The antimicrobial activity of maggots: in-vivo results

Steenvoorde, P.; Jukema, G. N.

doi:10.1016/s0965-206x(04)43005-8

Cited by 68 publications

(56 citation statements)

References 14 publications

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“…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].…”

Section: Discussionmentioning

confidence: 99%

“…Interest in MDT for wound healing was renewed in the 1980s [25], because the antibiotic resistance of bacteria increased rapidly [26] and antibiotic therapy and surgical treatment of wounds did not suffice in some cases. Currently, maggots of Lucilia sericata are widely used, have successful healing effects, and were approved by the US Food and Drug Administration in 2004 (510[k] #33391) [24,27,35]. Research to discover the underlying mechanisms of action by which maggots reduce bacterial infections could provide us with new treatment possibilities for severe, infected wounds.…”

Section: Introductionmentioning

confidence: 99%

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

Cazander

Veen

Bouwman

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Biofilm formation in wounds and on biomaterials is increasingly recognized as a problem. It therefore is important to focus on new strategies for eradicating severe biofilm-associated infections. The beneficial effects of maggots (Lucilia sericata) in wounds have been known for centuries. We hypothesized sterile maggot excretions and secretions (ES) could prevent, inhibit, and break down biofilms of Pseudomonas aeruginosa (PAO1) on different biomaterials. Therefore, we investigated biofilm formation on polyethylene, titanium, and stainless steel. Furthermore, we compared the biofilm reduction capacity of Instar-1 and Instar-3 maggot ES and tested the temperature tolerance of ES. After biofilms formed in M63 nutrient medium on comb-forming models of the biomaterials, ES solutions in phosphate-buffered saline or M63 were added in different concentrations. PAO1 biofilms adhered tightly to polyethylene and titanium but weakly to stainless steel. Maggot ES prevent and inhibit PAO1 biofilm formation and even break down existing biofilms. ES still had considerable biofilm reduction properties after storage at room temperature for 1 month. ES from Instar-3 maggots were more effective than ES from Instar-1 maggots. These results may be relevant to patient care as biofilms complicate the treatment of infections associated with orthopaedic implants.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Cazander

Veen

Bouwman

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…However, wounds with Gram-negative bacteria like E. coli, a high percentage of the wound covered with fibrin or biofilms with Pseudomonas sp. seem to be more difficult to treat with maggot therapy although the reason for this is not clear [6, 7]. One hypothesis [8] might be that P. aeruginosa produces biofilms with a shielding mechanism that protects them from phagocytic activity of activated so-called polymorphonuclear neutrophils (PMNs).…”

Section: Discussionmentioning

confidence: 99%

Maggots Do Not Survive in Pyoderma Gangrenosum

2008

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“…[11][12][13][14][15][16] Clinical observations indicate that maggots are more effective in the treatment of Gram-positive infected wounds, compared to Gram-negative infected wounds. [17][18][19][20] In January 2004, the US Food and Drug Administration (FDA) issued 510(k)#33391, thereby allowing production and marketing of maggots as a medical device. Based on the literature, there seem to be no clear indications or contra-indications for MDT, but patients with open wounds and ulcers that contain gangrenous or necrotic tissue with infection seem suited for MDT.…”

mentioning

confidence: 99%

Maggot Debridement Therapy of Infected Ulcers: Patient and Wound Factors Influencing Outcome – A Study on 101 Patients with 117 Wounds

Steenvoorde

Jacobi

Doorn

et al. 2007

annals

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INTRODUCTION It has been known for centuries that maggots are potent debriding agents capable of removing necrotic tissue and slough. In January 2004, the US Food and Drug Administration decided to regulate maggot debridement therapy (MDT). As it is still not clear which wounds are likely or unlikely to benefit from MDT, we performed a prospective study to gain more insight in patient and wound characteristics influencing outcome. PATIENTS AND METHODS In the period between August 2002 and December 2005, patients with infected wounds with signs of gangrenous or necrotic tissue who seemed suited for MDT were enrolled in the present study. In total, 101 patients with 117 ulcers were treated. Most wounds were worst-case scenarios, in which maggot therapy was a treatment of last resort. RESULTS In total, 72 patients (71%) were classified as ASA III or IV. In total, 78 of 116 wounds (67%) had a successful outcome. These wounds healed completely (n = 60), healed almost completely (n = 12) or were clean at least (n = 6) at last follow-up. These results seem to be in line with those in the literature. All wounds with a traumatic origin (n = 24) healed completely. All wounds with septic arthritis (n = 13), however, failed to heal and led in half of these cases to a major amputation. According to a multivariate analysis, chronic limb ischaemia (odds ratio [OR], 7.5), the depth of the wound (OR, 14.0), and older age (≥ 60 years; OR, 7.3) negatively influenced outcome. Outcome was not influenced by gender, obesity, diabetes mellitus, smoking, ASAclassification, location of the wound, wound size or wound duration. CONCLUSIONS Some patient characteristics (i.e. gender, obesity, smoking behaviour, presence of diabetes mellitus and ASA-classification at presentation) and some wound characteristics (i.e. location of the wound, wound duration and size) do not seem to contra-indicate eligibility for MDT. However, older patients and patients with chronic limb ischaemia or deep wounds are less likely to benefit from MDT. Septic arthritis does not seem to be a good indication for MDT.

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The antimicrobial activity of maggots: in-vivo results

Cited by 68 publications

References 14 publications

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

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

Maggots Do Not Survive in Pyoderma Gangrenosum

Maggot Debridement Therapy of Infected Ulcers: Patient and Wound Factors Influencing Outcome – A Study on 101 Patients with 117 Wounds

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