Application of <em>Lucilia sericata</em> Larvae in Debridement of Pressure Wounds in Outpatient Settings

Abstract

Biological therapy using Lucilia sericata larvae has numerous advocates worldwide, yet it is still fairly unknown and not commonly applied in daily practice because of the limited awareness and insufficient experience of medical and nursing personnel.There are case reports suggesting that maggot therapy can be applied and supported by lay caregivers, provided they are supervised and informed by physicians/nurses.The foregoing observation suggests that the method should be considered for implementation by a wider group of caregivers if accepted and meticulously supervised by trained and experienced medical staff. The concerns related to the therapeutic use of maggots in certain regions seem understandable, but are not supported by scientific facts. It should be noted that many therapeutic agents (including brood) used in medicine are of natural origin, and are associated with low production costs and high possibilities of implementation in the course of therapy. By analyzing the literature and using our own clinical and research experience, we have come to conclusions related to using larvae therapy, as a quick and safe method providing cleaning and revitalization in the process of treating wounds of various etiologies, especially pressure ulcers. In the current study, medical-grade Lucilia sericata maggots were applied to remove necrotic tissue from deep pressure sores. The treatment is mostly accepted by both caregivers and patients. In most cases, it is conducted by trained and experienced medical personnel in home and outpatient settings. Over the course of the conducted analyzes involving the collected specimens, there were no statistically significant relationships (p> 0.05) confirmed between the wound surface successfully cleared by brood and variables, such as time from wound formation, location, surface size, and the depth of damage to the tissue structure. The lack of statistical dependence may result from the small size of the studied group. Based on the current findings, we have formulated the following conclusions: Maggot Debridement Therapy (MDT) is a fast and effective method enabling the preparation of the wound bed.

Pushing the Frontiers in the Fight Against Antimicrobial Resistance: The Potential of Fecal and Maggot Therapies

“…The application of MDT has proven effective in managing chronic wounds such as diabetic foot ulcers [ 35 ], venous leg ulcers [ 36 ] and pressure sores [ 37 ] as well as other kinds of wounds where traditional therapies often fail [ 11 ]. Furthermore, some studies have shown that wounds treated with MDT have lower rates of bacterial colonization, including by antibiotic-resistant strains, supporting MDT's potential role in the fight against AMR.…”

“…The utilization of maggots in medical treatment often elicits a natural repulsion or discomfort among many individuals. This psychological barrier may stem from cultural perceptions, personal phobias, or general unease with the unconventional nature of the therapy [ 11 , 37 ]. The challenge, then, lies not just in demonstrating the efficacy and safety of MDT but also in educating patients and healthcare providers to overcome these instinctive reactions.…”

“…The challenge, then, lies not just in demonstrating the efficacy and safety of MDT but also in educating patients and healthcare providers to overcome these instinctive reactions. This calls for a comprehensive approach, integrating scientific evidence with empathetic communication and potentially involving counseling or other support mechanisms to facilitate acceptance [ 11 , 37 ]. Additionally, standardized protocols and guidelines for MDT use are still in development, reflecting the therapy's relatively novel position in the medical landscape.…”