Maggot therapy is a type of biotherapy that involves the introduction of live maggots and disinfected (fly larvae) into non-healing skin and soft tissue injuries from humans or animals for the purpose of clearing necrotic tissue (dead) within the wound (debridement ) and disinfection.
There is evidence that maggot therapy can help wound healing.
Video Maggot therapy
Medical use
Maggot therapy improves healing in chronic ulcers. In diabetic foot ulcers there is evidence of temporary benefit. A Cochrane review of methods for foot ven ulcer ulceration found maggot therapy in general as effective as most other methods, but also noted that the quality of data was poor.
In 2004, the FDA cleared the maggots for use as medical devices in the United States for medicinal purposes:
- Non-healing necrotic skin and soft tissue injuries
- Pressure ulcers
- Venous stasis ulcer
- Neuropathic foot ulcers
- Traumatic or post-healing surgical lesions
Limitations
Wounds should be of the kind that could benefit from the application of maggot therapy. Moist wounds and exudates with sufficient oxygen supply are a prerequisite. Not all types of wounds fit: a dry wound, or an open wound in the body cavity does not provide a good environment for the maggots to be fed. In some cases it is possible to make suitable dry sores for larval therapy by moistening them with saline solution, applied for 48 hours.
Patients and doctors may find the maggots unpleasant, although studies show that this does not cause patients to reject the offer of maggot therapy. Maggots can be closed in an opaque polymer bag to hide it from view. Dressings should be designed to prevent maggots from fleeing, while allowing air to get to the maggots. Dressings are also designed to minimize the unpleasant tingling sensations that often cause maggots.
Maps Maggot therapy
Action mechanism
The blade has 4 main actions:
- Debridement
- Wound disinfection
- Healing stimulation
- Inhibition and disappearance of biofilms Debian
In maggot therapy, large numbers of small grubs consume necrotic tissue much more precisely than is possible in normal surgery, and can crush the wound within a day or two. The surface area of ​​the wound usually increases with the use of a maggot because the undebrided surface does not reveal the actual size of the underlying wound. They obtain nutrients through a process known as "extracorporeal digestion" by removing a wide spectrum of proteolytic enzymes that dilute the necrotic tissue, and absorb the semi-liquid results within a few days. In maggots the optimal environment, twice the molars, increases in length from 1-2 mm to 8-10 mm, and in thickness, within 48-72 hours by swallowing necrotic tissue, leaving free clean wounds from the necrotic tissue when they are removed.
Disinfection
The secretions of maggots are believed to have broad-spectrum antimicrobial activity including allantoin, urea, phenylacetic acid, phenylacetaldehyde, calcium carbonate, proteolytic enzymes, and many others.
In vitro studies have shown that the maggots inhibit and destroy various pathogenic bacteria including methicillin-resistant Staphylococcus aureus (MRSA), Group A and B streptococci, and Gram-positive. aerobic and anaerobic strains. Other bacteria such as Pseudomonas aeruginosa , E.coli or Proteus spp. not attacked by maggots, and in the case of Pseudomonas even the maggots are in danger.
Maggots biology
Flies that larvae feed on dead animals will sometimes lay eggs on the dead (gangrenous necrotic or gangrenous tissue) of living animals. The infestation by live animal maggots is called myiasis. Some maggots will only eat dead tissue, some only on living tissue, and some in the tissues live or die. The flies most commonly used for the purpose of maggot therapy are the sucker flies from Calliphoridae: the most commonly used flies are Lucilia sericata , common green bottle flies. Another important species, Protophormia terraenovae , is also notable for its feed secretions, which fight infection by Streptococcus pyogenes and S. pneumoniae .
History
Written records have documented that the maggots have been used since antiquity as wound treatment. There have been reports of the use of maggots for wound healing by Native Americans and Aborigines in Australia. There are also reports of the use of maggot treatment in Renaissance times. Military doctors have observed that soldiers whose wounds have been colonized by maggots experience far less morbidity and mortality than soldiers whose wounds are not colonized. These doctors include Napoleon's general surgeon, Baron Dominique Larrey. Larrey reported during the French Egypt campaign in Syria, 1798-1801, that certain species of flies consume only dead tissue and help heal wounds.
Joseph Jones, a Confederate medical official ranked during the American Civil War, is quoted as follows, "I have often seen neglected wounds... filled with maggots... as far as my experience is widespread, these worms only eat dead tissue, and do not injure specifically the parts of the well. "The use of the first documented maggot therapy in the United States was credited to the second Confederate medical officer. JF Zacharias, who reported during the American Civil War that, "Maggots... in a single day will clean the wound much better than our agent at our command... I am sure I saved many lives by its use." He noted the survival rate life is high in patients treated with maggots.
During World War I, William S. Baer, ​​an orthopedic surgeon, noticed that a soldier went away for a few days on a battlefield suffering from a broken femur and major bodily injuries and arrived at the hospital with a maggot which infects his wounds are not feverish. or other signs of infection and survivors of the wound, which are usually fatal. After the war Baer began using maggot therapy at Boston Children's Hospital in Massachusetts.
There are reports that Japanese American war prisoners in World War II used maggot therapy to treat severe injuries.
A survey of US Army doctors published in 2013 found that 10% of them had been using maggot therapy.
Rule
In January 2004, the US Food and Drug Administration (FDA) granted permission to produce and market maggots for use in humans or animals as a special medical device prescribed for the following indications: "For non-healing necrosis skin debriding and soft-tissue injuries, including pressure ulcers, venous stasis ulcers, neuropathic foot ulcers, and traumatic or postoperative post traumatic injuries. "
Veterinary use
The use of maggots to clean dead tissue from animal wounds is part of traditional medicine in many parts of the world. This is especially helpful with chronic osteomyelitis, chronic ulcers, and other pus-producing infections that are often caused by abrasion due to work equipment. Maggot's therapy for horses in the United States was reintroduced after a study published in 2003 by Dr. Scott Morrison. This therapy is used on horses for conditions such as secondary osteomyelitis for laminitis, sub-solar abscess leading to osteomyelitis, post-operative treatment of nail procedures for stab wounds infecting the navicular burs, cancer, non-healing ulcers on frogs, and post- surgery to remove keratoma.
Source of the article : Wikipedia
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