1
|
Akhoundi M, Mathieu A, Hannachi W, Nasrallah J, Quezel G, Blaizot R, Blanchet D, Ben Romdhane H, Epelboin L, Izri A. Morphological and Molecular Characterizations of Cochliomyia hominivorax (Diptera: Calliphoridae) Larvae Responsible for Wound Myiasis in French Guiana. Diagnostics (Basel) 2023; 13:2575. [PMID: 37568937 PMCID: PMC10416906 DOI: 10.3390/diagnostics13152575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Myiasis is an ectoparasitic infection caused by the larvae of true flies (Diptera). We came across a rather rare case of myiasis in an immunocompetent 34-year-old man from French Guiana with advanced wound myiasis masquerading as cavitary myiasis and a history of cholesteatoma surgery in the left ear. The Diptera larvae responsible for the disease were isolated and identified using morphological and molecular approaches as Cochliomyia hominivorax. We underline the importance of this parasitosis as the second case of myiasis caused by C. hominivorax and the first case of wound myiasis in this overseas department of France and its incidence in pre-urban areas of the capital, Cayenne, in South America.
Collapse
Affiliation(s)
- Mohammad Akhoundi
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93000 Bobigny, France
| | - Alexandre Mathieu
- Groupe d’Étude et de Protection des Oiseaux en Guyane, Rémire-Montjoly 97354, French Guiana
| | - Wajih Hannachi
- ENT Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne 97306, French Guiana
| | - Jade Nasrallah
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93000 Bobigny, France
| | - Guillaume Quezel
- Infectious and Tropical Diseases Unit, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne 97306, French Guiana
| | - Romain Blaizot
- Department of Dermatology, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne 97306, French Guiana
| | - Denis Blanchet
- Parasitology Mycology Universitary Laboratory, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne 97306, French Guiana
| | | | - Loïc Epelboin
- Infectious and Tropical Diseases Unit, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne 97306, French Guiana
- Centre d’Investigation Clinique Antilles Guyane CIC Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne 97306, French Guiana
| | - Arezki Izri
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93000 Bobigny, France
- Unité des Virus Émergents (UVE: Aix-Marseille Université-IRD 190-Inserm 1207-IHU Méditerranée Infection), 13005 Marseille, France
| |
Collapse
|
2
|
Sherman RA. Response to practice article, 'Phantom pain as an adverse effect after maggot ( Lucilia sericata) debridement therapy: a case study'. J Wound Care 2023; 32:193-194. [PMID: 36930192 DOI: 10.12968/jowc.2023.32.3.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
|
3
|
Sahin E, Karaismailoglu B, Tutuncu MN, Polat E, Botanlioglu H. Maggot Treatment of Necrotic Toe Developed After Traumatic Subtotal Amputation. THE INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS 2023; 22:174-178. [PMID: 33626955 DOI: 10.1177/1534734621997283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Maggot debridement therapy (MDT) has been used for years in the treatment of chronic wounds and necrotic tissues. We report a case of subtotally amputated third toe that was treated with MDT after reattachment and developing complete necrosis. The necrotic toe was replaced with viable tissue and the wound healed completely after 2 weeks of MDT application. This case points out the regenerative effects of MDT besides its mechanical debridement effect on the necrotic tissue.
Collapse
Affiliation(s)
| | | | | | - Erdal Polat
- Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | |
Collapse
|
4
|
Ongarora BG. Recent technological advances in the management of chronic wounds: A literature review. Health Sci Rep 2022; 5:e641. [PMID: 35601031 PMCID: PMC9117969 DOI: 10.1002/hsr2.641] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Wound treatment comprises a substantial portion of the healthcare budgets in developed countries. Studies suggest that about 50% of patients admitted to hospitals have wounds, while 1%−2% of the general population in the developed world suffers from chronic wounds. Chronic wounds fail to repair themselves within the expected period of 30 days. Technologies have been developed to address challenges encountered during wound care with the aim of alleviating pain, promoting healing, or controlling wound infections. Objective The objective of this study was to explore the technological improvements that have been made in this field over time. Methods To gain insight into the future of wound management, a systematic review of literature on the subject was conducted in scientific databases (PubMed, Scopus, Web of Science, Medline, and Clinical Trials). Results and Discussion Results indicate that wound dressings have evolved from the traditional cotton gauze to composite materials embedded with appropriate ingredients such as metal‐based nanoparticles. Studies on biodegradable dressing materials are also underway to explore their applicability in dressing large and irregular wounds. On the other hand, conventional drugs and traditional formulations for the management of pain, inflammation, infections, and accelerating healing have been developed. However, more research needs to be carried out to address the issue of microbial resistance to drugs. Drugs for managing other ailments also need to be designed in such a way that they can augment wound healing. In addition, it has been demonstrated that a coordinated integration of conventional and traditional medicine can produce laudable results in chronic wound management. Conclusion Accordingly, collaborative efforts and ingenuity of all players in the field can accelerate technological advances in the wound care market to the benefit of the patients. Wounds affect about 50% of patients admitted to hospitals.
Technologies have been developed including biodegradable dressing materials to address underlying challenges.
Technological advancement, rising incidences of chronic wounds, growing government support, and a rising elderly population will drive wound market growth.
A careful combination of recent research outputs can greatly change wound care technologies.
This review highlights the recent research advances and opportunities in the wound care field.
The future lies in biodegradable dressing materials, probably embedded with selected nanoparticles and which shall be combined in predetermined ratios.
Collapse
Affiliation(s)
- Benson G. Ongarora
- Department of Chemistry Dedan Kimathi University of Technology Nyeri Kenya
| |
Collapse
|
5
|
Phang ZH, Khoo SS, Gunasagaran J, Tunku Ahmad TS. Clinical outcome of Maggot Debridement Therapy followed by Negative Pressure Wound Therapy for chronic hand wound with Multi-Drug Resistant Organism infection: Two cases and review of the literature. J Orthop Surg (Hong Kong) 2022; 29:23094990211067302. [PMID: 34920683 DOI: 10.1177/23094990211067302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The advancement in science and research has led to development of medical maggots which feed exclusively on dead tissue. Medical maggots have three important functions namely debridement, disinfection, and stimulation of wound healing. The modern use of medical maggots now goes by the term "Maggot Debridement Therapy" (MDT) for use in wound management. MDT is still used infrequently due to the effectiveness of surgical debridement and antibiotics for treatment of wound infection. Lately, there was emergence of Multi-Drug Resistant Organism (MDRO) likely due to inappropriate antibiotics usage. Maggot secretions have been shown to be effective in inhibiting some MDRO, for example, Methicillin-resistant Staphylococcus aureus, thus making MDT an attractive option for wounds with MDRO. We report two patients with multiple medical comorbidities, diagnosed with serious MDRO Diabetic Hand Infections treated with three cycles of MDT followed by Negative Pressure Wound Therapy.
