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Organ transplant recipients and patients with burn scars are under increased risk of developing basal- (BCC) and squamous-cell carcinoma (SCC).1 2 Moreover, the rate of wound-healing complications is elevated among these patients. We describe the management of periocular skin graft failure following surgery for BCC in two such patients by the use of maggots.
A 62-year-old man with a heart transplant presented with a BCC of the right medial canthus. The tumour was excised, and the defect of 16×11 mm covered with a full-thickness skin graft from the ipsilateral upper lid. Ten days after surgery, the graft was, however, rejected. Thus, we allowed the defect to granulate. Since accelerated wound closure was mandatory due to the patient’s immunocompromised state, the wound was covered with an envelope of nylon mesh (20×40 mm) containing 50 maggots of the …