Clinical research on the bio‐debridement effect of maggot therapy for treatment of chronically infected lesions

Wang, Shouyu; Lv, Decheng; Diao, Yun-Peng; Zhang, Zhen

doi:10.1111/j.1757-7861.2010.00087.x

Cited by 58 publications

(29 citation statements)

References 26 publications

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“…The use of larval therapy to enhance wound healing remains unsupported with only five studies identified, each of which had a high risk of bias …”

Section: Recommendationsmentioning

confidence: 99%

“…11 The use of larval therapy to enhance wound healing remains unsupported with only five studies identified, each of which had a high risk of bias. [12][13][14][15][16] Overall, there are data of low quality to suggest that debridement of some sort is beneficial and effective, but insufficient good quality evidence to support one form of debridement over another. Current expert opinion recommends that sharp debridement should be adopted in preference to other techniques, particularly as this is the least expensive of the methods and available in all geographic areas.…”

Section: Rationalementioning

confidence: 99%

See 1 more Smart Citation

Guidelines on use of interventions to enhance healing of chronic foot ulcers in diabetes (IWGDF 2019 update)

Rayman

Vas

Dhatariya

et al. 2020

Diabetes Metabolism Res

171

183

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The International Working Group on the Diabetic Foot (IWGDF) has published evidence‐based guidelines on the prevention and management of diabetic foot disease since 1999. In conjunction with advice from internal and external reviewers and expert consultants in the field, this update is based on a systematic review of the literature centred on the following: the Population (P), Intervention (I), Comparator (C) and Outcomes (O) framework; the use of the SIGN guideline/Cochrane review system; and the 21 point scoring system advocated by IWGDF/EWMA. This has resulted in 13 recommendations. The recommendation on sharp debridement and the selection of dressings remain unchanged from the last recommendations published in 2016. The recommendation to consider negative pressure wound therapy in post‐surgical wounds and the judicious use of hyperbaric oxygen therapy in certain non‐healing ischaemic ulcers also remains unchanged. Recommendations against the use of growth factors, autologous platelet gels, bioengineered skin products, ozone, topical carbon dioxide, nitric oxide or interventions reporting improvement of ulcer healing through an alteration of the physical environment or through other systemic medical or nutritional means also remain. New recommendations include consideration of the use of sucrose‐octasulfate impregnated dressings in difficult to heal neuro‐ischaemic ulcers and consideration of the use of autologous combined leucocyte, platelet and fibrin patch in ulcers that are difficult to heal, in both cases when used in addition to best standard of care. A further new recommendation is the consideration of topical placental derived products when used in addition to best standard of care.

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“…The use of larval therapy to enhance wound healing remains unsupported with only five studies identified, each of which had a high risk of bias …”

Section: Recommendationsmentioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

Guidelines on use of interventions to enhance healing of chronic foot ulcers in diabetes (IWGDF 2019 update)

Rayman

Vas

Dhatariya

et al. 2020

Diabetes Metabolism Res

171

183

View full text Add to dashboard Cite

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“…Another retrospective study by Wang et al followed 25 diabetic foot ulcers and 18 pressure ulcers in spinal cord-injury patients treated with either MDT or traditional dressings. 27 The MDT group had a significantly shorter time to achieve bacterial negativity, healthy granulation, and complete healing. Finally, the most recent RCT was conducted in 2014 at the Wound Healing Research Unit, Cardiff University by Mudge et al 28 This study compared the clinical effectiveness of a larval therapy dressing (Bio-FOAM) with a standard debridement technique (Purilon gel; hydrogel) in terms of time to debridement of venous or mixed arterial/venous leg ulcers.…”

mentioning

confidence: 99%

Maggot debridement therapy: the current perspectives

Naik¹,

Harding²

2017

CWCMR

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Chronic wounds remain a challenge to most healthcare systems worldwide despite the technological advances we have seen to date. Many chronic non-healing wounds require alternative approaches, in addition to standard conventional therapies. Maggot debridement therapy (MDT) or the use of maggots to treat wounds is one such therapy that has been in use for centuries. We conducted a review of articles published in PubMed, NICE evidence documents, and linked literature with the aim of providing a brief perspective on the evolution of MDT, and the context in which maggot therapy is currently used along with evidence behind such methods.

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“…Only one recent retrospective controlled cohort study at a high risk of bias 17 was found in addition to the four studies previously reported. [18][19][20][21] All four of the older studies were at high risk of bias, non-randomized, and unblinded. Any apparent effect of improved healing should therefore be treated with caution.…”

Section: Larval Therapymentioning

confidence: 99%

Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: a systematic review

Vas

Rayman

Dhatariya

et al. 2020

Diabetes Metabolism Res

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The management of diabetic foot ulcers (DFU) remains a challenge, and there is continuing uncertainty concerning optimal approaches to wound healing. The International Working Group of the Diabetic Foot (IWGDF) working group on wound healing has previously published systematic reviews of the evidence in 2008, 2012 and 2016 to inform protocols for routine care and to highlight areas which should be considered for further study. The working group has now updated this review by considering papers on the interventions to improve the healing of DFU's published between June 2014 and August 2018. Methodological quality of selected studies was independently assessed by a minimum of two reviewers using the recently published 21‐point questionnaire as recommended by IWGDF/European Wound Management Association, as well as the previously incorporated Scottish Intercollegiate Guidelines Network criteria. Of the 2275 papers identified, 97 were finally selected for grading following full text review. Overall, there has been an improvement in study design and a significant rise in the number of published studies. While previous systematic reviews did not find any evidence to justify the use of newer therapies, except for negative pressure wound therapy in post‐surgical wounds, in this review we found additional evidence to support some interventions including a sucrose‐octasulfate dressing, the combined leucocyte, fibrin and platelet patch as well as topical application of some placental membrane products, all when used in addition to usual best care. Nonetheless, the assessment and comparison of published trials remains difficult with marked clinical heterogeneity between studies: in patient selection, study duration, standard of usual care provision and the timing and description of the clinical endpoints.

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Clinical research on the bio‐debridement effect of maggot therapy for treatment of chronically infected lesions

Abstract: Maggot therapy is a safe and effective method for treating chronically infected lesions.

Cited by 58 publications

References 26 publications

Guidelines on use of interventions to enhance healing of chronic foot ulcers in diabetes (IWGDF 2019 update)

Guidelines on use of interventions to enhance healing of chronic foot ulcers in diabetes (IWGDF 2019 update)

Maggot debridement therapy: the current perspectives

Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: a systematic review

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