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



  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


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.




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.