Collapse
Affiliation(s)
- Zi Hao Phang
- National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University Malaya, Kuala Lumpur, Malaysia
| | - Saw Sian Khoo
- National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University Malaya, Kuala Lumpur, Malaysia
| | - Jayaletchumi Gunasagaran
- National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University Malaya, Kuala Lumpur, Malaysia
| | - Tunku Sara Tunku Ahmad
- National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
6
|
Gazi U, Taylan-Ozkan A, Mumcuoglu KY. The effect of Lucilia sericata larval excretion/secretion (ES) products on cellular responses in wound healing. MEDICAL AND VETERINARY ENTOMOLOGY 2021; 35:257-266. [PMID: 33314340 DOI: 10.1111/mve.12497] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
Chronic wounds are still regarded as a serious public health concern, which are on the increase mainly due to the changes in life styles and aging of the human population. There are different types of chronic wounds, each of which requires slightly different treatment strategies. Nevertheless, wound bed preparation is included in treatment of all types of chronic wounds and involves tissue debridement, inflammation, and infection control, as well as moisture balance and epithelial edge advancement. Maggot therapy (MT) is a form of biological debridement which involves the application of live medical grade Lucilia sericata (Meigen, 1826) (Diptera: Calliphoridae) larvae. Whereas it was initially thought to act mainly through debridement, today MT is known to influence all four overlapping physiological phases of wound repair: homeostasis, inflammation, proliferation, and remodelling/maturing. During MT, medical-grade larvae are applied either freely or enclosed in tea-bag like devices (biobag) inside the wounds, which suggests that larva excretion/secretion (ES) products can facilitate the healing processes directly without the need of direct contact with the larvae. This review summarizes the relevant literature on ES-mediated effects on the cellular responses involved in wound healing.
Collapse
Affiliation(s)
- U Gazi
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - A Taylan-Ozkan
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - K Y Mumcuoglu
- Parasitology Unit, Department of Microbiology and Molecular Genetics, The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University-Hadassah Medical School, Jerusalem, Israel
| |
Collapse
|
7
|
Tombulturk FK, Kanigur-Sultuybek G. A molecular approach to maggot debridement therapy with Lucilia sericata and its excretions/secretions in wound healing. Wound Repair Regen 2021; 29:1051-1061. [PMID: 34343386 DOI: 10.1111/wrr.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 06/15/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Chronic wounds caused by underlying physiological causes such as diabetic wounds, pressure ulcers, venous leg ulcers and infected wounds affect a significant portion of the population. In order to treat chronic wounds, a strong debridement, removal of necrotic tissue, elimination of infection and stimulation of granulation tissue are required. Maggot debridement therapy (MDT), which is an alternative treatment method based on history, has been used quite widely. MDT is an efficient, simple, cost-effective and reliable biosurgery method using mostly larvae of Lucilia sericata fly species. Larvae can both physically remove necrotic tissue from the wound site and stimulate wound healing by activating molecular processes in the wound area through the enzymes they secrete. The larvae can stimulate wound healing by activating molecular processes in the wound area through enzymes in their excretions/secretions (ES). Studies have shown that ES has antibacterial, antifungal, anti-inflammatory, angiogenic, proliferative, hemostatic and tissue-regenerating effects both in vivo and in vitro. It is suggested that these effects stimulate wound healing and accelerate wound healing by initiating a direct signal cascade with cells in the wound area. However, the enzymes and peptides in ES are mostly still undefined. Examining the molecular content of ES and the biological effects of these ingredients is quite important to illuminate the molecular mechanism underlying MDT. More importantly, ES has the potential to have positive effects on wound healing and to be used more as a therapeutic agent in the future, so it can be applied as an alternative to MDT in wound healing.
Collapse
Affiliation(s)
- Fatma Kubra Tombulturk
- Medical Laboratory Techniques, Vocational School of Health Services, Istinye University, Istanbul, Turkey
| | - Gonul Kanigur-Sultuybek
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| |
Collapse
|
8
|
Maeda T, Yamamoto Y, Murao N, Hayashi T, Kimura C, Matsui S, Saito T, Matsui H, Osawa M, Funayama E. Maggot debridement therapy in critical limb ischaemia: a case study. J Wound Care 2021; 29:S28-S32. [PMID: 33320762 DOI: 10.12968/jowc.2020.29.sup12.s28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In critical limb ischaemia (CLI), first-line therapy is revascularisation, but alternative treatment options are needed in certain cases. Maggot debridement therapy (MDT) is historically considered to be contraindicated in ischaemic ulcers. Wound care in patients with CLI is becoming increasingly diverse with the development of novel revascularisation strategies; therefore, CLI now needs to be reconsidered as an indication for MDT. METHOD We retrospectively reviewed five legs with CLI (five male, one female) treated with MDT between January 2013 and December 2017. Changes in skin perfusion pressure (SPP) around the ulcer before and after MDT were evaluated. One or two cycles of MDT were performed (eight in total). We also evaluated the proportion of necrotic tissue in the ulcer and the presence of exposed necrotic bone. The proportion of necrotic tissue in the ulcer was classified as NT 1+ (<25%), NT 2+ (25-50%), NT 3+ (50-75%) or NT 4+ (>75%). RESULTS When the proportion of necrotic tissue was >50%, with no exposed necrotic bone in the wound, an increase in SPP was observed after five (62.5%) of eight cycles of MDT. And with a proportion of necrotic tissue of <25% and/or exposed necrotic bone in the wound, a decrease in SPP was observed after three (37.5%) of eight cycles. Wound healing was accelerated in the presence of increased SPP. CONCLUSION Effective MDT with increased SPP requires an ulcerative state of necrotic tissue grade > NT 3+, with no exposed necrotic bone.
Collapse
Affiliation(s)
- Taku Maeda
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yuhei Yamamoto
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Naoki Murao
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Toshihiko Hayashi
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Chu Kimura
- Department of Plastic and Reconstructive Surgery, Hakodate General Central Hospital, Hokkaido, Japan
| | - Suguru Matsui
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Tatsuya Saito
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Hotaka Matsui
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Masayuki Osawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Emi Funayama
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| |
Collapse
|
9
|
Fonseca‐Muñoz A, Sarmiento‐Jiménez HE, Pérez‐Pacheco R, Thyssen PJ, Sherman RA. Clinical study of Maggot therapy for Fournier's gangrene. Int Wound J 2020; 17:1642-1649. [PMID: 32691532 PMCID: PMC7949221 DOI: 10.1111/iwj.13444] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/26/2020] [Accepted: 06/08/2020] [Indexed: 12/14/2022] Open
Abstract
Fournier's Gangrene is a fulminating necrotizing fasciitis of the perineum and genitalia. Standard treatment involves immediate excision of all necrotic tissue, aggressive antibiotic coverage, and supportive medical care. Still, the infection is commonly fatal or disfiguring. Wound treatment with disinfected blowfly larvae (maggot debridement therapy or MDT) has been shown to be highly effective, with multiple studies demonstrating effective debridement, disinfection, and promotion of granulation tissue. MDT also has been associated with preservation of viable tissue and minimised blood loss. This report describes a prospective clinical study of MDT for Fournier's gangrene aimed to test the hypothesis that early use of maggots could decrease the number of surgical treatments required to treat Fournier's gangrene. Subjects were provided with one initial surgical excision, followed by debridement using only medical grade Lucilia sericata larvae. Only two subjects were enrolled, both diabetic men. Intensive care and culture-directed antimicrobial coverage were administered as usual. Maggot debridement was associated with the disappearance of necrotic tissue, control of infection and granulation tissue growth. In both subjects, wounds healed without requiring further surgical resection or anatomical reconstruction. Maggot therapy decreased the number of surgical procedures that otherwise would have been necessary, and led to favourable outcomes.
