Maggot debridement therapy in the tropics – Preliminary outcomes from a tertiary hospital

Gunasegaran, Nanthakumahrie; Seah, Vivian; Ang, Shin Yuh; Aloweni, Fazila; Goh, Wee Ting; Liew, Angela Yi Jia; Tan, Wei Xian; Tay, Hsien Ts’ung; Chong, Tze Tec

doi:10.1016/j.jtv.2022.05.006

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…According to the report, the ulcers healed three months after maggot debridement therapy. Gunasegaran et al, (2022) also reported that supplementary treatment offered in addition to maggot debridement seemed to promote wound healing and reduce non-viable tissue rate in most patients. They also revealed that the method of maggot debridement therapy applied should depend on the characteristics and the location of the wound, for instance, free larvae range is easier to apply to irregular and deep wounds than biobag method.…”

Section: Maggot Debridement Therapy In Humansmentioning

confidence: 95%

Maggot debridement therapy and innovation from myiasis - A review

Nnachi¹,

Okeanya²,

Ezinwa³

2022

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Maggot debridement therapy is the introduction of live and disinfected fly larvae in a wound in order to aid cleaning and healing. This technique was discovered as a beneficial effect of colonization of human tissue by fly larvae (myiasis). This discovery was made during the World War I when it was observed that injured soldiers whose wounds were infested with maggots healed faster than their counterparts whose wounds were free from maggots. In this therapy, the larvae of Blow fly (Lucilia sericata) are used because they feed exclusively on dead tissues. There are two different ways through which these maggots are applied into the wound, namely, free range dressing and biobag dressing. The mechanism of action of the maggots during debridement involves secretion of digestive enzymes which breakdown the dead tissues, liquidizing it before ingesting the liquefied contents of the wound. They also secrete antimicrobials which inhibit microbial growth in the wound, thereby disinfecting it. This therapy has been successfully used in the treatment of leg ulcers, deep and diabetic wounds in humans. The advantages of maggot debridement therapy are enormous. The cost of using it is relatively low, it quickens healing of wounds, and it is painless. However, the patient may experience irritation and itching at the wound site which is associated with larval movement in the wound. The adoption of this therapeutic wound management is advocated as practical evidence show that it has proven effective in the management of diabetic wounds more than conventional medical practices.

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Section: Maggot Debridement Therapy In Humansmentioning

confidence: 95%

Maggot debridement therapy and innovation from myiasis - A review

Nnachi¹,

Okeanya²,

Ezinwa³

2022

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“…Larval or maggot debridement therapy is a biological debridement by the sterile larvae of green bottle fly ( Lucilia species)[ 124 - 126 ]. Infection control is achieved by debridement, ingestion of bacteria, and antimicrobial action of the maggot secretions facilitating the action of topical antimicrobials[ 125 - 127 ]. Despite acceptable and relatively painless debriding action, maggots are not socio-culturally accepted as traditional medicine by patients and health-care personnel in many communities.…”

Section: Maggots Larvae and Leechesmentioning

confidence: 99%

“…Maggot therapy related trials in DFU are very few with very small sample size. Overall debridement effect was in 50%-80% patients with an average healing duration of 8-14 wk[ 125 , 129 ]. There is heterogenous data on slough vs total wound area, dose/exposure per cm 2 , and duration of usage and healing.…”

Section: Maggots Larvae and Leechesmentioning

confidence: 99%

Current scenario of traditional medicines in management of diabetic foot ulcers: A review

Rayate¹,

Nagoba²,

Mumbre³

et al. 2023

World J Diabetes

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Diabetic foot infections and diabetic foot ulcers (DFU) cause significant suffering and are often recurring. DFU have three important pathogenic factors, namely, microangiopathy causing local tissue anoxia, neuropathy making the foot prone to injuries from trivial trauma, and local tissue hyperglycaemia favouring infection and delaying the wound healing. DFU have been the leading cause for non-traumatic amputations of part or whole of the limb. Western medicines focus mainly on euglycaemia, antimicrobials, debridement and wound cover with grafts, and off-loading techniques. Advances in euglycaemic control, foot care and footwear, systemic antimicrobial therapy, and overall health care access and delivery, have resulted in an overall decrease in amputations. However, the process of wound care after adequate debridement remains a major cost burden globally, especially in developing nations. This process revolves around two basic concerns regarding control/eradication of local infection and promotion of faster healing in a chronic DFU without recurrence. Wound modulation with various dressings and techniques are often a costly affair. Some aspects of the topical therapy with modern/Western medicines are frequently not addressed. Cost of and compliance to these therapies are important as both the wounds and their treatment are “chronic.” Naturally occurring agents/medications from traditional medicine systems have been used frequently in different cultures and nations, though without adequate clinical base/relevance. Traditional Chinese medicine involves restoring yin-yang balance, regulating the ‘chi’, and promoting local blood circulation. Traditional medicines from India have been emphasizing on ‘naturally’ available products to control wound infection and promote all the aspects of wound healing. There is one more group of chemicals which are not pharmaceutical agents but can create acidic milieu in the wound to satisfy the above-mentioned basic concerns. Various natural and plant derived products ( e.g ., honey, aloe vera, oils, and calendula) and maggots are also used for wound healing purposes. We believe that patients with a chronic wound are so tired physically, emotionally, and financially that they usually accept native traditional medicine which has the same cultural base, belief, and faith. Many of these products have never been tested in accordance to “evidence-based medicine.” There are usually case reports and experience-based reports about these products. Recently, there have been some trials ( in vitro and in vivo ) to verify the claims of usage of traditional medicines in management of DFU. Such studies show that these natural products enhance the healing process by controlling infection, stimulating granulation tissue, antimicrobial action, promoting fibroblastic activity and collagen deposition, etc. In this review, we attempt to study and analyse the available literature on results of topical tradit...

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