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Maggots Clean Up Wounds


Maggot are used as a biological dressing for chronic wounds. Maggots debride the necrotic tissue and thus clean up wounds. The use of maggots for wounds by medical personnel has waxed and waned through the years. Ambroise Pare (1509-1590) is generally given credit for first noting the beneficial effects of maggots in suppurative wounds.

A study just published in the British Medical Journal is the first randomized trial to compare the use of maggot therapy to hydrogel dressings for chronic leg ulcers. The end point for measurement was the time of healing.

Among the 267 patients enrolled in the study, it was found that the time to healing of their wounds was not significantly different between the maggot larvae group and the hydrogel group.

It was noted that the maggot larva therapy significantly reduced the time to debridement. The maggots cleaned up the wounds faster and better than the hydrogel group.

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The maggot larva did not decrease the MRSA bacterial load any faster or better than the hydrogel therapy.

Maggot larva therapy is associated with a small increase in ulcer pain during the debridement phase.

Maggots, by definition, are fly larvae, just as caterpillars are butterfly or moth larvae. Phaenicia sericata (green blow fly) larvae is the one used in maggot therapy. It is the larvae of the green blowfly (Phaenicia sericata) that is used. This larvae is sterilized with radiation before being used so that they will not be able to convert from the larvae to the pupae stage. They secrete enzymes that dissolve the necrotic tissue and the biofilm that surrounds bacteria. This forms a nutrient-rich liquid that larvae can feed on. Thirty larvae can consume 1 gram of tissue per day.

Larval therapy for leg ulcers (VenUS II): randomised controlled trial; BMJ 2009;338:b773; Jo C Dumville, Gill Worthy, J Martin Bland, Nicky Cullum, Christopher Dowson, Cynthia Iglesias, Joanne L Mitchell, E Andrea Nelson, Marta O Soares, David J Torgerson

Maggot Therapy; Suture for a Living blog, January 14, 2009