Creature Comforts Warnings - used to create a cage around the maggots. They may be Duration of maggot therapy. One treatment Creature Comforts Nylon Stockings affixed directly to the skin with tape or adhesive; but it Nylon Stockings (Kneehighs & Pantyhose) are manufactured with is less traumatic to the skin if these stockings are Creature Comforts Nylon Stockings, should a stretchable weave, so the fibers slide back and affixed to a strip of hydrocolloid placed proximally (+/- last 48 (maximum 72) hours. The total number forth. This provides nylon stockings with an distally) to the wound, as described in: Arch Dermatol of treatment cycles will depend upon the size (Kneehighs & Pantyhose) excellent fit and look, but allows the smallest 1996;132: 254-256. Set down a 1-2 cm wide strip of and character of the wound, clinical response, larvae with a stretchable pathway to escape. When hydrocolloid and paint it with a liquid adhesive before and goals of therapy. Most ulcers are Stretchable polyester woven properly affixed and intact, nylon stockings will applying the maggots and a little loose gauze to the completely debrided within 1 to 5 cycles. Do stockings, for confining Medical confine the mature maggots well, but when first wound. After the maggots are in place (by which time not re-use these products. Maggots,TM to the wound. applied some of the very young larvae (generally the adhesive should be quite tacky), slide on the Nylon less than 5%) may escape through the pores. If this Stockings (Kneehighs or Pantyhose). Line up the Disposal - happens, the escaped larvae will quickly die from edge of the stocking with the strip(s) of hydrocolloid, After use, handle and discard the maggots and desiccation and starvation. and press it down gently over the glue. Pleat the maggot dressings as you do your other Description - Do not use in patients allergic to nylon or other stocking if necessary, to remove all wrinkles. Add potentially infectious dressing waste (i.e., another layer of adhesive over this portion of the Creature Comforts Nylon Stockings polyesters. discard in "red bag" securely sealed to prevent stocking, so that the adhesive will flow through the (Kneehighs & Pantyhose) are simple nylon Do not use if packaging or product appears escape). Double-bag the sealed bag within pores and bond with the hydrocolloid and adhesive stockings that have been selected and sterilized damaged. another sealed bag for added security. See also underneath. Then apply a fabric-based (not paper or TM for the purpose of confining medicinal maggots to Remember always to familiarize yourself with all Disposal for Medical Maggots . plastic) tape over this part of the dressing to ensure that the wound area where applied, even though the instructions and package labeling before using this it remains secure. Framing the dressing with a anatomy may be 3-dimensionally challenging: or any other medical device. Call Monarch Labs Overdosage - transparent semi-permeable dressing (half over the toes, feet, ankles, legs, amputation stumps, etc. immediately if you have any questions or concerns Guerrini (1988) demonstrated that blow fly glued edges of the nylon stocking, half over the Flat fabric nets, including standard Creature about the use or quality of this item. strike in sheep resulted when very large peripheral intact skin) will add another optional layer of Comforts, may work well at confining maggots maggot burdens (> 16,000 maggots per animal) Do not apply in a manner or location that might security, and is especially valuable in the patient is to a simple wound on a planar surface; but such a constrict blood flow. infested the sheep. In these cases, serum mobile, or if this area is likely to perspire or become dressing can not easily be applied to 3- ammonia levels were found to be elevated Do not apply over povidone iodine or other skin - dimensional surfaces. (presumably due to the large protein irritants or products that are not intended to be dressings are not permeable enough to provide air to the breakdown in the wound), and the animals covered in this way. maggots. Do not cover the central mesh area with became encephalopathic. Mechanisms of Action - This product is an accessory to Medical transparent membrane dressings or any other dressing

nylon Maggots the package labeling besides a breathable loose absorbent gauze-like (polyester) mesh prevents fully-grown medicinal and instructions completely for Medical How supplied - TM dressing because the maggots may suffocate. maggots from escaping the area of confinement. Maggots or whatever brand of medicinal Creature Comforts Nylon Stocking maggot maggots you are using. If you want to use the stocking as a cylinder rather than confinement dressings are provided in two [See package insert for as a blind pouch, cut off the sealed bottom sizes (Kneehighs & Pantyhose), each Instructions for Use - stocking). If you want the pouch shorter (for example, individually wrapped and sterilized. Check Remember always to familiarize yourself with all package wrapper for size and sterility Clinical Indications - instructions and package labeling before using this or , then tie the legs validation markings. Batch numbers include Creature Comforts Nylon Stockings any other medical device. Remember always to wash into a tight knot to shorten them. the date of production & sterilization (YYYY- (Kneehighs & Pantyhose) are intended to hands before handling patients or patient care items. MM-DD). If stored correctly and the packaging is intact, they should remain sterile for one year confine mature medicinal maggots on the wound Always put on gloves if you are likely to touch a Finally, cover the dressing loosely with a breathable bed, on the affected limb, or wherever this wound or infected area. absorbent pad (i.e., two ply of cotton gauze). Change after this date. product is securely fastened. In essence, they are the top absorbent pad 4 - 8 hours and whenever it an accessory, functioning as corrals for medicinal Creature Comforts Nylon Stockings (Kneehighs becomes soiled. If it is not wet after 8 hours, the wound Restrictions and Disclaimers - maggots. For indications for using medicinal & Pantyhose) are sterile if the packaging is intact and maggots may be too dry. Moisten the wound No warranty is made or implied regarding the maggots, please refer to their labeling. Medical and not expired (expiration date is generally 1 year through the mesh with a little sterile irrigation fluid therapeutic benefit of maggot therapy for any TM Maggots brand of medicinal maggots are after manufacturing date, unless otherwise noted). (water or saline). Leave the Nylon Stockings dressing specific patient. Creature Comforts Nylon indicated for debriding non-healing necrotic skin in place for a total of approximately 48 hours. Stockings maggot dressings are not and soft tissue wounds, including pressure ulcers, Dressing Application. Gently wash out of the appropriate for all wounds nor all locations. venous stasis ulcers, neuropathic foot ulcers, and wound any residual medications, secretions or Dressing removal. To remove the maggot confinement Call Monarch Labs if you have any questions non-healing traumatic or post surgical -wounds. debris. Clean the peri-wound skin with an dressings with minimal effort, cut or peal back the or concerns about these products. appropriate skin cleaner, at least as large an area as maggot dressing while wiping up the maggots with a Storage & Handling - this dressing will cover. Then protect the peri-wound wet 4" x 4" gauze pad held in the other hand, Inquiries and Orders - Creature Comforts Nylon Stockings skin from wound drainage during treatments with a sandwiching the maggots between the two gloved This product is produced and distributed by: (Kneehighs & Pantyhose) by Monarch Labs polyurethane or similar skin protectant. Do not use hands. Consider placing a liner or garbage bag o povidone iodine or other potential skin irritants. should be stored at room temperature (68-78 F). underneath, to catch escaping larvae. Discard the MONARCH LABS X Under such conditions, and as long as the Do not apply in a manner or location that might maggots and dressings as you do your other potentially constrict blood flow. 17875 Sky Park Circle, Ste K; Irvine, CA 92614 packaging remains intact, they should remain infectious dressing waste (i.e., discard in "red bag" Phone: (949) 679-3000 / Fax: (949) 679-3001 sterile and usable for up to one year after the date securely sealed to prevent escape. Double-bag the Creature Comforts Nylon Stockings (Kneehighs e-mail: [email protected] of production. sealed bag within another sealed bag for added www.MonarchLabs.com & Pantyhose) maggot confinement dressings are security).

L-0801-01-14-CCNS_Nylon Stockings_Package Insert_Rev B