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

Abstract

Several chronic wounds require alternative therapy in addition to the conventional ones. Maggot therapy (MT) is one of these alternatives. MT is one form of animal-based treatment options known as Biotherapy (medicinal use of live organisms). MT or Maggot debridement therapy (MDT) is the medical use of live maggots for cleaning chronic, nonhealing wounds or certain wounds that are not amenable to other forms of therapy. MT is achieved through maggots' secretion of proteolytic enzymes that liquefy the necrotic tissues and then feed on such tissues (wound debridement activity), wound disinfection (antimicrobial) activity and growth-promoting (wound healing) activity. MT has been used for centuries. Occasionally used since the 1930's and early 1940's and then in 2004, the Food and Drug Administration (FDA) approved maggots as a medical device that has been prescribed for patients in more than 200 hospitals in the United States. This article presents a review of published articles on the different aspects of MT (mainly the past and current uses, maggots used, how to apply maggots for wound treatments, advantages and disadvantages, problems and adverse reactions and its application in Egypt) that serves as a guide to health professionals who may be users of this form of treatment now and in the future.

Maggot Debridement Treatment and Its Applications in Veterinary Medicine

“…For this purpose, larval treatment, which will perform all these procedures, is widely used (Kurtoğlu and Karataş 2009). Although MDT has been used in humans for the treatment of chronic wounds for centuries (Kočišovă et al 2006;Michelle et al 2011;Lepage et al 2012;Kenawy and Abdel-hamid 2020), it has rarely been used in animal infections (Table 2) (Bell and Thomas 2000;Jones and Wall 2008).…”

“…While larval treatment is progressing positively in human medicine, clinical studies on animal treatments are very few. However, in recent years, there has been a significant increase in the treatment of chronic wounds in veterinary medicine (Choudhary et al 2016;Kenawy and Abdel-hamid 2020;Uslu et al 2021;Uslu et al 2022). MDT is most commonly used to treat different types of wounds in horses and small animals, especially dogs and cats, and as an alternative to amputation (Sherman et al 2007a;Dar et al 2013); however, it is used less frequently in farm animals.…”

Use of fly larva (Maggots) in Cancer Treatment: A systematic review

“…The most commonly used larvae in larval therapy are Lucilia (Phoenicia) sericata which belong to the Calliphoridae family. (8). Other species of flies, such as Lucilia cuprina, have been used in some studies to treat ulcers (9).…”

“…The larvae only need oxygen during the period and due to their photophobic nature, they penetrate deep into the wound, where it is not accessible to the surgeon without invasive surgical intervention. No significant side effects have been reported for larval therapy (8,13). The larval therapy method has been performed by Dr. Mirabzadeh and his colleagues in special centers in Iran for several years (14).…”

A Parallel Randomized Clinical Trial for Comparison of Two Methods of Maggot Therapy, Free-Range Larvae and Larval-bag, in Diabetic Ulcer (Wagner 2)

“…10 Various studies have been performed on the healing of chronic wounds using maggot therapy. 10,11 With the advent of antibiotic-resistant bacteria, larval therapy has received more attention from physicians and treatment staff and in 2004 the Food and Drug Administration (FDA) approved maggots as a medical device. 12,13 Maggot's debridement has been suggested to work by mechanical and biochemical techniques.…”