This is the second of two articles on maggot therapy. They should be all full text, published articles in english since 1995, and conducted on human adult males and. Maggot therapy is a type of biotherapy involving the introduction of live, disinfected maggots fly larvae into the nonhealing skin and soft tissue wounds of a human or animal for the purpose of cleaning out the necrotic dead tissue within a wound debridement and disinfection there is evidence that maggot therapy may help with wound healing. Mdt has been applied successfully in more than 20 additional medical conditions 4, 5. A long history of maggot therapy maggottherapy is a medical curiosity that has had little in. Towards next generation maggot debridement therapy. The use of maggot therapy is on the rise, owing to recognized limitations in our current medical and surgical wound care options. Maggot debridement therapy mdt is an old remedy that has been revised and proven to be invaluable in cleansing nonhealing wounds. This article describes the use of maggot debridement therapy for intractable wounds of the lower extremity. 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. 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. Whether your practice is an acutecare setting, a clinic, home care, or elsewhere, maggot debridement therapy mdt can prove to be a useful tool in wound care.
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. The guideline is designed to support qualified healthcare professionals in managing wound debridement using larval. Maggots faster than scalpel in wound debridement medscape. In the past, maggot debridement therapy was used as a last resort method of wound healing. Maggot debridement therapy mdt university of sydney. This article presents a general overview of maggot debridement therapy, as used in the management of chronic infected wounds. Zacharias and jones were the first that applied maggots to the wounds during the american civil war. Benefits of maggot debridement therapy on leg ulcers. Pdf maggot debridement therapy in chronic wound care.
The beneficial effect of maggot debridement therapy mdt on wound debridement has been known to surgeons since 1557. Maggot debridement therapy has been used for more than 70 years to treat nonhealing soft tissue wounds. When you buy this youll get access to the epub version, a downloadable pdf, and the ability to print the full article. In this therapy live, sterile maggots of green bottle fly. 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. This biotherapy is well known as the maggot debridement therapy mdt. Significantly better outcomes were achieved with the freerange technique versus the contained technique p. Maggot debridement therapy has been used for the treatment of various conditions. Chronic wounds remain a challenge to most healthcare systems worldwide despite the technological advances we have seen to date. Several techniques are available including maggot debridement therapy mdt.
Maggot debridement therapy mdt is a costeffective, fdaapproved treatment for diabetic foot ulcers 2, 3. Key words used in the literature search were maggot debridement therapy. Calciphylaxis is a rare disease with significant morbidity and mortality. Any document appearing in paper form should always be checked against the electronic version prior to use. Initially, the use of the lucilia sericata larvae maggots was viewed as a last effort to save the patient from septicemia while awaiting surgery. Maggot debridement therapy mdt or the use of maggots to treat wounds is one such therapy that has been in use for centuries. 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. Maggot debridement therapy mdt is a safe, effective, and controlled method of healing of chronic wounds by debridement and disinfection.
Maggot debridement therapy is the application of a specific breed of medical grade, sterile maggots to a necrotic wound bed whitaker et al. Maggot therapy for calciphylaxis wound debridement. Maggot debridement therapy and its role in chronic wound. December 19, 2011 maggot debridement therapy mdt appears to be more effective for wound debridement compared with conventional therapy, but. 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. 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 mdt is one alternative utilized with successful results. Once a popular wound care treatment, especially prior to the discovery of antibiotics, modern dressings or debridement techniques, mdt fell out of favor after the 1940s. Maggot therapy has not only been shown to remove necrotic tissue, it has also been proven to work on disinfecting wounds unresponsive to antibiotics. Maggot debridement therapy journal of the american. 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.
Although the methodological limitations of the present openlabel, noncomparative cohort study precludes a definite conclusion. 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. Wayman j, nirojogi v, walker a, sowinski a, walker ma. To describe the efficacy of mdt for treating problem wound especially diabetic foot ulcers. Maggot therapy for wound debridement in calciphylaxis has been reported, but the literature is limited. We used maggot debridement therapy with the larvae of phaenicia sericata for limb salvage after bilateral lower extremity fourthdegree burns.
It includes recommendations to engage healthcare providers and increase awareness of this therapeutic treatment. Maggot debridement therapy in the treatment of complex. These studies indicate that maggot therapy could be considered as a. Many chronic nonhealing wounds require alternative approaches, in addition to standard conventional therapies. Worldwide, live maggot has been used to clean wounds by degrading, liquefying, and ingesting only devitalizednecrotic tissues for centuries. Introduction maggot therapy sometimes called larval therapy is the. Reported 1year mortality is up to 80%, with sepsis as the leading cause of death. In one study, 12 patients with venous ulcers were randomized to receive either larval debridement therapy or treatment with a hydrogel dressing. Early clinical experience suggests it could also be a formidable weapon against meticillinresistant staphylococcus aureus mrsa. 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. 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 may also be helpful in individuals with diabetes mellitus whose wounds need rapid control, but our trial did not include this population. Maggot debridement therapy mdt has a long and welldocumented history. If maggots remind you of flyblown meat and rotting corpses, think again.
Mdt commonly involves the application of sterile lucilia sericata larvae to a nonhealing wound to promote healing and decrease infection. Blowfly larvae are used to debride, disinfect, and promote healing of chronic wounds. A printed copy may not reflect the current, electronic version on the clck intranet. Maggot debridement therapy in the treatment of nonhealing.
Author links open overlay panel xinjuan sun a kechun jiang a jingan. The first article appeared in our julyaugust 2014 issue, read part 1 here. Ebscohost serves thousands of libraries with premium essays, articles and other content including maggot debridement therapy and its role in chronic wound management. Diabetic patients with infectious hand ulceration, known as tropical diabetic hand syndrome tdhs, are generally less well recognised than those with foot ulcers. 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. 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. Maggots as medicinal devices introduction maggot therapy or maggot debridement therapy mdt is once again being used by doctors around the world.
Much has been written about this treatment method, both historically and in the past decade. For maggot debridement therapy, the larvae of the blowfly are applied over necrotic or nonhealing wounds. For maggot therapythe debridement of necrotic tissue with sterile fly larvaeis fast securing a place in wound care. Observations have indicated that maggots have the ability to debride wound beds, provide antimicrobial activity and also stimulate wound healing in diabetic patients. Maggots can debride a wound more quickly and more cheaply than standard treatments such as hydrogel dressings. Woc nursing was consulted at the request of the family to utilize maggot debridement therapy mdt to treat her necrotic lower extremities. Maggot debridement therapy shortens healing and disinfects wounds. Data extraction all relevant english and chinese articles.
Debridement is an essential component to promote healing in a problem wound. New evidence is emerging to suggest that maggots might. 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. Two cases of maggot debridement therapy in pyoderma. However, the evidence of these effects of mdt on the highest level is presently lacking. Data sources literature search of pubmed and medline was performed up to january 2007. Use of maggot debridement therapy for tropical diabetic. With the freerange technique, the mean number of maggot applications and the total number of maggots per treatment were significantly lower than with the.
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