Maggot debridement therapy: the current perspectives

Abstract

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.

Using a combination therapy to combat scalp necrosis: a case report

“…Our patient's scalp wound was infected and turned into necrotic tissue despite conventional therapies. Management of chronic wounds is challenging and requires other unconventional therapies in order to achieve healing [3]. We used MDT in combination with NPWT and AMG in order to achieve a better result in shorter time.…”

“…Diabetes, obesity, medications, and aging are among multiple risk factors that rapidly increase the prevalence of chronic nonhealing wounds [1,2]. Many chronic nonhealing wounds need alternative combination treatment in addition to conventional therapies [3]. Debridement is an essential factor to help wound healing [1].…”

Myiasis – Pathology or Treatment?

“…Fly larvae have an epithelializing, neovascularizing and tissue-forming role due to gamma-interferon, secreted interleukins, reduced complement (anti-inflammatory effect), stimulating the production of growth factors, especially liver growth factor (HGF). (12,13) They play a role in the migration of keratinocytes and fibroblasts that promote ulcer healing. The substances secreted by the larvae stimulate the production of vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF), which stimulate endothelial cell migration and local proliferation.…”

Maggot Therapy “Use of Fly Larvae for Treatment of Wounds”- A Review

“…For biobag dressing (Fig. 1), sterile first instar larvae of L. sericata are applied to the wound sealed in with a bandage (Janssen, 2005;Naik and Harding, 2017) and left to feed for 2-3 days and then removed and replaced with fresh ones. The old larvae are removed simply by detaching the outer dressing and collecting them with forceps or flushed out of the wound with sterile saline (Baer.…”

“…Maggot therapy (MT) is one form of animal-based treatment options known as Biotherapy (medicinal use of live organisms) which includes also those of the honey bee (Apitherapy),leech (Hirudotherapy), fish (Ich thiotherapy), worm (Helmitherapy), pets (Animal-assisted therapy) and Phage (Microbialtherapy). Maggot therapy "Larva therapy, Biosurgery or Maggot debridement therapy (MDT)" is the medical use of live maggots for cleaning human chronic and non-healing wounds or certain wounds that are not amenable to other forms of therapy (Sherman et al, 2000;Church and Courtenay, 2002;Tantawi et al, 2007Tantawi et al, & 2010Gupta, 2008;Hall, 2010;Marineau et al, 2011;Sherman, 2014a;Naik andHarding, 2017 andYan et al, 2018). It involves allowing maggots of certain species of blowflies (Family: Calliphoridae)…”