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Clinical Application of Maggots in Chronic Difficult Wounds

Abstract

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.

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참고문헌 (13)

  1. Attinger CE, Janis JE, Steinberg J, Schwartz J, Al-Attar A, Couch K: Clinical approach to wounds: debridement and wound bed preparation including the use of dressings and wound-healing adjuvants. Plast Reconstr Surg 117: 72S, 2006 
  2. Sherman RA: A new dressing design for use with maggot therapy. Plast Reconstr Surg 100: 451, 1997 
  3. Mathes SJ, McCarthy JG, May JW Jr: Pharmacologic and mechanical management of wounds. Plastic Surgery. 2nd ed, Philadelphia, Elsevier, 2006, p 873 
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  6. Pechter EA, Sherman RA: Maggot therapy: the surgical metamorphosis. Plast Reconstr Surg 72: 567, 1983 
  7. Nwomeh BC, Yager DR, Cohen IK: Physiology of the chronic wound. Clin Plast Surg 25: 341, 1998 
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  9. Mumcuoglu KY: Clinical applications for maggots in wound care. Am J Clin Dermatol 2: 219, 2001 
  10. Sherman RA, Tran JM, Sullivan R: Maggot therapy for venous stasis ulcers. Arch Dermatol 132: 254, 1996 
  11. Vistnes LM, Lee R, Ksander GA: Proteolytic activity of blowfly larvae secretions in experimental burns. Surgery 90: 835, 1981 
  12. Mumcuoglu KY, Ingber A, Gilead L, Stessman J, Friedmann R, Schulman H, Bichucher H, Ioffe- Uspensky I, Miller J, Galun R, Raz I: Maggot therapy for the treatment of diabetic foot ulcers. Diabetes Care 21: 2030, 1998 
  13. Simmons SW: A bactericidal principle in excretions of surgical maggots which destroys important etiological agents of pyogenic infections. J Bacteriol 30: 253, 1935 

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