ABSTRACT
Myiasis is the infestation of human and animal tissues with dipterous fly larvae, commonly referred to as maggots. Over the past few years, there has been resurgence in the use of maggot debridement therapy [MDT] for cleaning non-healing wounds. This work threw some light on the wound myiatic cases in patients attending Tanta University Hospitals and other affiliated hospitals in two years. Identification of the isolated larvae and breading them to adult stage with monitoring of bacterial diversity in those patients were done. Also, MDT was tried in three intractable wounds as a preliminary study. In the present study, 9 cases of wound Myiasis were recorded, average age was 36years. The higher incidence was among males and most cases were recorded in summer months. The accused larvae were Megaselia scalaris [33.3%], Lucilia sericata [22.2%], Sarcophaga haemoroidalis [22.2%] and Musca domestica [22.2%]. Mixed bacterial isolates were reported in 7 cases and a single organism in the remaining 2 cases with a total of 18 isolates. MDT was applied in two settings and resulted in hastened growth of granulation tissue, greater wound healing rates, disappearance of foul odour and marked improvement of pain in the two leg ulcer cases while in neuropathic ulcer, no marked difference was detected. Except for Proteus, MDT showed remarkable ability to eliminate most of the infecting organisms including MRSA and the majority [2 cases, 66.7%] of Pseudomonas infection with decrease in its bioburden in the remaining [33.3%] case. Therefore, it could be concluded that the problem of wound Myiasis is always the end of neglection of careful wound dressings. MDT could be considered as a promising tool in cleaning and healing enhancement of chronic ulcers with mixed resistant bacterial communities including MRSA and Pseudomonas with special consideration when dealing with Proteus. However, further studies with larger scale of patients are needed to support these findings