management and Research, 2017(4), 121-128. https://doi.org/10.2147/CWCMR.S121055

Ng, P., Ling, J., Chew, J., & Lau, Y. (2022). The role of artificial intelligence in enhancing clinical nursing care: A scoping review. Journal of Nursing Management, 30(8), 365-372. https://doi.org/10.1111/jonm.13267

Nigam, Y., Williams, S., Humphreys, I., Clifford, R., & Brown, A. (2022). An exploration of public perceptions and attitudes towards maggot therapy. Journal of Wound Care, 31(9), 756-770. https://doi.org/10.12968/jowc.2022.31.9.756

Nishijima, A., Gosho, M., Yoshida, R., Yanagibayashi, S., Takikawa, M., Nishijima, J., & Yamamoto, N. (2017). Effective wound bed preparation using maggot debridement therapy for patients with critical limb ischaemia. Journal of Wound Care, 26(8), 483-489. https://doi.org/10.12968/jowc.2017.26.8.483

Nishijima, A., Yamamoto, N., Yoshida, R., Hozawa, K., Yanagibayashi, S., Takikawa, M., & Sekido, M. (2017). Maggot debridement therapy for a patient with critical limb ischaemia and severe cardiac dysfunction: Possibility of limb salvage. Case Reports in Plastic Surgery and Hand Surgery, 4(1), 42-47. https://doi.org/10.1080/2331206X.2017.1374846

Nishijima, A., Yamamoto, N., Yoshida, R., Yanagibayashi, S., Takikawa, M., Hayasaka, R., & Sekido, M. (2017). Maggot debridement therapy with a direct dressing can cause compression injuries in patients with chronic limb ischemia. Case Reports in Plastic Surgery and Hand Surgery, 4(1), 84-88. https://doi.org/10.1080/2331206X.2017.1374847

Nowak, M., Mehrholz, D., Barańska-Rybak, W., & Nowicki, R. (2022). Wound debridement products and techniques: Clinical examples and literature review. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(3), 479-490. https://doi.org/10.5114/ada.2022.118391

Ovens, L. (2017). Electrical stimulation therapy and electroceutical treatment for the management of venous leg ulcers. British Journal of Community Nursing, 22(3), 28-36. https://doi.org/10.12968/bjcn.2017.22.Sup3.S28

Pajarillo, C., Sherman, A., Sheridan, R., & Kazis, E. (2021). Health professionals' perceptions of maggot debridement therapy. Journal of Wound Care, 30(9), VIIi-VIIxi. https://doi.org/10.12968/jowc.2021.30.Sup9a.VIIi

Papi, M., Rerkasem, K., & Mani, R. (2018). Future of biologics in healing angiopathic wounds. The International Journal of Lower Extremity Wounds, 17(4), 203-204. https://doi.org/10.1177/1534734618764480

Pawlowska, R., Radzikowska-Cieciura, E., Jafari, S., Fastyn, J., Korkus, E., Gendaszewska-Darmach, E., & Chworos, A. (2024). Double-modified, thio and methylene ATP analogue facilitates wound healing in vitro and in vivo. Scientific Reports, 14(1), 131-136. https://doi.org/10.1038/s41598-024-37745-5

Peña, A., & Martin, P. (2024). Cellular and molecular mechanisms of skin wound healing. Nature Reviews Molecular Cell Biology, 25(8), 599-616. doi: 10.1038/s41580-024-00715-1.

Perez-Favila, A., Martinez-Fierro, L., Rodriguez-Lazalde, G., Cid-Baez, A., Zamudio-Osuna, J., Martinez-Blanco, R., & Garza-Veloz, I. (2019). Current therapeutic strategies in diabetic foot ulcers. Medicina, 55(11), 714. https://doi.org/10.3390/medicina55110714

Pfettscher, A. (2021). Florence Nightingale: Modern nursing. In M. R. Alligood (Ed.), Nursing Theorists and Their Work (pp. 52-70). Elsevier.

Phillips, J., Humphreys, I., Thayer, D., Elmessary, M., Collins, H., Roberts, C., & Harding, K. (2020). Cost of managing patients with venous leg ulcers. International Wound Journal, 17(4), 1074-1082. https://doi.org/10.1111/iwj.13432

Pinto, M., Cerqueira, A., Bañobre-Lópes, M., Pastrana, M., & Sillankorva, S. (2020). Bacteriophages for chronic wound treatment: From traditional to novel delivery systems. Viruses, 12(2), 235. https://doi.org/10.3390/v12020235

Polat, N., Koç, M., Ayhan, H., & Mollahaliloğlu, S. (2022). A systematic review of effective bioagents in chronic wounds: The maggot biotherapy pyramid. Ankara Medical Journal, 22(2), 76-78. https://doi.org/10.5505/amj.2022.04251

