Keywords

first aid, head, neck, management, myiasis, squamous cell carcinoma, wound care

Authors

1. Grinblat, Golda MD
2. Frenkel, Yulia MD
3. Shochat, Itzhak MD
4. Kosec, Andro MD, PhD, FEBORL-HNS
5. Midbari, Ayelet MD
6. Rysin, Roman MD
7. Dandinarasaiah, Manjunath MD
8. Braverman, Itzhak MD
9. Wolf, Yoram MD

ABSTRACT

OBJECTIVE: To propose a first-aid management protocol for myiasis in neglected cutaneous squamous cell carcinoma (SCC) in the ED based on a recent literature review.

DATA SOURCES: PubMed.

STUDY SELECTION: Inclusion criteria were all series and case reports of primary/secondary cutaneous SCC with myiasis of the head and neck, including orbital SCC cases, published after 2005.

DATA EXTRACTION: A total of 14 articles including 15 patients were included.

DATA SYNTHESIS: Demographics, socioeconomic situation, site of the lesion, larvae species with bacterial suprainfection, and first-aid treatment options were discussed. Two representative cases are described.

CONCLUSIONS: Large, ulcerated, necrotic, myiasis-burdened SCC lesions in the head and neck area present a challenge for treatment, and to date, no consensus regarding first-aid management exists. The authors' proposed four-pillar first-aid management scheme may be a valid option to rapidly improve wound condition through disinfection, pain relief, and malodor and discharge eradication as a bridge to surgery.