Boston University School of Public Health, US.
BioTherapeutics, Education & Research (BTER) Foundation, US.
J Wound Care. 2021 Sep 2;30(Sup9a):VIIi-VIIxi. doi: 10.12968/jowc.2021.30.Sup9a.VII.
Maggot debridement therapy (MDT), or the use of maggots in dead tissue removal, has been shown to be beneficial in wound healing. Yet MDT in the US is often only used once conventional debridement methods have failed.
In this study, nine health professionals, experienced in MDT, were interviewed in order to identify and analyse the perceived societal barriers to MDT acceptance and usage in the US.
Through qualitative analysis, using the grounded theory framework, this study found that among those interviewed, insurance reimbursement restrictions and stigmatisation of medicinal maggots were the factors driving resistance to MDT use.
Specifically, the 'yuck' factor and the perception of MDT as an 'ancient' modality contributed towards MDT stigma; in addition, lack of outpatient insurance coverage deterred MDT use. These findings provide useful information regarding the perceptual and systemic barriers that prevent greater acceptance of MDT. Ultimately, these barriers must be understood if we are to facilitate MDT implementation and improve MDT usage in the future.
蛆虫清创疗法(MDT),即利用蛆虫清除坏死组织,已被证明对伤口愈合有益。然而,在美国,MDT 通常仅在传统清创方法失败后才使用。
本研究对 9 名具有 MDT 经验的卫生专业人员进行了访谈,以确定和分析在美国,阻碍 MDT 接受和使用的社会障碍因素。
通过使用扎根理论框架的定性分析,本研究发现,在接受访谈的人员中,保险报销限制和对药用蛆虫的污名化是阻碍 MDT 使用的因素。
具体而言,“恶心”因素和将 MDT 视为“古老”模式的观念导致了 MDT 的污名化;此外,缺乏门诊保险覆盖阻碍了 MDT 的使用。这些发现为理解阻碍 MDT 更广泛接受的感知和系统障碍提供了有用的信息。最终,如果我们要促进 MDT 的实施并改善未来 MDT 的使用,就必须了解这些障碍。