Review of Research

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  • Topic: Maggot therapy, Wound healing, Chronic wound
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  • Published : March 3, 2013
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Review of Research
The Effects Maggots Have on Wounds
Stacie Brown
ENGL 321
November 19, 2012

Abstract
The purpose of this study was to review the literature in an attempt to determine the efficacy of maggot debridement therapy (MDT) of skin ulcers (e.g. diabetic foot ulcers, venous stasis, osteomyelitis), with specific focus on assessing the healing time and amputation rate. Maggot therapy utilizes freshly emerged, sterile larvae of the common green bottle fly, Phaenicia (Lucilia) sericata, which secrete digestive enzymes that selectively dissolve necrotic tissue, disinfect the wound, and thus stimulate wound healing.

Introduction
Maggots or green bottle blowflies, Phaenicia (Lucilia) sericata, emit digestive enzymes that dissolve necrotic tissue from wounds and ingest bacteria which both promote wound healing (Sherman, 1988). These two beneficial effects of maggots on wounds are why maggot debridement therapy can help heal wounds, and potentially save limbs from amputation and in some cases, death. In medicine, there is a variety of methods to consider when treating patients. Patients with chronic wounds are no exception. Antibiotics and surgery are the two most common methods of chronic wound care. In some cases, neither of these treatments is the most effective choice. MDT is one of the oldest methods of wound healing, yet is relatively new or completely unused by many physicians. Several physicians may not fully understand the healing effects of maggots and their potential as a wound healer. This research studies MDT through clinical trials that strongly suggest MDT as an effective and successful method of wound healing. By looking at studies that involved the use of MDT on the treatment of wounds, an additional option for treating chronic, nonhealing wounds was presented. According to De la Torre, (2006) treating nonhealing chronic wounds are a major challenge for health care professionals and affect the quality of life for millions of people all over the world. When the wound healing process is interrupted, a chronic wound will result. Infection, malnutrition, diabetes mellitus, and necrotic tissue are a few of the many reasons how a wound could become chronic. Infection is the most common reason for chronic wounds. Infection and necrotic tissue impede the ability of the wound to start healing, making debridement of the tissue so important. The Background of Medical Maggot Therapy and its Results

History of maggot therapy
Sherman (2011) found that maggot therapy has been with us for nearly 100 years, many wound care specialists are still unfamiliar with it. Therefore, we should step back and briefly review the history and general concepts underlying maggot therapy, before delving into the recent scientific literature on this method of biotherapy. For centuries, military surgeons observed the benefits of maggots in the wounds of fallen soldiers. Maggot-infested wounds were cleaner, and healed faster than non-infested wounds. Soldiers whose wounds where infested with maggots were more likely to survive their wounds than soldiers not so infested. William S. Baer, Chief of Orthopedic Surgery at Johns Hopkins University and Baltimore Children’s Hospital, established the first laboratory for breeding maggots specifically for wound care. His case series of 89 patients was published in 1931 and by 1935 over a thousand surgeons in North America were using maggot therapy. Lederle Laboratories (New Jersey) even produced vials of “Surgical Maggots-Lederle” for those hospitals that did not have their own maggot-rearing insectaries. The therapy disappeared by the mid-1940s, probably due to the availability of antibiotics. Antibiotics dramatically reduced the frequency of wounds being treated by maggot therapy - skin and soft tissue infections, and bone infections (osteomyelitis), which had often resulted from trauma or from bacteremia spread from other infections. With the development of antimicrobial...
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