Collapse
Affiliation(s)
- Alicia Fonseca‐Muñoz
- Centro Interdisciplinario de Investigación para el Desarrollo Integral Regional (CIIDIR)Instituto Politécnico Nacional (IPN), Unidad OaxacaSanta Cruz XoxocotlánMexico
| | | | - Rafael Pérez‐Pacheco
- Centro Interdisciplinario de Investigación para el Desarrollo Integral Regional (CIIDIR)Instituto Politécnico Nacional (IPN), Unidad OaxacaSanta Cruz XoxocotlánMexico
| | - Patricia J. Thyssen
- Department of Animal BiologyInstitute of Biology, University of Campinas (UNICAMP)CampinasBrazil
| | - Ronald A. Sherman
- Board Chair and DirectorBioTherapeutics, Education & Research (BTER) FoundationIrvineCaliforniaUSA
| |
Collapse
|
10
|
Abstract
Myiasis is defined as an infestation of the organs or tissues of live vertebrates (humans or animals) by dipterous larvae, commonly referred to as maggots. Wound myiasis is a common presentation in the emergency department. The presence of wild maggots and larvae in wounds is concerning for subsequent myiasis-induced infections and complications. Proper extraction of wild maggots and larvae is required to avoid complications that may occur with wound myiasis. Surgical debridement is often utilized to extract wild maggots and larvae, but can be painful and time-consuming. There is limited literature available on alternative approaches for removal of wild maggots and larvae. We present a case of lower extremity wound myiasis that had wild maggots and larvae successfully removed with no complications using ether. This procedure is a novel, noninvasive, and pain-free way to extract wild maggots and larvae from wound myiasis.
Collapse
Affiliation(s)
- Rachel E Wein
- Department of Pharmacy, Detroit Receiving Hospital, Detroit, MI, USA
| | - Alison Paplaskas
- Emergency Medicine, Mercy Health St. Vincent Medical Center, Toledo, OH, USA
| | - Suprat Saely
- Department of Pharmacy, Detroit Receiving Hospital, Detroit, MI, USA
| |
Collapse
|
11
|
Context for Practice: Intraoperative Pressure Injury Prevention, Moisture-Associated Skin Damage, and Self-management of Urinary Incontinence. J Wound Ostomy Continence Nurs 2019; 46:10-11. [PMID: 30608335 DOI: 10.1097/won.0000000000000503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
12
|
Lu Y, Yang R, Zhu J. [Research progress of chronic wound debridement]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2018; 32:1096-1101. [PMID: 30238742 PMCID: PMC8429985 DOI: 10.7507/1002-1892.201801126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/12/2018] [Indexed: 01/22/2023]
Abstract
Objective To review the research progress of chronic wound debridement. Methods The recent related literature concerning the mechanisms, advantages, limitations, and indications of the technologies of chronic wound debridement was extensively consulted, reviewed, and summarized. Results Debridement is essential for chronic wound healing, which includes autolytic debridement, enzymatic debridement, biodebridement, mechanical debridement, sharp/surgical debridement, ultrasound debridement, hydrosurgery debridement, and coblation debridement. Each technique has its own advantages and disadvantages. Conclusion There are many types of technologies of chronic wound debridement, which can be chosen according to clinical conditions. It is showed there are more significant advantages associated with the technique of coblation debridement relatively, which also has greater potential. Further study is needed to improve its efficacy.
Collapse
Affiliation(s)
- Yao Lu
- Chinese PLA Medical School, Beijing, 100853, P.R.China;Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, Beijing, 100048, P.R.China
| | - Rungong Yang
- Chinese PLA Medical School, Beijing, 100853, P.R.China;Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, Beijing, 100048,
| | - Jialiang Zhu
- Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, Beijing, 100048, P.R.China
| |
Collapse
|
13
|
Pharmacological Properties of the Medical Maggot: A Novel Therapy Overview. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:4934890. [PMID: 29853956 PMCID: PMC5960508 DOI: 10.1155/2018/4934890] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/05/2018] [Indexed: 02/01/2023]
Abstract
In the last decade, maggot has been hailed as the miraculous “medicinal maggot” for its diverse properties, including antimicrobial, antibiofilm, anti-inflammatory, and wound healing activities. The fact that maggots show so many beneficial properties has increased the interest in these tiny larvae dramatically. Whilst there is relatively abundant clinical evidence to demonstrate the success of maggots as debridement agents, not so much emphasis has been placed on the basic science evidence, which was a combination of physical and biochemical actions. This review differs from those earlier works in that it is undertaken to provide an update of the latest scientific basis published on maggot, particularly active ingredients within maggot excretions/secretions (ES). Further investigations should focus on the isolation, identification, recombination, transgenosis, and mass production of the beneficial molecules within maggots.
Collapse
|
14
|
YAMAN MEHMET, ZEREK AYKUT. MİYAZ SİNEKLERİ LARVALARININ YARA TEDAVİSİNDE KULLANILMASI. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2017. [DOI: 10.17944/mkutfd.311929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
15
|
Nishijima A, Yamamoto N, Yoshida R, Hozawa K, Yanagibayashi S, Takikawa M, Hayasaka R, Nishijima J, Okada T, Sekido M. Maggot debridement therapy for a patient with critical limb ischaemia and severe cardiac dysfunction: possibility of limb salvage. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2017; 4:42-47. [PMID: 28567433 PMCID: PMC5439397 DOI: 10.1080/23320885.2017.1327322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/02/2017] [Indexed: 12/02/2022]
Abstract
Ischaemic skin ulcer occurred on the foot of a 73-year-old man who had a history of fulminant myocarditis with severe cardiac dysfunction. We attempted wound bed preparation by maggot debridement therapy and salvaged his limb. It can be one of the adjuvant treatment strategies for critical limb ischaemia.
Collapse
Affiliation(s)
- Akio Nishijima
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Naoto Yamamoto
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Ryuichi Yoshida
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Koji Hozawa
- Department of Cardiovascular Medicine, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Satoshi Yanagibayashi
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Megumi Takikawa
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Rie Hayasaka
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Junko Nishijima
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Tadasu Okada
- Department of Dermatology, Mami Dermatology Clinic, Koshiba, Nara, Japan
| | - Mitsuru Sekido
- Department of Plastic and Reconstructive Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| |
Collapse
|
16
|
Mirabzadeh A, Ladani M, Imani B, Rosen S, Sherman R. Maggot therapy for wound care in Iran: a case series of the first 28 patients. J Wound Care 2017; 26:137-143. [DOI: 10.12968/jowc.2017.26.3.137] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Mirabzadeh
- Assistant Professor, Department of Entomology, Iranian Research Organization for Science And Technology (IROST), Tehran, Iran
| | - M.J. Ladani
- Assistant Professor of Orthopaedic Surgery, University of Medical Sciences, Tehran, Iran
| | - B. Imani
- Expert, Department of Entomology, Department of Entomology, Iranian Research Organization for Science And Technology (IROST), Tehran, Iran
| | - S.A.B. Rosen
- Medical Resident, University of California, San Diego, California, US
| | - R.A. Sherman
- Director BioTherapeutics, BioTherapeutics, Education & Research (BTER) Foundation, Irvine, California, US
| |
Collapse
|
17
|
Choudhary V, Choudhary M, Pandey S, Chauhan VD, Hasnani JJ. Maggot debridement therapy as primary tool to treat chronic wound of animals. Vet World 2016; 9:403-9. [PMID: 27182137 PMCID: PMC4864483 DOI: 10.14202/vetworld.2016.403-409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/12/2016] [Indexed: 11/10/2022] Open
Abstract
Maggot debridement therapy (MDT) is a safe, effective, and controlled method ofhealing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia) sericata are used, as they prefernecrotic tissues over healthy for feeding. Since centuries, MDT is used in humanbeings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies are few. However, with the increasing antibiotic resistance and chronic wound infections in veterinary medicine, maggot therapy may even become the first line of treatment for some infections. This paper will present a brief discussion of MDT and its role in veterinary medicine that may add one more treatment method to utilize in non-healing wounds of animals and overcome the use of amputation and euthanasia. The objective of this review paper is to assemble relevant literature on maggot therapy to form a theoretical foundation from which further steps toward clinical use of maggot therapy in animals for chronic wounds can be taken.
