Management steps may include:
(1) Complete resection of the tumor (if possible) or wound debridement if not.
(2) Optimal wound care with control of fluids, adequate covering and regular dressing changes.
(3) Make any necessary improvements to sanitation and level of nursing care.
(4) Environmental changes to reduce fly access (screens on windows, etc).
(5) Physical removal of any larvae. A suction device can be useful. Irrigation of the wound with various solutions (70% alcohol, 10% chloroform, saline, iodine saline, oil) may be helpful.
(6) Consider oral or topical ivermectin.
where:
• Removal of larvae from bulky, complex wounds can be difficult. The larvae are light sensitive and may withdraw into deep crevices.
A patient with advanced cancer who develops wound myiasis may require psychiatric support.
