Amputation‐Sparing Treatment by Nature: “Surgical” Maggots Revisited

Abstract

Maggots were used as adjunct treatment for infected wounds that showed no response to the classical approach of wound debridement and antibiotic therapy. We summarize findings for 11 patients with necrotic wounds who received treatment with "surgical" maggots (100-2900 applied in 3-10 changes of dressing) for 11-34 days, which apparently aided in tissue remodeling and cure, and describe 2 typical patients in detail.

The Influence of Maggot Excretions on PAO1 Biofilm Formation on Different Biomaterials

“…These bags allow free exchange of maggot excretions and secretions [11]. We have observed resolution of infections suspected for biofilm formation using maggots in bags.…”

“…Some clinical reports document successful results of maggots in the débridement, disinfection, and healing of many types of severely infected wounds that failed to heal with conventional treatment [11,27,30,35]. Research of débridement mechanisms underlying MDT show the production of proteolytic and chymotrypsin-like enzymes in ES, which could degrade extracellular matrix components in wounds [3,4,33].…”

Larveterapi i sårbehandling

“…Behandlingsformen har først og fremst vaert benyttet i behandlingen av alvorlige hud-og bløtdelsinfeksjoner assosiert med decubitus, pyoderma gangrenosum, osteomyelitt, vaskulaer insuffisiens og nevropati (2,6,18). Larvene brukes normalt ikke i sår der infeksjonen umiddelbart må under kontroll for å berge lemmer og liv.…”

“…Bare én av dem sammenlikner resultatene av larveterapi med konvensjonell sår-behandling (22). Enkeltobservasjoner tyder på at amputasjon har vaert unngått som en direkte følge av behandling med fluelarver (24). Diabetikere har en betydelig forhøyet risiko for underekstremitetsamputasjoner i forhold til normalbefolkningen.…”

Biocompatibility of Antimicrobials to Maggot Debridement Therapy: Medical MaggotsLucilia sericata(Diptera: Calliphoridae) Exhibit Tolerance to Clinical Maximum Doses of Antimicrobials

“…With the revival of maggot therapy as a viable adjunct to conventional modalities, clinicians are Þnding that simultaneous administration of antimicrobials during a course of maggot therapy is useful for patients with infections that showed no response to the classical approach of surgical wound debridement and antimicrobial therapy (Jukema et al 2002). While there are no in vivo studies, maggot excretions/secretions increase the potency of selected antimicrobials in a dose-dependent fashion for in vitro assays (Cazander et al 2010a).…”