Collapse
Affiliation(s)
- Vijayata Choudhary
- Department of Veterinary Parasitology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| | - Mukesh Choudhary
- Department of Veterinary Pathology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| | - Sunanda Pandey
- Department of Veterinary Pathology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| | - Vandip D. Chauhan
- Department of Veterinary Parasitology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| | - J. J. Hasnani
- Department of Veterinary Parasitology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| |
Collapse
|
18
|
Wilson MR, Nigam Y, Jung W, Knight J, Pritchard DI. The impacts of larval density and protease inhibition on feeding in medicinal larvae of the greenbottle fly Lucilia sericata. MEDICAL AND VETERINARY ENTOMOLOGY 2016; 30:1-7. [PMID: 26463514 DOI: 10.1111/mve.12138] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/18/2015] [Accepted: 06/21/2015] [Indexed: 06/05/2023]
Abstract
Larval therapy, the therapeutic use of blowfly larvae to treat chronic wounds, is primarily used in debridement. There are, however, gaps in current knowledge of the optimal clinical application of the therapy and mechanisms of action in the debridement process. Using an artificial assay, two studies were undertaken to investigate these aspects of larval debridement by Lucilia sericata Meigen (Diptera: Calliphoridae); the first studied the effects of the density of larvae on tissue digestion and larval mass, and the second considered the effects on the same parameters of incorporating protease inhibitors into the feeding substrate. The total mass of tissue digested increased with larval density until saturation was observed at 5.0-7.5 larvae/cm(2) . This range was considered optimal as lower doses resulted in the removal of less tissue and higher doses offered no additional tissue removal and appeared to exacerbate competition for feeding. In the second study, increased protease inhibitor concentration led to significant decreases in tissue digestion and larval mass, suggesting that serine proteases, particularly trypsin, may play major roles in larval digestion. Such information is important in elucidating the main constituents that make up larval digestive products and may be significant in the development of new therapies.
Collapse
Affiliation(s)
- M R Wilson
- College of Human and Health Sciences, Swansea University, Swansea, U.K
| | - Y Nigam
- College of Human and Health Sciences, Swansea University, Swansea, U.K
| | - W Jung
- Department of Research and Development, BioMonde GmbH, Barsbüttel, Germany
| | - J Knight
- College of Human and Health Sciences, Swansea University, Swansea, U.K
| | - D I Pritchard
- School of Pharmacy, Nottingham University, Nottingham, U.K
| |
Collapse
|
19
|
Nigam Y, Morgan C. Does maggot therapy promote wound healing? The clinical and cellular evidence. J Eur Acad Dermatol Venereol 2015; 30:776-82. [DOI: 10.1111/jdv.13534] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/30/2015] [Indexed: 01/27/2023]
Affiliation(s)
- Y. Nigam
- College of Human and Health Sciences; Swansea University; Swansea UK
| | - C. Morgan
- College of Medicine; Swansea University; Swansea UK
| |
Collapse
|
20
|
Kahl M, Gökçen A, Fischer S, Bäumer M, Wiesner J, Lochnit G, Wygrecka M, Vilcinskas A, Preissner KT. Maggot excretion products from the blowfly Lucilia sericata contain contact phase/intrinsic pathway-like proteases with procoagulant functions. Thromb Haemost 2015; 114:277-88. [PMID: 25948398 DOI: 10.1160/th14-06-0499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 03/15/2015] [Indexed: 01/09/2023]
Abstract
For centuries, maggots have been used for the treatment of wounds by a variety of ancient cultures, as part of their traditional medicine. With increasing appearance of antimicrobial resistance and in association with diabetic ulcers, maggot therapy was revisited in the 1980s. Three mechanisms by which sterile maggots of the green bottle fly Lucilia sericata may improve healing of chronic wounds have been proposed: Biosurgical debridement, disinfecting properties, and stimulation of the wound healing process. However, the influence of maggot excretion products (MEP) on blood coagulation as part of the wound healing process has not been studied in detail. Here, we demonstrate that specific MEP-derived serine proteases from Lucilia sericata induce clotting of human plasma and whole blood, particularly by activating contact phase proteins factor XII and kininogen as well as factor IX, thereby providing kallikrein-bypassing and factor XIa-like activities, both in plasma and in isolated systems. In plasma samples deficient in contact phase proteins, MEP restored full clotting activity, whereas in plasma deficient in either factor VII, IX, X or II no effect was seen. The observed procoagulant/intrinsic pathway-like activity was mediated by (chymo-) trypsin-like proteases in total MEP, which were significantly blocked by C1-esterase inhibitor or other contact phase-specific protease inhibitors. No significant influence of MEP on platelet activation or fibrinolysis was noted. Together, MEP provides contact phase bypassing procoagulant activity and thereby induces blood clotting in the context of wound healing. Further characterisation of the active serine protease(s) may offer new perspectives for biosurgical treatment of chronic wounds.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - K T Preissner
- Klaus T. Preissner, PhD, Department of Biochemistry, Medical School, Justus-Liebig-University, Friedrichstrasse 24, 35392 Giessen, Germany, Tel.: +49 641 994 7500, Fax: +49 641 994 7509, E-mail:
| |
Collapse
|
21
|
Chirino MG, Rossi LF, Bressa MJ, Luaces JP, Merani MS. Comparative study of mitotic chromosomes in two blowflies, Luciliasericata and L.cluvia (Diptera, Calliphoridae), by C- and G-like banding patterns and rRNA loci, and implications for karyotype evolution. COMPARATIVE CYTOGENETICS 2015; 9:103-18. [PMID: 25893078 PMCID: PMC4387384 DOI: 10.3897/compcytogen.v9i1.8671] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 12/22/2014] [Indexed: 05/27/2023]
Abstract
The karyotypes of Luciliacluvia (Walker, 1849) and Luciliasericata (Meigen, 1826) from Argentina were characterized using conventional staining and the C- and G-like banding techniques. Besides, nucleolus organizer regions (NORs) were detected by fluorescent in situ hybridization (FISH) and silver staining technique. The chromosome complement of these species comprises five pairs of autosomes and a pair of sex chromosomes (XX/XY, female/male). The autosomes of both species have the same size and morphology, as well as C- and G-like banding patterns. The X and Y chromosomes of Luciliacluvia are subtelocentric and easily identified due to their very small size. In Luciliasericata, the X chromosome is metacentric and the largest of the complement, showing a secondary constriction in its short arm, whereas the Y is submetacentric and smaller than the X. The C-banding patterns reflect differences in chromatin structure and composition between the subtelocentric X and Y chromosomes of Luciliacluvia and the biarmed sex chromosomes of Luciliasericata. These differences in the sex chromosomes may be due to distinct amounts of constitutive heterochromatin. In Luciliacluvia, the NORs are placed at one end of the long-X and of the long-Y chromosome arms, whereas one of the NORs is disposed in the secondary constriction of the short-X chromosome arm and the other on the long-Y chromosome arm in Luciliasericata. Although the G-like banding technique does not yield G-bands like those in mammalian chromosomes, it shows a high degree chromosomal homology in both species because each pair of autosomes was correctly paired. This chromosome similarity suggests the absence of autosomal rearrangements during karyotype evolution in the two species studied.