Popescu, V., Cauni, V., Petrutescu, S., Rustin, M., Bocai, R., Turculet, R., & Mastalier, B. (2023). Chronic wound management: From gauze to homologous cellular matrix. Biomedicines, 11(9), 124-133. https://doi.org/10.3390/biomedicines11010124

Powell, K., Pujji, S., & Jeffery, S. (2021). Wound healing: What is the NICE guidance from the UK?. Journal of Wound Care, 30(3), 172-182. https://doi.org/10.12968/jowc.2021.30.3.172

Prieto, J., Wilson, J., Bak, A., Denton, A., Flores, A., Lusardi, G., & Loveday, H. (2020). A prevalence survey of patients with indwelling urinary catheters on district nursing caseloads in the United Kingdom: The Community Urinary Catheter Management (CCaMa) Study. Journal of Infection Prevention, 21(4), 129-135. https://doi.org/10.1177/1757177420927343

Qiu, Y., Sun, X., Lin, X., Yi, W., & Jiang, J. (2022). An injectable metal nanoparticle containing cellulose derivative-based hydrogels: Evaluation of antibacterial and in vitro–vivo wound healing activity in children with burn injuries. International Wound Journal, 19(3), 666-678. DOI: 10.1111/iwj.13647

Rahma, S., Woods, J., Brown, S., Nixon, J., & Russell, D. (2022). The use of point-of-care bacterial autofluorescence imaging in the management of diabetic foot ulcers: a pilot randomized controlled trial. Diabetes Care, 45(7), 1601-1609. DOI: 10.2337/dc21-2340

Raina, N., Rani, R., Pahwa, R., & Gupta, M. (2022). Biopolymers and treatment strategies for wound healing: an insight view. International Journal of Polymeric Materials and Polymeric Biomaterials, 71(5), 359-375. DOI: 10.1080/00914037.2021.1943580

Redford, K., Murphy, K., & Hill, B. (2024). Factors influencing nurses’ use of maggot debridement therapy. British Journal of Nursing, 33(15), 34-37. DOI: 10.12968/bjon.2024.33.15.S34

Rickard, F., Ibitoye, S., Deakin, H., Walton, B., Thompson, J., Shipway, D., & Braude, P. (2021). The Clinical Frailty Scale predicts adverse outcome in older people admitted to a UK major trauma centre. Age and Ageing, 50(3), 891-897. DOI: 10.1093/ageing/afaa258

Rippon, G., Rogers, A., & Ousey, K. (2023). Polyhexamethylene biguanide and its antimicrobial role in wound healing: A narrative review. Journal of Wound Care, 32(1), 5-20. DOI: 10.12968/jowc.2023.32.1.5

Robinson, P. (2021). Pharmacology, polypharmacy and the older adult: a review. British Journal of Community Nursing, 26(6), 290-295. DOI: 10.12968/bjcn.2021.26.6.290

Roehrs, H., Stocco, G., Pott, F., Blanc, G., Meier, J., & Dias, A. (2023). Dressings and topical agents containing hyaluronic acid for chronic wound healing. Cochrane Database of Systematic Reviews, 27(7), 45-49. DOI: 10.1002/14651858.CD013557.pub2

Ryan, H., Post, H., & Board, A. (2022). The shared wound care continuum: factors that influence a patient’s preference and suitability for shared wound care. Wounds International, 13(4), 54-60. DOI: 10.1016/j.wint.2022.07.001

Saab, M., Landers, M., Murphy, D., O’Mahony, B., Cooke, E., O’Driscoll, M., & Hegarty, J. (2022). Nursing students’ views of using virtual reality in healthcare: A qualitative study. Journal of Clinical Nursing, 31(9-10), 1228-1242. DOI: 10.1111/jocn.16147

Samuriwo, R., & Hannigan, B. (2020). Wounds in mental health care: The archetype of a ‘wicked problem of many hands’ that needs to be addressed?. International Journal of Mental Health, 49(1), 81-96. DOI: 10.1080/00207411.2019.1650190

Sayeed, A., Ahmed, A., Sharma, C., & Hasan, A. (2019). Ivermectin: A novel method of treatment of nasal and nasopharyngeal myiasis. Indian Journal of Otolaryngology and Head & Neck Surgery, 71(3), 2019-2024. DOI: 10.1007/s12070-019-01556-0

Sen, K. (2021). Human wound and its burden: updated 2020 compendium of estimates. Advances in Wound Care, 10(5), 281-292. DOI: 10.1089/wound.2021.1306

