Maggot debridement therapy may also be helpful in individuals with diabetes mellitus whose wounds need rapid control, but our trial did not include this population. Maggot therapy for wound debridement in calciphylaxis has been reported, but the literature is limited. With the freerange technique, the mean number of maggot applications and the total number of maggots per treatment were significantly lower than with the. Worldwide, live maggot has been used to clean wounds by degrading, liquefying, and ingesting only devitalizednecrotic tissues for centuries. Initially, the use of the lucilia sericata larvae maggots was viewed as a last effort to save the patient from septicemia while awaiting surgery. The cost effectiveness of larval therapy in venous ulcers. Towards next generation maggot debridement therapy. The beneficial effect of maggot debridement therapy mdt on wound debridement has been known to surgeons since 1557. This article describes the use of maggot debridement therapy for intractable wounds of the lower extremity. Maggot therapy also known as maggot debridement therapy mdt, larval therapy, larva therapy, or larvae therapy, is the intentional introduction by a health care practitioner of live. Diabetic patients with infectious hand ulceration, known as tropical diabetic hand syndrome tdhs, are generally less well recognised than those with foot ulcers. A printed copy may not reflect the current, electronic version on the clck intranet.
Blowfly larvae are used to debride, disinfect, and promote healing of chronic wounds. Ebscohost serves thousands of libraries with premium essays, articles and other content including maggot debridement therapy and its role in chronic wound management. Maggot debridement therapy shortens healing and disinfects wounds. Data synthesis the mechanism of such maggot therapy was shown to be due to the debridement, disinfection, and wound healing enhancement actions of maggot excretionssecretions. Maggot debridement therapy mdt is usually used for the treatment of diabetic foot ulcers and, in these wounds, the remarkable wound cleansing properties can be of considerable value. Early clinical experience suggests it could also be a formidable weapon against meticillinresistant staphylococcus aureus mrsa. This biotherapy is well known as the maggot debridement therapy mdt.
In this therapy live, sterile maggots of green bottle fly. Maggot debridement therapy mdt is an effective method for debriding wounds such as leg ulcers, supporting the concept of wound bed preparation dumville et al, 2009. New evidence is emerging to suggest that maggots might. Maggots can debride a wound more quickly and more cheaply than standard treatments such as hydrogel dressings. Maggot debridement therapy mdt is a safe, effective, and controlled method of healing of chronic wounds by debridement and disinfection. Maggot therapy has not only been shown to remove necrotic tissue, it has also been proven to work on disinfecting wounds unresponsive to antibiotics. Google scholar see all references physicians using maggot therapy for offlabel applications have reported positive results in reepithelialization of nonhealing wounds, disinfection, odor and drainage reduction, and debridement of acute burns, necrotic tumors, and ischemic ulcers, including unusual sites such as the glans penis, pleural space. Maggot debridement therapy is the application of a specific breed of medical grade, sterile maggots to a necrotic wound bed whitaker et al. This simple procedure involves the placement, using restrictive dressings, of live disinfected maggots into nonhealing wounds to provide for cleansing of necrotic tissue and initiation of the healing process. Two cases of maggot debridement therapy in pyoderma. Maggots as medicinal devices introduction maggot therapy or maggot debridement therapy mdt is once again being used by doctors around the world.
In the past, maggot debridement therapy was used as a last resort method of wound healing. Wayman j, nirojogi v, walker a, sowinski a, walker ma. Many chronic nonhealing wounds require alternative approaches, in addition to standard conventional therapies. Several techniques are available including maggot debridement therapy mdt. Maggot debridement therapy mdt university of sydney. Maggots, once considered an obsolete therapeutic modality, can be a useful addition to the armamentarium of the foot and ankle specialist. We used maggot debridement therapy with the larvae of phaenicia sericata for limb salvage after bilateral lower extremity fourthdegree burns.