Collapse
Affiliation(s)
- Mónica G. Chirino
- Instituto de Ecología, Genética y Evolución de Buenos Aires, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, C1428EHA Ciudad Autónoma de Buenos Aires, Argentina
- Laboratorio de Biología Cromosómica, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
| | - Luis F. Rossi
- Laboratorio de Biología Cromosómica, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
| | - María J. Bressa
- Instituto de Ecología, Genética y Evolución de Buenos Aires, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, C1428EHA Ciudad Autónoma de Buenos Aires, Argentina
| | - Juan P. Luaces
- Laboratorio de Biología Cromosómica, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
| | - María S. Merani
- Laboratorio de Biología Cromosómica, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
22
|
Pape T, Beuk P, Pont AC, Shatalkin AI, Ozerov AL, Woźnica AJ, Merz B, Bystrowski C, Raper C, Bergström C, Kehlmaier C, Clements DK, Greathead D, Kameneva EP, Nartshuk E, Petersen FT, Weber G, Bächli G, Geller-Grimm F, Van de Weyer G, Tschorsnig HP, de Jong H, van Zuijlen JW, Vaňhara J, Roháček J, Ziegler J, Majer J, Hůrka K, Holston K, Rognes K, Greve-Jensen L, Munari L, de Meyer M, Pollet M, Speight MCD, Ebejer MJ, Martinez M, Carles-Tolrá M, Földvári M, Chvála M, Barták M, Evenhuis NL, Chandler PJ, Cerretti P, Meier R, Rozkosny R, Prescher S, Gaimari SD, Zatwarnicki T, Zeegers T, Dikow T, Korneyev VA, Richter VA, Michelsen V, Tanasijtshuk VN, Mathis WN, Hubenov Z, de Jong Y. Fauna europaea: Diptera - brachycera. Biodivers Data J 2015:e4187. [PMID: 25733962 PMCID: PMC4339814 DOI: 10.3897/bdj.3.e4187] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/12/2015] [Indexed: 11/12/2022] Open
Abstract
Fauna Europaea provides a public web-service with an index of scientific names (including important synonyms) of all extant multicellular European terrestrial and freshwater animals and their geographical distribution at the level of countries and major islands (east of the Urals and excluding the Caucasus region). The Fauna Europaea project comprises about 230,000 taxonomic names, including 130,000 accepted species and 14,000 accepted subspecies, which is much more than the originally projected number of 100,000 species. Fauna Europaea represents a huge effort by more than 400 contributing taxonomic specialists throughout Europe and is a unique (standard) reference suitable for many user communities in science, government, industry, nature conservation and education. The Diptera-Brachycera is one of the 58 Fauna Europaea major taxonomic groups, and data have been compiled by a network of 55 specialists. Within the two-winged insects (Diptera), the Brachycera constitute a monophyletic group, which is generally given rank of suborder. The Brachycera may be classified into the probably paraphyletic 'lower brachyceran grade' and the monophyletic Eremoneura. The latter contains the Empidoidea, the Apystomyioidea with a single Nearctic species, and the Cyclorrhapha, which in turn is divided into the paraphyletic 'aschizan grade' and the monophyletic Schizophora. The latter is traditionally divided into the paraphyletic 'acalyptrate grade' and the monophyletic Calyptratae. Our knowledge of the European fauna of Diptera-Brachycera varies tremendously among families, from the reasonably well known hoverflies (Syrphidae) to the extremely poorly known scuttle flies (Phoridae). There has been a steady growth in our knowledge of European Diptera for the last two centuries, with no apparent slow down, but there is a shift towards a larger fraction of the new species being found among the families of the nematoceran grade (lower Diptera), which due to a larger number of small-sized species may be considered as taxonomically more challenging. Most of Europe is highly industrialised and has a high human population density, and the more fertile habitats are extensively cultivated. This has undoubtedly increased the extinction risk for numerous species of brachyceran flies, yet with the recent re-discovery of Thyreophoracynophila (Panzer), there are no known cases of extinction at a European level. However, few national Red Lists have extensive information on Diptera. For the Diptera-Brachycera, data from 96 families containing 11,751 species are included in this paper.
Collapse
Affiliation(s)
- Thomas Pape
- Natural History Museum of Denmark, Copenhagen, Denmark
| | - Paul Beuk
- Natural History Museum Maastricht / Diptera.info, Maastricht, Netherlands
| | | | | | | | - Andrzej J Woźnica
- Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Bernhard Merz
- Muséum d'histoire naturelle Genève, Paris, Switzerland
| | - Cezary Bystrowski
- Forest Research Institute, Department of Forest Protection, Warszawa, Poland
| | - Chris Raper
- Tachinidae Recording Scheme, London, United Kingdom
| | | | - Christian Kehlmaier
- Senckenberg Natural History Collections Dresden, Museum of Zoology, Dresden, Germany
| | | | | | | | - Emilia Nartshuk
- Zoological Institute Russian Academy of Sciences, St Petersburg, Russia
| | - Frederik T Petersen
- Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marc Pollet
- Research Institute for Nature and Forest, Brussels, Belgium
| | | | | | - Michel Martinez
- INRA, UMR Centre de Biologie pour la Gestion des Populations, Montferrier-sur-Lez, France
| | | | - Mihály Földvári
- MTA-DE 'Lendület' Behavioural Ecology Research Group, Department of Evolutionary Zoology, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | - Rudolf Meier
- National University of Singapore, Singapore, Singapore
| | | | | | - Stephen D Gaimari
- California Department of Food and Agriculture, Sacramento, California, United States of America
| | | | | | - Torsten Dikow
- National Museum of Natural History, Smithsonian Institution, Washington DC, United States of America
| | | | | | | | | | - Wayne N Mathis
- National Museum of Natural History, Smithsonian Institution, Washington DC, United States of America
| | | | - Yde de Jong
- University of Eastern Finland, Joensuu, Finland ; University of Amsterdam - Faculty of Science, Amsterdam, Netherlands
| |
Collapse
|
23
|
Yazdanpanah L, Nasiri M, Adarvishi S. Literature review on the management of diabetic foot ulcer. World J Diabetes 2015; 6:37-53. [PMID: 25685277 PMCID: PMC4317316 DOI: 10.4239/wjd.v6.i1.37] [Citation(s) in RCA: 264] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/22/2014] [Accepted: 12/17/2014] [Indexed: 02/05/2023] Open
Abstract
Diabetic foot ulcer (DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime. Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it’s suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.
