Cybermedlife - Therapeutic Actions Maggot therapy

Maggot therapy in wound management. 📎

Abstract Title: [Maggot therapy in wound management]. Abstract Source: Tidsskr Nor Laegeforen. 2009 Sep 24;129(18):1864-7. PMID: 19844278 Abstract Author(s): Birgit Margrethe Falch, Louis de Weerd, Arnfinn Sundsfjord Article Affiliation: Det medisinske fakultet, Universitetet i Tromsø, 9037 Tromsø, Norway. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: Maggots' ability to prevent infections and promote wound healing has been known since the 19th century. Increasing problems with treatment-resistant wounds and antibiotic-resistant bacteria has aroused interest in maggot therapy. MATERIAL AND METHODS: Literature on maggot therapy - identified through a non-systematic search of Pubmed - was reviewed. RESULTS: Maggot therapy is the medical use of disinfected fly larvae (usually the larvae of Lucilia sericata) in treatment of wounds resistant to conventional treatment. The maggots work through three mechanisms of action; they debride wounds by dissolving necrotic tissue, clean wounds by killing bacteria and promote wound healing. The larvae have a broad antibacterial action against Gram-negative and Gram-positive bacteria, including MRSA. Maggot therapy is used to debride a number of complicated skin and soft tissue wounds - e.g.. pressure ulcers, venous stasis ulcers, neurovascular ulcers, traumatic wounds and burns - but also as a treatment for osteomyelitis. Large controlled clinical trials have not been performed. Maggot therapy has not been associated with serious side effects. INTERPRETATION: Maggot therapy seems to be an effective and environmentally friendly treatment of complicated necrotic wounds that are resistant to conventional treatment. Maggot therapy should also be considered in earlier stages of treatment. Article Published Date : Sep 24, 2009

Clinical and microbiological efficacy of MDT in the treatment of diabetic foot ulcers.

Abstract Title: Clinical and microbiological efficacy of MDT in the treatment of diabetic foot ulcers. Abstract Source: J Wound Care. 2007 Oct;16(9):379-83. PMID: 17987750 Abstract Author(s): T I Tantawi, Y M Gohar, M M Kotb, F M Beshara, M M El-Naggar Article Affiliation: Department of Zoology, Faculty of Science, Alexandria University, Alexandria, Egypt. This email address is being protected from spambots. You need JavaScript enabled to view it. 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. Article Published Date : Oct 01, 2007

Maggot therapy for treating diabetic foot ulcers unresponsive to conventional therapy. 📎

Abstract Title: Maggot therapy for treating diabetic foot ulcers unresponsive to conventional therapy. Abstract Source: Diabetes Care. 2003 Feb;26(2):446-51. PMID: 12547878 Abstract Author(s): Ronald A Sherman Abstract: OBJECTIVE: To assess the efficacy of maggot therapy for treating foot and leg ulcers in diabetic patients failing conventional therapy. RESEARCH DESIGN AND METHODS: Retrospective comparison of changes in necrotic and total surface area of chronic wounds treated with either maggot therapy or standard (control) surgical or nonsurgical therapy. RESULTS: In this cohort of 18 patients with 20 nonhealing ulcers, six wounds were treated with conventional therapy, six with maggot therapy, and eight with conventional therapy first, then maggot therapy. Repeated measures ANOVA indicated no significant change in necrotic tissue, except when factoring for treatment (F [1.7, 34] = 5.27, P = 0.013). During the first 14 days of conventional therapy, there was no significant debridement of necrotic tissue; during the same period with maggot therapy, necrotic tissue decreased by an average of 4.1 cm(2) (P = 0.02). After 5 weeks of therapy, conventionally treated wounds were still covered with necrotic tissue over 33% of their surface, whereas after only 4 weeks of therapy maggot-treated wounds were completely debrided (P = 0.001). Maggot therapy was also associated with hastened growth of granulation tissue and greater wound healing rates. CONCLUSIONS: Maggot therapy was more effective and efficient in debriding nonhealing foot and leg ulcers in male diabetic veterans than was continued conventional care. Article Published Date : Feb 01, 2003

Maggot versus conservative debridement therapy for the treatment of pressure ulcers.

Abstract Title: Maggot versus conservative debridement therapy for the treatment of pressure ulcers. Abstract Source: Wound Repair Regen. 2002 Jul-Aug;10(4):208-14. PMID: 12191002 Abstract Author(s): Ronald A Sherman Article Affiliation: Department of Pathology, University of California, Irvine, California 92697-4800, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: To define the efficacy and safety of maggot therapy, a cohort of 103 inpatients with 145 pressure ulcers was evaluated. Sixty-one ulcers in 50 patients received maggot therapy at some point during their monitored course; 84 ulcers in 70 patients did not. Debridement and wound healing could be quantified for 43 maggot-treated wounds and 49 conventionally treated wounds. Eighty percent of maggot-treated wounds were completely debrided, while only 48% of wounds were completely debrided with conventional therapy alone (p=0.021). Within 3 weeks, maggot-treated wounds contained one-third the necrotic tissue (p = 0.05) and twice the granulation tissue (p<0.001), compared to non-maggot-treated wounds. Of the 31 measurable maggot-treated wounds monitored initially during conventional therapy, necrotic tissue decreased 0.2 cm(2) per week during conventional therapy, while total wound area increased 1.2 cm(2) per week. During maggot therapy, necrotic tissue decreased 0.8 cm(2) per week (p = 0.003) and total wound surface area decreased 1.2 cm2 per week (p = 0.001). Maggot therapy was more effective and efficient in debriding chronic pressure ulcers than were the conventional treatments prescribed. Patients readily accepted maggot therapy, and adverse events were uncommon. Article Published Date : Jul 01, 2002

