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Larval Therapy — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardWound HealingLarval TherapySCE Dermatology

An adult has a sloughy heel pressure ulcer requiring debridement. Autolytic debridement is unlikely to be timely, but peripheral arterial disease makes sharp debridement unsafe. Which next option best accords with NICE?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Use larval debridement, with analgesia, off-loading and consent after vascular assessment

Explanation lettering: E = shown as A · D = shown as B · B = shown as C · C = shown as D · A = shown as E

A is correct. NICE does not recommend larval therapy routinely, but specifically advises considering it when debridement is needed and sharp debridement is contraindicated or vascular insufficiency is present. Selection still requires assessment of ulcer extent, perfusion, comorbidity, tolerance and preference. B reverses NICE, which also advises against routine enzymatic debridement. C ignores the stated safety problem. D confuses infection treatment with removal of devitalised tissue; systemic antibiotics are reserved for clinical sepsis, spreading cellulitis or osteomyelitis. E is an unjustified absolute and leaves non-viable tissue unmanaged.

Reference: NICE CG179 pressure-ulcer recommendations: https://www.nice.org.uk/guidance/cg179/chapter/recommendations