Collapse
|
24
|
Borst GM, Goettler CE, Kachare SD, Sherman RA. Maggot Therapy for Elephantiasis Nostras Verrucosa Reveals New Applications and New Complications: A Case Report. INT J LOW EXTR WOUND 2014; 13:135-139. [PMID: 24861094 DOI: 10.1177/1534734614536036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Elephantiasis nostras verrucosa (ENV) is a rare dermatologic condition caused by chronic nonfilarial lymphedema. The treatment for ENV is challenging and based solely on case reports. We report novel therapy for ENV with maggot debridement therapy (MDT), an effective wound therapy that has gained popularity with the rise of antimicrobial resistance. MDT, in combination with tangential surgical debridement, was effective in the treatment of ENV. In nature, sheep infested with more than 16 000 blow fly larvae exhibit ammonia toxicity. Although hyperammonemia as a side effect of maggot therapy has been theorized, its existence has not been described in human studies until this case. This patient exhibited hyperammonemia during maggot therapy; with alterations in serum ammonia reflecting changes in larval population. Maggot therapy should be considered for the treatment of ENV. Hyperammonemia with maggot therapy exists, and clinicians who employ this treatment should be aware of this potential adverse effect.
Collapse
Affiliation(s)
- Gregory M Borst
- Department of Surgery, East Carolina University, Greenville, NC, USA
| | | | - Swapnil D Kachare
- Department of Surgery, East Carolina University, Greenville, NC, USA
| | - Ronald A Sherman
- BioTherapeutics, Education & Research (BTER) Foundation, Irvine, CA, USA
| |
Collapse
|
25
|
Sherman RA. Mechanisms of maggot-induced wound healing: what do we know, and where do we go from here? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2014; 2014:592419. [PMID: 24744812 PMCID: PMC3976885 DOI: 10.1155/2014/592419] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 01/15/2014] [Indexed: 12/18/2022]
Abstract
MEDICINAL MAGGOTS ARE BELIEVED TO HAVE THREE MAJOR MECHANISMS OF ACTION ON WOUNDS, BROUGHT ABOUT CHEMICALLY AND THROUGH PHYSICAL CONTACT: debridement (cleaning of debris), disinfection, and hastened wound healing. Until recently, most of the evidence for these claims was anecdotal; but the past 25 years have seen an increase in the use and study of maggot therapy. Controlled clinical studies are now available, along with laboratory investigations that examine the interaction of maggot and host on a cellular and molecular level. This review was undertaken to extract the salient data, make sense, where possible, of seemingly conflicting evidence, and reexamine our paradigm for maggot-induced wound healing. Clinical and laboratory data strongly support claims of effective and efficient debridement. Clinical evidence for hastened wound healing is meager, but laboratory studies and some small, replicated clinical studies strongly suggest that maggots do promote tissue growth and wound healing, though it is likely only during and shortly after the period when they are present on the wound. The best way to evaluate-and indeed realize-maggot-induced wound healing may be to use medicinal maggots as a "maintenance debridement" modality, applying them beyond the point of gross debridement.
Collapse
Affiliation(s)
- Ronald A. Sherman
- BioTherapeutics, Education & Research (BTER) Foundation, 36 Urey Court, Irvine, CA 92617, USA
| |
Collapse
|
26
|
Elder JW, Grover CA. Wound Debridement: Lessons Learned of When and How to Remove “Wild” Maggots. J Emerg Med 2013; 45:585-7. [DOI: 10.1016/j.jemermed.2013.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 01/15/2013] [Accepted: 01/18/2013] [Indexed: 11/17/2022]
|
27
|
Lee SF, Chen Z, McGrath A, Good RT, Batterham P. Identification, analysis, and linkage mapping of expressed sequence tags from the Australian sheep blowfly. BMC Genomics 2011; 12:406. [PMID: 21827708 PMCID: PMC3176259 DOI: 10.1186/1471-2164-12-406] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 08/10/2011] [Indexed: 12/04/2022] Open
Abstract
Background The Australian sheep blowfly Lucilia cuprina (Wiedemann) (Diptera: Calliphoridae) is a destructive pest of the sheep, a model organism for insecticide resistance research, and a valuable tool for medical and forensic professionals. However, genomic information on L. cuprina is still sparse. Results We report here the construction of an embryonic and 2 larval cDNA libraries for L. cuprina. A total of 29,816 expressed sequence tags (ESTs) were obtained and assembled into 7,464 unique clusters. The sequence collection captures a great diversity of genes, including those related to insecticide resistance (e.g., 12 cytochrome P450s, 2 glutathione S transferases, and 6 esterases). Compared to Drosophila melanogaster, codon preference is different in 13 of the 18 amino acids encoded by redundant codons, reflecting the lower overall GC content in L. cuprina. In addition, we demonstrated that the ESTs could be converted into informative gene markers by capitalizing on the known gene structures in the model organism D. melanogaster. We successfully assigned 41 genes to their respective chromosomes in L. cuprina. The relative locations of these loci revealed high but incomplete chromosomal synteny between L. cuprina and D. melanogaster. Conclusions Our results represent the first major transcriptomic undertaking in L. cuprina. These new genetic resources could be useful for the blowfly and insect research community.
Collapse
Affiliation(s)
- Siu F Lee
- Centre for Environmental Stress and Adaptation Research, Bio21 Institute, Genetics Department, University of Melbourne, 30 Flemington Road, Parkville, VIC 3010, Australia
| | | | | | | | | |
Collapse
|
28
|
Cornell RS, Meyr AJ, Steinberg JS, Attinger CE. Débridement of the noninfected wound. J Vasc Surg 2010; 52:31S-36S. [DOI: 10.1016/j.jvs.2010.06.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
29
|
Abstract
Wound-related pain is a common phenomenon for many patients and in recent years there has been a growing awareness of the impact it has on both wound healing and quality of life. Research in the field of wound pain and the patient experience, the development of new products and the issue of expert consensus statements have all contributed to an improvement in our understanding of wound-related pain issues and our ability to effectively manage them. However, there are a multitude of intrinsic sources of wound-related pain which can be triggered or exacerbated by numerous external factors, making management both complex and challenging at times. In this article, key sources and triggers of wound-related pain are discussed, along with practical strategies for effective, patient-focused management to help health-care practitioners reduce both the incidence and impact of wound-related pain.
Collapse
|
30
|
Paul AG, Ahmad NW, Lee HL, Ariff AM, Saranum M, Naicker AS, Osman Z. Maggot debridement therapy with Lucilia cuprina: a comparison with conventional debridement in diabetic foot ulcers. Int Wound J 2009; 6:39-46. [PMID: 19291114 DOI: 10.1111/j.1742-481x.2008.00564.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This is prospective case-control study of more than 18 months performed to assess the effectiveness of maggot debridement therapy (MDT) with the sterile larvae of Lucilia cuprina (a tropical blowfly maggot) for the treatment of diabetic foot ulcers. Literature thus far has only reported results with the temperate maggot, Lucilia sericata. This study documents outcome in diabetic foot wounds treated with maggot debridement versus those treated by conventional debridement alone. In this series of 29 patients treated with MDT, 14 wounds were healed, 11 were unhealed and 4 were classified under others. The control group treated by conventional debridement had 30 patients of which 18 wounds were healed, 11 unhealed and 1 classified under others. There was no significant difference in outcome between the two groups. The conclusion that can be made from this study is that MDT with L. cuprina is as effective as conventional debridement in the treatment of diabetic foot ulcers. It would be a feasible alternative to those at high risk for surgery or for those who refuse surgery.
