Effectiveness of maggot debridement therapy in treating chronic wounds – review of current literature

Abstract

Larval therapy in recent years has gained more interest as a method of treating chronic wounds. It could be an alternative to conventional therapies due to the increasing multidrug resistance of bacteria and observed allergic reactions to antibiotics and disinfectants. The aim of the study was to evaluate the effectiveness and safety of the treatment on the basis of a review of medical databases. Results of the studies have demonstrated greater maggot debridement therapy (MDT) effectiveness in the debridement and stimulation of granulation process over conventional methods. In addition, using this method can shorten the healing time, reduce the consumption of antibiotics, and reduce the cost of treatment. The results of analysed studies are promising; however, it would be advisable to perform randomised, blinded studies with longer follow-up time, in which a larger group of patients would participate. Streszczenie Larwaterapia w ostatnich latach zyskuje coraz większe zainteresowanie jako metoda leczenia ran przewlekłych. Stanowi alternatywę dla konwencjonalnych metod terapii ze względu na rosnącą wielolekooporność bakterii i obserwowane reakcje alergiczne na antybiotyki i środki odkażające. Celem pracy była ocena skuteczności i bezpieczeństwa larwaterapii na podstawie przeglądu medycznych baz danych. Wyniki badań wskazują na większą skuteczność larwaterapii w oczyszczaniu ran z martwej tkanki oraz pobudzaniu procesu ziarninowania w stosunku do metod konwencjonalnych. Zastosowanie larwaterapii umożliwia skrócenie czasu leczenia, ograniczenie zużycia antybiotyków i zmniejszenie kosztów leczenia. Wyniki analizowanych badań są obiecujące, natomiast wskazane byłoby zaplanowanie badań z randomizacją przeprowadzonych metodą podwójnie ślepiej próby, z dłuższym czasem obserwacji, w których uczestniczyłaby większa liczba pacjentów.

Defensins of Lucilia sericata Larvae and Their Influence on Wound Repair Processes in Practical Assessment—A Study of Three Cases

“…In our opinion, medical maggots can be used for debridement and revitalization of tissues before further surgical management related to the surgical treatment of ulcers. During the COVID-19 pandemic, this form of wound debridement becomes not only an alternative but also a necessity for patients who, for various reasons, cannot have a surgically debrided wound in hospital conditions [ 28 , 31 , 54 ].…”

Could maggot therapy be taught in primary schools?

“…There is, however, a therapy available on the NHS that can combat this, this is Maggot therapy (MT) -the clinical application of living, baby maggots onto an infected, chronic wound bed. Maggot Therapy is a clinically recognised and scientifically proven intervention (Dumville et al, 2009;Sherman 2014;Malekian et al, 2019) and works efficiently to manage the clearing and cleansing of stagnant infected wounds (Gieroń, et al 2018;Yan et al, 2018), which can often result from conditions such as diabetes and blood circulation disorders.…”