Maggot debridement therapy mdt is one alternative utilized with successful results. Maggot debridement therapy is the realtime placement of maggots into a wound by health professionals for the treatment of diabetic ulcers or hardtoheal wounds infected with antibioticresistant. For maggot debridement therapy, the larvae of the blowfly are applied over necrotic or nonhealing wounds. Maggot debridement therapy journal of the american. When you buy this youll get access to the epub version, a downloadable pdf, and the ability to print the full article. Reviewing the effectiveness of larval therapy lt versus conventional therapy maggotassociated pain results the inclusion criteria were that the studies should be quantitative research papers relevant to the research question. Maggot debridement therapy mdt has been infrequently used in the last 60 years due to improved dressings, new surgical techniques, and the surge of new antibiotics to treat nonhealing wounds when they become infected. It includes recommendations to engage healthcare providers and increase awareness of this therapeutic treatment. Use of maggot debridement therapy for tropical diabetic. Maggot debridement therapy in the treatment of nonhealing. December 19, 2011 maggot debridement therapy mdt appears to be more effective for wound debridement compared with conventional therapy, but. Zacharias and jones were the first that applied maggots to the wounds during the american civil war.
Purpose the purpose of these guidelines is to provide knowledge for the appropriate use of larval debridement therapy and the management of patients receiving this therapy. There is no benefit in continuing the treatment after 1 week, and mdt does not improve the time to wound closure, which is why it should be stopped when debridement is achieved. The first article appeared in our julyaugust 2014 issue, read part 1 here. However, the evidence of these effects of mdt on the highest level is presently lacking. Maggots faster than scalpel in wound debridement medscape. Pdf maggot debridement therapy in chronic wound care. Mexican association for wound care and healing 2010. Mdt commonly involves the application of sterile lucilia sericata larvae to a nonhealing wound to promote healing and decrease infection. Observations have indicated that maggots have the ability to debride wound beds, provide antimicrobial activity and also stimulate wound healing in diabetic patients. To describe the efficacy of mdt for treating problem wound especially diabetic foot ulcers. For maggot therapythe debridement of necrotic tissue with sterile fly larvaeis fast securing a place in wound care.
Maggot therapy for calciphylaxis wound debridement. Maggot debridement therapy mdt has a long and welldocumented history. Maggot debridement therapy in the treatment of complex. Changing attitudes toward maggot debridement therapy in. A long history of maggot therapy maggottherapy is a medical curiosity that has had little in. Chronic wounds remain a challenge to most healthcare systems worldwide despite the technological advances we have seen to date. Much has been written about this treatment method, both historically and in the past decade. This manuscript is a case study of a 6yearold critically ill boy who was admitted to the pediatric intensive care unit in cardiac failure and developed deep tissue injury. Reported 1year mortality is up to 80%, with sepsis as the leading cause of death. Any document appearing in paper form should always be checked against the electronic version prior to use. In one study, 12 patients with venous ulcers were randomized to receive either larval debridement therapy or treatment with a hydrogel dressing. Maggot debridement therapy has been used for more than 70 years to treat nonhealing soft tissue wounds. Key words used in the literature search were maggot debridement therapy. Although the methodological limitations of the present openlabel, noncomparative cohort study precludes a definite conclusion.
The use of maggot therapy is on the rise, owing to recognized limitations in our current medical and surgical wound care options. Data sources literature search of pubmed and medline was performed up to january 2007. Maggot debridement therapy is as good as or better than conventional often surgical debridement, is more selective than surgical debridement, decreases time to healing and stay of patients in the ward, and may decrease the risk of major amputations. If maggots remind you of flyblown meat and rotting corpses, think again. Known as maggot debridement therapy mdt, larval therapy, biotherapy, and biosurgery, treatment with maggots can help heal stubborn ulcers, save limbs, eradicate antibioticresistant organisms, and shorten hospital stays. Maggot debridement therapy of a leg wound from kaposis. Woc nursing was consulted at the request of the family to utilize maggot debridement therapy mdt to treat her necrotic lower extremities. Debridement is an essential component to promote healing in a problem wound. Mdt has been applied successfully in more than 20 additional medical conditions 4, 5. Significantly better outcomes were achieved with the freerange technique versus the contained technique p. These studies indicate that maggot therapy could be considered as a.
Maggot debridement therapy mdt is an old remedy that has been revised and proven to be invaluable in cleansing nonhealing wounds. Maggot debridement therapy and its role in chronic wound. They should be all full text, published articles in english since 1995, and conducted on human adult males and. Data extraction all relevant english and chinese articles.
1205 1082 187 1063 253 1490 920 1397 363 486 59 1264 1322 168 823 856 1191 1247 1168 1228 542 928 561 982 1038 765 31 252 1204 43 420 88 593 760 280 1241 264