Collapse
Affiliation(s)
- Aaron G Paul
- Department of Orthopaedic Surgery, Sarawak General Hospital, Sarawak, Malaysia.
| | | | | | | | | | | | | |
Collapse
|
31
|
Nordström A, Hansson C, Karlström L. Larval therapy as a palliative treatment for severe arteriosclerotic gangrene on the feet. Clin Exp Dermatol 2009; 34:e683-5. [PMID: 20055837 DOI: 10.1111/j.1365-2230.2009.03405.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Larval therapy (LT) is known to be a gentle and effective method for removing necrotic tissue and bacteria and reducing the accompanying unpleasant odour. Ischaemia has been considered a relative contraindication for LT. We report a patient with ischaemia treated with LT. Inguinal revascularization was performed on a 69-year-old man with critical limb ischaemia, diabetes mellitus, heart failure and end-stage renal disease. Areas of dry black malodorous gangrene remained on the distal areas of the feet after surgery and the patient's poor health did not allow any additional surgery. The patient was referred to the dermatology department for LT. Although patients are usually given this treatment as inpatients, the patient requested treatment at home. After the first LT, there was a marked reduction in odour. The gangrene needed repeated applications of larvae to remove the dead tissue. After eight treatments, the result was more positive than we had expected, with total lack of odour and initiation of healing. Larvae cannot penetrate eschar, thus free-range larvae were used because they can move beneath the hard necrotic tissue and dissolve it.
Collapse
Affiliation(s)
- A Nordström
- Department of Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | |
Collapse
|
32
|
Sherman RA. Maggot therapy takes us back to the future of wound care: new and improved maggot therapy for the 21st century. J Diabetes Sci Technol 2009; 3:336-44. [PMID: 20144365 PMCID: PMC2771513 DOI: 10.1177/193229680900300215] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In the 21st century, eighty years after William Baer presented his groundbreaking work treating bone and soft tissue infections with live maggots, thousands of therapists around the globe have rediscovered the benefits of maggot therapy. The renaissance in maggot therapy is due in large part to recent technological advancements that have solved or minimized many of the treatment's earlier drawbacks: the need for reliable access to this perishable medical device, simplified application, and low-cost production. Modern dressing materials have simplified the procedure and minimized the risk of escaping maggots. The establishment of dozens of laboratories throughout the world, along with access to overnight courier services in many regions, has made medicinal maggots readily available to millions of people in need. Studies show that fears of patient nonacceptance are unfounded. The medical literature is rapidly growing with scientific evidence demonstrating the efficacy and safety of maggot therapy for a variety of problematic wounds. This article examines how these and other technologies are optimizing the study and application of maggot therapy for wound care.
Collapse
Affiliation(s)
- Ronald A Sherman
- BioTherapeutics, Education and Research Foundation, Irvine, California, USA.
| |
Collapse
|
33
|
Maggot-therapy in veterinary medicine. Res Vet Sci 2008; 85:394-8. [DOI: 10.1016/j.rvsc.2007.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 12/04/2007] [Accepted: 12/13/2007] [Indexed: 11/22/2022]
|
34
|
Ai H, Wang F, Lei C. Antioxidant activities of protein-enriched fraction from the larvae of housefly, Musca domestica. Nat Prod Res 2008; 22:507-15. [PMID: 18415858 DOI: 10.1080/14786410701592034] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
UNLABELLED The protein-enriched fraction (PEF) was isolated and purified from the larvae of housefly, Musca domestica. This study was designed to investigate amino acid compositions, antioxidative effects and protective effects of PEF on red blood cell (RBC) hemolysis, lipid peroxidation. The effects of PEF treatment were studied on aged mice liver lipid peroxidation and antioxidant enzyme activities, which included superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). RESULTS PEF not only inhibited H(2)O(2) stimulated oxidative hemolysis of erythrocytes of mice, but also depressed malondialdehyde (MDA) production in mice liver homogenate by auto-oxidation and hepatic mitochondria expanded induced by Fe(2+)-ascorbic acid system. Compared to control group, treatments of PEF significantly increases SOD and GSH-Px activity of serum and liver homogenate in aged mice. MDA level of serum and liver homogenate decreased significantly in aged mice. In conclusion, this study demonstrates that PEF possesses antioxidative activity and might be a valuable source of natural antioxidative agents.
Collapse
Affiliation(s)
- Hui Ai
- College of Plant Science and Technology, Huazhong Agricultural University, Wuhan 430070, P. R. China
| | | | | |
Collapse
|
35
|
Ai H, Wang F, Yang Q, Zhu F, Lei C. Preparation and biological activities of chitosan from the larvae of housefly, Musca domestica. Carbohydr Polym 2008. [DOI: 10.1016/j.carbpol.2007.09.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
36
|
Tantawi TI, Gohar YM, Kotb MM, Beshara FM, El-Naggar MM. Clinical and microbiological efficacy of MDT in the treatment of diabetic foot ulcers. J Wound Care 2008; 16:379-83. [PMID: 17987750 DOI: 10.12968/jowc.2007.16.9.27868] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To assess the clinical and microbiological efficacy of maggot debridement therapy (MDT) in the management of diabetic foot ulcers unresponsive to conventional treatment and surgical intervention. METHOD Consecutive diabetic patients with foot wounds presenting at the vascular surgery unit and the diabetic foot unit of Alexandria Main University Hospital were selected for MDT. Lucilia sericata medicinal maggots were applied to the ulcers for three days per week. Changes in the percentage of necrotic tissue and ulcer surface area were recorded each week over the 12-week follow-up period. Semiquantitative swab technique was used to determine the bacterial load before and after MDT. RESULTS The sample comprised 10 patients with 13 diabetic foot ulcers. The mean baseline ulcer surface area was 23.5cm2 (range 1.3-63.1), and the mean percentage of necrotic tissue was 74.9% (range 29.9-100). Complete debridement was achieved in all ulcers in a mean of 1.9 weeks (range 1-4). Five ulcers (38.5%) were completely debrided with one three-day MDT cycle. The mean reduction in ulcer size was significant at 90.2%, and this occurred in a mean of 8.1 weeks (range 2-12). The mean weekly reduction in ulcer size was 16.1% (range 8.3-50). Full wound healing occurred in 11 ulcers (84.6%) within a mean of 7.3 weeks (range 2-10). The bacterial load of all ulcers reduced sharply after the first MDT cycle to below the 10(5) threshold, which facilitates healing. CONCLUSION The results highlight the potential benefits of MDT in diabetic wound care in developing countries. MDT was proved to be a rapid, simple and efficient method of treating these ulcers.
Collapse
Affiliation(s)
- T I Tantawi
- Department of Zoology, Faculty of Science, Alexandria University, Alexandria, Egypt.
| | | | | | | | | |
Collapse
|
37
|
Gericke A, Hoffmann EM, Pitz S, Pfeiffer N. Maggot therapy following orbital exenteration. Br J Ophthalmol 2007; 91:1715-6. [PMID: 18024820 DOI: 10.1136/bjo.2007.116673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Adrian Gericke
- Department of Ophthalmology, University of Mainz, Langenbeckstrasse 1, 55101 Mainz, Germany.
| | | | | | | |
Collapse
|
38
|
Putting Wild Maggots on Your Head Is Not “Maggot Therapy,” but It Does Suggest Pre-Existing Pathology. Plast Reconstr Surg 2007; 120:1737-1738. [DOI: 10.1097/01.prs.0000284669.88359.f0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
39
|
Sherman RA, Morrison S, Ng D. Maggot debridement therapy for serious horse wounds – A survey of practitioners. Vet J 2007; 174:86-91. [PMID: 16831562 DOI: 10.1016/j.tvjl.2006.05.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hoof disease and injuries are common and serious problems for equines. Maggot debridement therapy (MDT) has been used to treat problematic wounds in humans, but has been used only rarely in other animals. US veterinarians who had employed MDT were surveyed to investigate their reasons for the choice of this treatment and their clinical experiences with it. Between 1997 and 2003, 13 horses were treated by eight veterinarians who used MDT to control infection or debride wounds, which could not easily be reached surgically or were not responding to conventional therapy. Seven animals were lame, and six were expected to require euthanasia. Following maggot therapy, all infections were eradicated or controlled, and only one horse had to be euthanased. No adverse events were attributed to maggot therapy for any of these cases, other than presumed discomfort during therapy. The data collected suggest that maggot therapy could be useful for treating some serious equine hoof and leg wounds.
