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discussion of medical care. And the low cost of maggot ther- Corporation. The 3 new products are Advantage System, apy has often been touted as one of its major attributes. The designed for the placement of midurethral slings through few studies that have addressed the issue of cost indicate transvaginal delivery; Lynx System, designed for the place- that maggot therapy is, indeed, more cost-effective than ment of midurethral slings suprapubically; and Obtryx comparable standard surgical or nonsurgical treatments. System, designed for the placement of midurethral slings We are not in a position to quantify the cost savings, but through the transobturator approach. we can surmise that it must be substantial, based on 2 ▲ Information: http://www.bostonscientific.com observations. In Europe, where national, single-payer health care is the norm, maggot therapy has become an Silipos increasingly common practice. Approximately 30,000 maggot Explorer Pin and Cushion prosthetic suspension liners. treatments are administered annually in Europe. But there Silipos has introduced new design features to its popular has been less demand in the United States, where insur- Explorer Pin and Cushion tri-block polymer gel prosthetic ance coverage of maggot therapy varies. In fact, the US suspension liners. The liners now have a proprietary stabi- demand for medical-grade maggots has been too small to lizing matrix to reduce distal elongation during gait while support a single commercial supplier. Thus, the nonprofit maintaining distal conformity, BTER Foundation is subsidizing the production and patient even with irregularly shaped care costs through donations. residual limbs. Both liners The cost-effectiveness of maggot therapy is apparent to have a smaller, silk-screened many in the United States, however. Some hospitals tell me logo that cannot be felt by they prefer to pay for maggots from their own operating the patient or seen when budgets to cure wounds and discharge patients faster than placed in the socket. A to use more conventional, billable treatments. The major translucent urethane cap expense associated with maggot therapy is the labor- provides improved strength intensive cost of preparing the perishable maggots. And, it and flexibility. requires clinical time to secure dressings upon the wound. The liners are retrofittable only to Explorer sockets that Q: Do you believe maggots will be more widely used have the same gel thickness, for wound treatment in the near future? liner shape, and size. A: The use of maggot therapy will soon increase, just as it ▲ Information: http://www.silipos.com has in the rest of the world. In the United States, the demand for medical maggots has increased by about 20% INDUSTRY NEWS per year over the past 10 years. Since the FDA ruling last year, the demand has already doubled. The Food and Drug Administration (FDA) recently cleared the Versatile 1 Wound Vacuum System from BlueSky Medical, Selected References La Costa, CA, for marketing. The system applies localized Graninger M, Grassberger M, Galehr E, et al. Comments, opinions, and brief case reports: bio- negative pressure to the wound bed to promote healing. The surgical debridement facilitates healing of chronic skin ulcers. Arch Intern Med 2002; Centers for Medicare & Medicaid Services (CMS) has also 162:1906-7. Jukema GN, Menon AG, Bernards AT, et al. Amputation-sparing treatment by nature: “surgi- approved reimbursement of the Versatile 1 Pump and acces- cal” maggots revisited. Clin Infect Dis 2002;35:1566-71. sory kits. This will allow the company’s dealer base to use Sherman RA. Maggot therapy for treating diabetic foot ulcers unresponsive to conventional the assigned codes for Medicare reimbursement purposes. therapy. Diabetes Care 2003;26:446-51. ▲ Information: http://www.blueskymedical.com Sherman RA. Maggot vs conservative debridement therapy for the treatment of pressure Wright Medical Group, Inc ulcers. Wound Repair Regen 2002;10:208-14. , Arlington, TN, has received Sherman RA, Shimoda KJ. Presurgical maggot debridement of soft tissue wounds is asso- reimbursement approval from the CMS for 2 of its wound ciated with decreased rates of postoperative infection. Clin Infect Dis 2004;39:1067-70. care products. The GRAFTJACKET Ulcer Repair Matrix Wollina U, Liebold K, Schmidt WD, et al. Biosurgery supports granulation and debridement in will have code “C9221,” and code “C9222” is assigned to chronic wounds—clinical data and remittance spectroscopy measurement. Int J Dermatol GRAFTJACKET XPRESS Flowable Soft-Tissue Scaffold. 2002;41:635-9. GRAFTJACKET’s Ulcer Repair Matrix is designed to allow healing at deeper levels, while protecting the external NEW PRODUCT NEWS layer of the wound with a graft material that converts into functional host tissue. The GRAFTJACKET XPRESS Flowable Soft-Tissue Scaffold can be administered easily Boston Scientific Corporation through a syringe to quickly fill the voids in the wound, cre- Midurethral sling products. A full line of midurethral ating a barrier against infection and providing a bioactive sling products for the treatment of stress urinary inconti- scaffold to aid in tissue formation. nence in women has been launched by Boston Scientific ▲ Information: http://www.wmt.com

WWW.WOUNDCAREJOURNAL.COM 15 ADVANCES IN SKIN & WOUND CARE • JANUARY/FEBRUARY 2005