Advances in the research of application of maggot therapy in chronic wounds / 中华烧伤杂志

Maggot therapy is a kind of biological therapy that uses maggot to eat and remove the necrotic tissue of wounds, while it has no adverse effect on living tissue with blood supply. Besides, maggot therapy can promote wound healing through various mechanisms, which has been used for debridement and treatment of wounds as early as hundreds of years ago. With the discovery and application of antibiotics, maggot therapy faded out of the medical field once. However, with the abuse of antibiotics and increasing drug resistance of bacteria in recent years, maggot therapy attracts widespread attention of clinicians again. This article reviews the advances in the application of maggot therapy in chronic wounds.

Laboratory colonization of Lucilia sericata Meigen (Diptera: Caliphoridae) strain from Hashtgerd, Iran.

Background & objectives: The treatment of wounds with live green bottle fly larvae is receiving considerable attention in many countries. Laboratory rearing of Lucilia sericata is crucially important for the treatment of wounds. Study design: The study was carried out for mass rearing of green bottle flies from April to November 2010. Hand catch and net trap baited with beef and cattle liver were used to collect adult flies from the field. The collected samples were placed in appropriately labeled tubes and sent to the laboratory. Adult stage flies reared in the insectary were used for species identification using specific keys. Results: A total of 89 flies (55 females and 34 males) were collected from Hashtgerd area. In the first generation, 299 flies were produced in the laboratory including 105 (35.12%) males, and 194 (64.88%) females. The female/ male sex ratio was 1.61 for parents, whereas it was 1.84, 1.30 for F1 and F2 generations respectively. In total, 432 flies were reared in F3 generation including 173 (40.04%) males, and 259 (59.96%) females, and the sex ratio was 1.49. Conclusion: Setting up the mass rearing of sheep blowfly at the School of Public Health, Tehran University of Medical Sciences is an important step in producing candidate flies for the treatment of myiasis by maggot therapy in future.

Biologic Maggot Therapy in Cutaneous Wounds and Postoperative Defects / 대한피부과학회지

BACKGROUND: Maggots are larva of Phaenicia Sericata, the Green Blowfly, and treatments with maggot have recently become widespread revealing their effectiveness in the treatment of chronic wounds, such as diabetic ulcers and pressure sores, by removing necrotic tissue selectively and avoiding damage of healthy tissue. OBJECTIVE: The aim of this study was to evaluate the usefulness and the adverse effects of maggot therapy in dermatology for the treatment of chronic wounds and rapid granulation tissue formation at postoperative defects before reconstruction. METHODS: Fourteen patients with various kinds of skin wounds were included and applied a biobag containing therapeutic maggots on their wounds. RESULTS: Four cases were included for treatment of acute and chronic skin wounds; 10 cases of surgical defects were included for reduction of the treatment period. Maggot therapy periods ranged from 4 to 17 days (mean: 8.3 days). Complete elimination of necrotic tissue was achieved in 7 cases (50%) and partial elimination was achieved in 7 cases (50%). There weren't any cases of incomplete elimination or no response. Eight cases (57.1%) were in the 'excellent' group which had shown rapid granulation tissue formation and 3 cases (21.4%) were in the 'good' group, which had shown relatively rapid granulation tissue formation. But, there were 3 cases (21.4%) which had shown no difference from the previous time. Acute complications such as pain and bleeding had occurred in a few cases after maggot therapy. CONCLUSION: We suggest that the maggot therapy is a useful and effective method to use in the field of dermatology.

Lucilia eximia (Diptera: Calliphoridae), una nueva alternativa para la terapia larval y reporte de casos en Colombia / Lucilia eximia (Diptera: Calliphoridae), a new alternative for maggot therapy: case series report

La terapia larval es utilizada desde los años 30 del siglo pasado para la remoción del tejido necrótico en el tratamiento de úlceras crónicas infectadas logrando con ello promover la formación de tejido granuloso para el crecimiento de piel sana; especialmente a partir de la aparición de la resistencia a los antibióticos se la reconoce como una alternativa eficaz. Se presentan los resultados de la aplicación de la terapia larval en 42 pacientes con úlceras de diferentes orígenes, utilizando, como una nueva alternativa en larviterapia, la especie Lucilia eximia. Se presenta documentación fotográfica de la aplicación de esta terapia en cuatro casos.

Larval therapy is used in the treatment of infected chronic wounds by allowing the removal ofnecrotic tissue, which induces the formation of granular tissue and the growth of healthy skin.Considering the increasing prevalence of antibiotic resistance, this type of therapy may be an effectivealternative in the management of infected chronic wounds. In this article we report the use ofmaggot therapy using the Lucilia eximia species in 42 patients with chronic skin wounds associatedto different pathologies including: venous and arterial ulcers, diabetic foot, sickle cell disease,vasculopathy, elephantiasis, Berger disease, pyoderma gangrenosum (PG), traumatic wounds, erysipelas, and hospital acquired infections. Four cases are depicted photographically.

Clinical Application of Maggots in Chronic Difficult Wounds

PURPOSE: Since ancient times, larval therapy has been applied to help wound healing. Its use has recently been rediscovered, and the interest in this therapy has been increased in clinical practice, as well as in research. The objective of this study is to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds. METHODS: Twenty patients, suffering mostly from chronic wounds were treated using maggots of greenfly (Phaenicia sericata). Sterile maggots were administered to the wound twice a week. The causes of the development of wounds were diabetic foot(14), trauma(3), plate exposure(1), and unknown origin(2). RESULTS: Complete debridement was achieved in 10 wounds; in 8 wounds, the debridement was partially achieved; 2 patients escaped. Four patients were healed without any additional surgical procedures but fourteen patients were treated with skin graft. Pain, reported by six patients, was relatively well controlled with oral analgesics. CONCLUSION: We found larval therapy to be effective for chronic wounds. Maggot therapy is a relatively rapid and effective treatment, particularly in necrotic wounds or the wounds resistant to conventional treatment.