Collapse
Affiliation(s)
- Ronald A Sherman
- Department of Pathology, University of California, Irvine, CA 92697-4800, United States.
| | | | | |
Collapse
|
40
|
Sherman RA, Stevens H, Ng D, Iversen E. Treating wounds in small animals with maggot debridement therapy: A survey of practitioners. Vet J 2007; 173:138-43. [PMID: 16386439 DOI: 10.1016/j.tvjl.2005.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Many small animals succumb to complications of serious wounds. Sometimes infection and sepsis overwhelm the animal; sometimes the costs of intensive care overwhelm the owner. Maggot therapy, a method of wound debridement using live fly larvae, could provide effective, simple, low cost wound care. All eight US veterinarians who had been provided with medicinal maggots were surveyed to determine if this treatment was being used for small animals, and for what indications. At least two dogs, four cats and one rabbit were treated with maggot therapy between 1997 and 2003. The most common indications for using maggot therapy were to effect debridement and control infection, especially if the wound failed to respond to conventional medical and/or surgical therapy. Practitioners reported the treatments as safe and often beneficial. Amputation and euthanasia may have been avoided. It is concluded that maggot therapy may have utility for small animals, and should be evaluated further.
Collapse
Affiliation(s)
- Ronald A Sherman
- Department of Pathology, University of California, Irvine, CA 92697-4800, USA.
| | | | | | | |
Collapse
|
41
|
Abstract
PURPOSE To provide practitioners with an overview of debridement and its role in wound healing. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses who assess and treat wounds. OBJECTIVES After reading the article and taking the test, the reader should be able to: 1. Discuss the physiologic process of wound healing and the rationale for debridement. 2. Describe evidence-based indications for and methods of debridement.
Collapse
Affiliation(s)
- Carly Kirshen
- External McMaster University, Hamilton, Ontario, Canada
| | | | | | | |
Collapse
|
42
|
Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR, Landsman AS, Lavery LA, Moore JC, Schuberth JM, Wukich DK, Andersen C, Vanore JV. Diabetic foot disorders. A clinical practice guideline (2006 revision). J Foot Ankle Surg 2006; 45:S1-66. [PMID: 17280936 DOI: 10.1016/s1067-2516(07)60001-5] [Citation(s) in RCA: 438] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The prevalence of diabetes mellitus is growing at epidemic proportions in the United States and worldwide. Most alarming is the steady increase in type 2 diabetes, especially among young and obese people. An estimated 7% of the US population has diabetes, and because of the increased longevity of this population, diabetes-associated complications are expected to rise in prevalence. Foot ulcerations, infections, Charcot neuroarthropathy, and peripheral arterial disease frequently result in gangrene and lower limb amputation. Consequently, foot disorders are leading causes of hospitalization for persons with diabetes and account for billion-dollar expenditures annually in the US. Although not all foot complications can be prevented, dramatic reductions in frequency have been achieved by taking a multidisciplinary approach to patient management. Using this concept, the authors present a clinical practice guideline for diabetic foot disorders based on currently available evidence, committee consensus, and current clinical practice. The pathophysiology and treatment of diabetic foot ulcers, infections, and the diabetic Charcot foot are reviewed. While these guidelines cannot and should not dictate the care of all affected patients, they provide evidence-based guidance for general patterns of practice. If these concepts are embraced and incorporated into patient management protocols, a major reduction in diabetic limb amputations is certainly an attainable goal.
Collapse
Affiliation(s)
- Robert G Frykberg
- Podiatric Surgery, Carl T. Hayden VA Medical Center, Phoenix, Arizona 85012, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Sherman RA, Roselle G, Bills C, Danko LH, Eldridge N. Healthcare-associated myiasis: prevention and intervention. Infect Control Hosp Epidemiol 2006; 26:828-32. [PMID: 16276958 DOI: 10.1086/502501] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Healthcare-associated myiasis (maggot infestation) can have complications that go well beyond the medical consequences of the infestation for patients, their families, and facilities. Prevention of healthcare-associated myiasis requires effort on two fronts: minimizing patient risk factors and reducing fly populations in the healthcare environment. If myiasis occurs, intervention must be swift, thorough, and interdisciplinary. The first priority always is the well-being of the patient. Preservation and identification of the maggots can help determine the likely timing and circumstances that led to the infestation. Conditions favoring the infestation must be identified and then corrected. Free and rapid communication must be promoted. A single designated knowledgeable spokesperson to communicate with the patient, employees, and, as needed, the media will reduce miscommunication and hasten mitigation. Following the guidelines presented in this document, healthcare facilities should be able to reduce the likelihood of healthcare-associated myiasis and effectively intervene when such events occur.
Collapse
Affiliation(s)
- Ronald A Sherman
- Department of Pathology, University of California, Irvine, CA 92697-4800, USA.
| | | | | | | | | |
Collapse
|
44
|
Sherman RA, Shimoda KJ. Presurgical maggot debridement of soft tissue wounds is associated with decreased rates of postoperative infection. Clin Infect Dis 2004; 39:1067-70. [PMID: 15472863 DOI: 10.1086/423806] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2004] [Accepted: 05/11/2004] [Indexed: 11/04/2022] Open
Abstract
Postoperative complications were assessed for all patients who received presurgical maggot debridement therapy (MDT) and for a matched group of patients who did not. Ten wounds were debrided by maggots within 1-17 days prior to surgical closure. Debridement was effective in all cases, and there were no postoperative wound infections. Six (32%) of 19 wounds not treated presurgically with MDT developed postoperative wound infections (95% CI, 10%-54%; P<.05). Presurgical MDT was effective in preparing the wound bed for surgical closure, without increased risk of postsurgical wound infection.
Collapse
|
45
|
Claxton MJ, Armstrong DG, Short B, Vazquez JR, Boulton AJM. 5 questions--and answers--about maggot debridement therapy. Adv Skin Wound Care 2003; 16:99-102. [PMID: 12690234 DOI: 10.1097/00129334-200303000-00012] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Matthew J Claxton
- Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson, AZ, USA
| | | | | | | | | |
Collapse
|
46
|
Beckert S, Coerper S, Becker HD. Skin Grafting of Venous Ulcers: A Review of its Current Role. INT J LOW EXTR WOUND 2002; 1:236-41. [PMID: 15871976 DOI: 10.1177/1534734602239564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As a therapeutic option, grafting of venous ulcers has not been very successfully received despite the different types of grafting methods. Currently, there are only a few controlled randomized trials offering clear guidance to clinicians. The development of artificially bioengineered skin constructs has led to a renewed interest in wound bed preparation, and preliminary successes suggest that the role of skin grafting could be studied in the current context.
Collapse
Affiliation(s)
- Stefan Beckert
- Department of General Surgery, University of Tübingen, Tübingen, Germany
| | | | | |
Collapse
|