Sherman, R. (2022). Medicinal Maggot Application and Maggot Therapy Dressing Technology. In A Complete Guide to Maggot Therapy: Clinical Practice, Therapeutic Principles, Production, Distribution, and Ethics 79-96. Open Book Publishers. DOI: 10.11647/OBP.0270.05

Shi, C., Wang, C., Liu, H., Li, Q., Li, R., Zhang, Y. & Wang, J. (2020). Selection of appropriate wound dressing for various wounds. Frontiers in Bioengineering and Biotechnology, 8(1), 182-186. https://doi.org/10.3389/fbioe.2020.000182

Shin, L., Bowling, L., Armstrong, G., & Boulton, J. (2020). Saving the diabetic foot during the COVID-19 pandemic: A tale of two cities. Diabetes Care, 43(8), 170-179. https://doi.org/10.2337/dci20-0011

Sig, K., Koru, O., & Araz, E. (2018). Maggot debridement therapy: Utility in chronic wounds and a perspective beyond. Wound Practice & Research: Journal of the Australian Wound Management Association, 26(3), 146-153. https://doi.org/10.33235/wpr.26.3.146-153

Smet, S., Probst, S., Holloway, S., Fourie, A., Beele, H. & Beeckman, D. (2021). The measurement properties of assessment tools for chronic wounds: A systematic review. International Journal of Nursing Studies, 121(1), 234-241. https://doi.org/10.1016/j.ijnurstu.2021.103973

Song, M., Bai, X., Wang, D., Wang, Q., Pan, L., He, P., & Wang, S. (2022). Combined application of moist exposed burn ointment and maggot therapy in wound healing. Journal of Wound Care, 31(10), 41-52. https://doi.org/10.12968/jowc.2022.31.Sup10.S41

Stan, D., Tanase, C., Avram, M., Apetrei, R., Mincu, B., Mateescu, L., & Stan, D. (2021). Wound healing applications of creams and “smart” hydrogels. Experimental Dermatology, 30(9), 1218-1232. https://doi.org/10.1111/exd.14447

Stephens, M., Wynn, M., Pradeep, S., Ackers, L., & Namiiro, R. (2023). Frugal innovation in wound management within a low resource inpatient setting: A case series. Wounds UK, 19(3), 81-84. https://doi.org/10.33235/wuk.19.3.81-84

Tabriz, G., & Douroumis, D. (2022). Recent advances in 3D printing for wound healing: A systematic review. Journal of Drug Delivery Science and Technology, 74(1), 115-126. https://doi.org/10.1016/j.jddst.2022.103671

Tatham, P., Stadler, F., Murray, A., & Shaban, Z. (2017). Flying maggots: A smart logistic solution to an enduring medical challenge. Journal of Humanitarian Logistics and Supply Chain Management, 7(2), 172-193. https://doi.org/10.1108/JHLSCM-12-2016-0042

Thyssen, J., Masiero, S., & Stadler, F. (2022). Bioprospecting and testing of new fly species for maggot therapy. In A Complete Guide to Maggot Therapy: Clinical Practice, Therapeutic Principles, Production, Distribution, and Ethics. 195-234. Open Book Publishers. https://doi.org/10.11647/OBP.0270.10

Timberlake, M., Beeber, S., & Hubbard, G. (2020). Nonsuicidal self-injury: Management on the inpatient psychiatric unit. Journal of the American Psychiatric Nurses Association, 26(1), 10-26. https://doi.org/10.1177/1078390319883583

Tiscar-González, V., Menor-Rodríguez, J., Rabadán-Sainz, C., Fraile-Bravo, M., Styche, T., Valenzuela-Ocaña, J., & Muñoz-García, L. (2021). Clinical and economic impact of wound care using a polyurethane foam multilayer dressing. Advances in Skin & Wound Care, 34(1), 23-30. https://doi.org/10.1097/01.ASW.0000730191.35856.3b

Vowden, K., & Vowden, P. (2017). Wound dressings: Principles and practice. Surgery (Oxford), 35(9), 489-494. https://doi.org/10.1016/j.mpsur.2017.07.001

Webb, R. (2017). For centuries in wound healing. Journal of Wound Care, 26(3), 77. https://doi.org/10.12968/jowc.2017.26.3.77

Weller, D., Richards, C., Turnour, L., & Team, V. (2020). Understanding factors influencing venous leg ulcer guideline implementation in Australian primary care. International Wound Journal, 17(3), 804-818. https://doi.org/10.1111/iwj.13335

Weller, D., Richards, C., Turnour, L., & V Team. (2021). Venous leg ulcer management in Australian primary care: Patient and clinician perspectives. International Journal of Nursing Studies, 113(1), 26-29. https://doi.org/10.1016/j.ijnurstu.2020.103773