Maggot therapy for the treatment of intractable wounds.

Abstract Title: Maggot therapy for the treatment of intractable wounds. Abstract Source: Int J Dermatol. 1999 Aug;38(8):623-7. PMID: 10487456 Abstract Author(s): K Y Mumcuoglu, A Ingber, L Gilead, J Stessman, R Friedmann, H Schulman, H Bichucher, I Ioffe-Uspensky, J Miller, R Galun, I Raz Article Affiliation: Department of Parasitology, Hebrew University-Hadassah Medical School, Jerusalem, Israel. Abstract: BACKGROUND: Fly maggots have been known for centuries to help debride and heal wounds. Maggot therapy was first introduced in the USA in 1931 and was routinely used there until the mid-1940s in over 300 hospitals. With the advent of antimicrobiols, maggot therapy became rare until the early 1990s, when it was re-introduced in the USA, UK, and Israel. The objective of this study was to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds and ulcers in long-term hospitalized patients in Israel. METHODS: Twenty-five patients, suffering mostly from chronic leg ulcers and pressure sores in the lower sacral area, were treated in an open study using maggots of the green bottle fly, Phaenicia sericata. The wounds had been present for 1-90 months before maggot therapy was applied. Thirty-five wounds were located on the foot or calf of the patients, one on the thumb, while the pressure sores were on the lower back. Sterile maggots (50-1000) were administered to the wound two to five times weekly and replaced every 1-2 days. Hospitalized patients were treated in five departments of the Hadassah Hospital, two geriatric hospitals, and one outpatient clinic in Jerusalem. The underlying diseases or the causes of the development of wounds were venous stasis (12), paraplegia (5), hemiplegia (2), Birger's disease (1), lymphostasis (1), thalassemia (1), polycythemia (1), dementia (1), and basal cell carcinoma (1). Subjects were examined daily or every second day until complete debridement of the wound was noted. RESULTS: Complete debridement was achieved in 38 wounds (88.4%); in three wounds (7%), the debridement was significant, in one (2.3%) partial, and one wound (2.3%) remained unchanged. In five patients who were referred for amputation of the leg, the extremities was salvaged after maggot therapy. CONCLUSIONS: Maggot therapy is a relatively rapid and effective treatment, particularly in large necrotic wounds requiring debridement and resistant to conventional treatment and conservative surgical intervention. Article Published Date : Aug 01, 1999
Therapeutic Actions Maggot therapy

NCBI pubmed

Survey of patients of the Tver region of Russia regarding maggots and maggot therapy.

Survey of patients of the Tver region of Russia regarding maggots and maggot therapy. Int Wound J. 2018 Dec 13;: Authors: Morozov AM, Sherman RA Abstract The 21st century is seeing a resurgence in the use of maggot therapy-using the physical and biochemical benefits of fly larvae to debride and heal chronic, problematic wounds. Maggots are repulsive to many people, and this could interfere with the acceptance of this modality. Before instituting a maggot therapy programme at our institution, we sought to better understand the psychological barriers that may exist among patients in the Tver region of Russia. Between 2014 and 2016, all patients with arterial insufficiency and trophic ulcers at City Clinical Hospital No. 7 in Tver were administered a survey consisting of six images. Subjects were asked to rank the images in the order of least to most repulsive or disgusting. A total of 576 subjects were recruited for this study: 414 (72%) women and 162 (28%) men. Nearly 60% of subjects considered the images of maggots to be more repulsive than images of gangrenous wounds. This finding is significant because it indicates that much education and support will need to be conducted to address patient fears and anxiety if patients are to be comfortable with a maggot therapy programme. PMID: 30548914 [PubMed - as supplied by publisher]

[Case of pneumonia associated sepsis accompaning pulmonary myiasis].

