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The Biosurgery in Indonesia Natural Hazard Management

1
Fais Dina Artika dan 2Yudha Nurdian
1
Student, Faculty of medicine, University of Jember, Indonesia
2
Faculty of medicine, University of Jember, Indonesia
Coresponding author: FD Artika, fsdnrtk@gmail.com; 152010101027@students.unej.ac.id

Abstract
Background
Indonesia is one of the most disaster-prone countries, given its high exposure to natural hazards. In
2016, there are 2.342 natural hazards, cosist of 766 Floods, 612 landslides, 669 tornadoes, 74
combination of flood and landslide, 178 forest and land fires, 13 earthquakes, 7 volcanic eruption
dan 23 abrations and tidal waves. Wounds are a common consequence of disasters. Musculoskeletal
and soft tissue injuries, open wounds, lacerations, fractures, crush injuries, abrasions, cuts, scratches,
blunt trauma, penetrating trauma, spinal injuries, and burns are tipically wound of the natural hazards.
People gets minor scratches to more serious injuries, also high incidence of acute wound infections,
abscesses, and other infections appearing weeks and months after disaster. Unreached location of the
hazard may be the predisposition factor that change a simple wound to a wound contain necrotizing
tissue. So, most of them need surgical intervention like fasciotomy and amputation. As alternative
way, the presence of necrotic devitalized tissue and wound infection are indications for the use of
biosurgery or maggot debridemant teraphy (MDT) in the clinical setting. Steril greenbottle blowfly
(Lucilia illustris, L. sericata) and blackbottle blowfly (Phormia regina) used in MDT. Blowfly
maggots feed only on dead tissue, so they don’t give harm to normal tissue. These maggots are easily
available and this therapy is cost-effective. Necrotic wounds that are complicated and resistant to
conventional treatment are treated with maggot therapy due to its effectiveness and environmental
friendly nature. It reduces the healing time, and relatively rapid treatment for chronic wounds that
require surgery and resistant to conventional therapy. Initially, when larvae are introduces at wound
site, they cause itching sensation over normal skin around the wound by crawling. This is inhibited by
covering the wound containing larvae with gauze. It is safe to assume that this is also the case in an
austere health care setting such as in the aftermath of disasters and other emergencies. Indeed, the
ability of medicinal maggots to control the microbial burden in wounds under the most extreme
conditions is remarkable, it suggests that MDT can debride wounds and stimulate wound healing
under such circumstances, and it’s without the need to close wounds for fear of infection.

Conclusion
Maggot debridemant therapy is recommended to be one of the management of natural hazard in
Indonesia.

References
Munir, T., Malik, M.F., Hashim, M., Qureshi, M.A. and Naseem, S., 2016. Therapeutic applications
of blowfly maggots: A review.

Purwo Nugroho, s. “2.342 Kejadian Bencana Selama 2016, Rekor Baru”. 2nd october 2017.
https://www.bnpb.go.id/home/detail/3233/2.342-Kejadian-Bencana-Selama-2016,-Rekor-Baru-

Stadler, F., Shaban, R.Z. and Tatham, P., 2016. Maggot Debridement Therapy in Disaster
Medicine. Prehospital and disaster medicine, 31(1), pp.79-84. doi:10.1017/S1049023X15005427