Maggot Therapy in Wound Healing: A Systematic Review

Abstract

Background: It is estimated that 2% of the population in developing countries suffer from a chronic wound, making it a hidden phenomenon that is increasing as populations age. The ease of access to maggot therapy has made it increasingly attractive for implementation. This study aimed to explore the effectiveness of maggot therapy as compared to hydrogel dressings in the healing of chronic wounds. Methods: An electronic literature search until October 2019 was performed using Medline, Embase, and Cumulative Index of Nursing and Allied Health Literature. The eligibility criteria were chronic wound patients with an intervention that involved a comparison of any maggot species with hydrogel dressings. Results: The full text of five studies, involving 580 patients with chronic wounds, was retrieved. Four studies used the Lucilia sericata species. The maggot therapy facilitated faster and more effective debridement of non-viable tissue. It enabled faster development of granulation tissue and increased reduction in the wound surface area compared to hydrogel dressings. Maggot therapy had no effect on disinfection or complete healing rate for the wound. Conclusion: Maggot therapy should be considered for faster wound debridement, granulation tissue development, and wound surface area reduction as well as in surgical contraindications. This review can be used as a guide to assist clinicians in identifying patients who may benefit from maggot therapy.

Impact of silk hydrogel secondary structure on hydrogel formation, silk leaching and in vitro response

“…The current treatment strategies for chronic wounds typically include application of standard and advanced wound dressings 1 and compression bandaging 2 . Ultrasound 3 , debridement 4 and skin substitutes 5 , 6 are more advanced therapeutic interventions, but the treatment of chronic wounds remains challenging and still requires orthogonal treatment strategies. Examples include physical methods, such as negative pressure wound therapy 7 and real-time sensing applications that can support clinical decision making (e.g.…”

Novel Sources of Bioactive Molecules: Gut Microbiome of Species Routinely Exposed to Microorganisms

“…Moreover, as insects such as cockroaches possess an innate system and rely on this entirely instead of adaptive immunity, it is imperative to study these mechanisms as well as to examine the various antimicrobial peptides produced by these interesting species [ 88 ]. Nonetheless, it is also important to highlight that there are gaps in the understanding of the interaction between the microbiome and the host and the pathway of its metabolites, as well as how these metabolites may influence the microenvironment, and further mechanistic studies should be accomplished, as previously described [ 89 ].…”

Clinical outcome of Maggot Debridement Therapy followed by Negative Pressure Wound Therapy for chronic hand wound with Multi-Drug Resistant Organism infection: Two cases and review of the literature

“…Two methods of application of maggots to wound bed described in the literature were free larvae and bagged larvae. 13 Theoretically, maggots need to be freely crawling to exert physical debridement effect. However, a recent randomised controlled trial conducted by Dehghan and colleagues to compare these two methods have shown similar efficacy of debridement 21 .…”

“…MDT is an alternative biological debridement option for patients who are not fit for surgery or for patients with chronic wound that have failed other options of treatment. 13 We report two patients with serious MDRO infection of the hand in which undergoing repeated debridement surgeries was not possible due to patients’ multiple medical comorbidities. Both patients were eventually successfully treated with three cycles of MDT followed by Negative Pressure Wound Therapy (NPWT).…”