Related Articles [Case of pneumonia associated sepsis accompaning pulmonary myiasis]. Mikrobiyol Bul. 2018 Oct;52(4):439-443 Authors: Naz H, Aslan L, Sönmez Tamer G, Naz C Abstract Myiasis; is defined as the infestation of dead or living tissues of humans and animals by the diptera larvae. It is prevalent all over the world, especially in tropical and subtropical countries with low socioeconomic status. Myiasis of humans has been associated with low socioeconomic status, alcoholism, mental or neurological diseases, poor personal hygiene, patients with varicose veins, diabetes, malnutrition, advanced stage cancer, pediculosis, immunosuppression, sexually transmitted disease, gingivitis and other oral cavity lesions. Myiasis is most commonly seen as skin invasion in the human body, but can be observed in many areas such as eye, ear, nose, throat, urogenital, intestinal, cerebral and tracheopulmonary. Tracheo pulmonary myiasis is a very rare condition. This report presents a case of pneumonia-associated sepsis in a patient with a tracheostomy accompanied by third-stage larval Sarcophagidae. A 51-year-old male patient developed hypoxic brain injury after myocardial infarction 10 months ago before his admission to the hospital. Tracheostomy and percutaneous endoscopic gastrostomy were performed. Shortness of breath and fever were present for five days. The patient has been admitted to the emergency service with the reason for the deterioration of the general situation. The patient was unconscious. Purulent secretion in the tracheostomy area and bilateral crepitation rales in the lung bases were detected. Leukocyte level was normal with C reactive protein (CRP) 14 mg/dl. Nodular infiltration was detected bilaterally in the middle and lower zones, more prominently in the right thoracic computerized tomography. Seftriaxon, moxifloxacin and fluid therapy were initiated in the patient who was admitted with pneumonia-related sepsis diagnosis. The tracheostomy cannula has changed. On the fourth day of admission, Sarcophagidae third stage larvae were detected in deep tracheal aspiration. Treatment of piperacillin/tazobactam and teicoplanin was started by discontinuing the current antibiotherapy of the patient who had no clinical response and elevated CRP level, 18 mg/dl. The patient was discharged on the 25th day of hospitalization with improved clinical and laboratory responses. Complete healing was observed in the control performed by the home care unit. Bed-dependent, lack of self-care, and poor tracheostomy hygiene were risk factors for this patient. In this case, fluid therapy and antibiotic treatment for sepsis was given but no treatment for myiasis. Larva has been considered to have prepared a base for pneumonia due to the foreign body effect and secretion accumulation. Untreated injuries, especially those with impaired oxygenation, leave the eggs of adult flies and provide a suitable environment for larval development. Therefore, should be given importance to combat with flies and regular tracheostomy care in bedside and tracheostomized patients. PMID: 30522429 [PubMed - in process]

Serpiginous Lesions in an Infant.

Related Articles Serpiginous Lesions in an Infant. J Cutan Med Surg. 2018 May/Jun;22(3):327 Authors: Maier J, Kofler L, Beck V, Schweinzer K, Ghoreschi K PMID: 29865948 [PubMed - indexed for MEDLINE]

Botanical essential oils and uses as mosquitocides and repellents against dengue.

Related Articles Botanical essential oils and uses as mosquitocides and repellents against dengue. Environ Int. 2018 04;113:214-230 Authors: Chellappandian M, Vasantha-Srinivasan P, Senthil-Nathan S, Karthi S, Thanigaivel A, Ponsankar A, Kalaivani K, Hunter WB Abstract Plants naturally produce bioactive compounds along with many secondary metabolites which serve as defensive chemical against herbivorers including insect pests. One group of these phytochemicals are the 'Essential Oils' (EO's), which possess an extensive range of biological activity especially insecticidal and insect repellents. This review provides a comprehensive viewpoint on potential modes of action of biosafety plant derived Essential Oils (EO's) along with their principal chemical derivatives against larvae and adult mosquito vectors of dengue virus. The development and use of Essential Oils (EO's) effectively applied in small rural communities provides an enormous potential for low cost effective management of insect vectors of human pathogens which cause disease. PMID: 29453089 [PubMed - indexed for MEDLINE]

Building early-larval sexing systems for genetic control of the Australian sheep blow fly Lucilia cuprina using two constitutive promoters.

Related Articles Building early-larval sexing systems for genetic control of the Australian sheep blow fly Lucilia cuprina using two constitutive promoters. Sci Rep. 2017 05 31;7(1):2538 Authors: Yan Y, Linger RJ, Scott MJ Abstract Transgenic sexing strains (TSS) that carry conditional female lethal genes are advantageous for genetic control programs based on the sterile insect technique (SIT). It is desirable if females die early in development as larval diet is a major cost for mass production facilities. This can be achieved by using a gene promoter that is only active in embryos to drive expression of the tetracycline transactivator (tTA), the transcription factor commonly used in two-component TSS. While an embryo-specific promoter is ideal it may not be essential for assembling an effective TSS as tTA can be repressed by addition of tetracycline to the diet at larval and/or adult stages. Here we have investigated this idea by isolating and employing the promoters from the Lucilia spitting image and actin 5C genes to drive tTA expression in embryos and later stages. L. cuprina TSS with the tTA drivers and tTA-regulated tetO-Lshid effectors produced only females when raised on a limited tetracycline diet. The Lshid transgene contains a sex-specific intron and as a consequence only females produce LsHID protein. TSS females died at early larval stages, which makes the lines advantageous for an SIT program. PMID: 28566730 [PubMed - indexed for MEDLINE]
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