Maggot debridement therapy and innovation from myiasis - A review

Abstract

Maggot debridement therapy is the introduction of live and disinfected fly larvae in a wound in order to aid cleaning and healing. This technique was discovered as a beneficial effect of colonization of human tissue by fly larvae (myiasis). This discovery was made during the World War I when it was observed that injured soldiers whose wounds were infested with maggots healed faster than their counterparts whose wounds were free from maggots. In this therapy, the larvae of Blow fly (Lucilia sericata) are used because they feed 
exclusively on dead tissues. There are two different ways through which these maggots are applied into the wound, namely, free range dressing and biobag dressing. The mechanism of action of the maggots during debridement involves secretion of digestive enzymes which breakdown the dead tissues, liquidizing it before ingesting the liquefied contents of the wound. They also secrete antimicrobials which inhibit microbial growth in the wound, thereby disinfecting it. This therapy has been successfully used in the treatment of leg ulcers, deep and diabetic wounds in humans. The advantages of maggot debridement therapy are enormous. The cost of using it is relatively low, it quickens healing of wounds, and it is painless. However, the patient may experience irritation and itching at the wound site which is associated with larval movement in the wound. The adoption of this therapeutic wound management is advocated as practical evidence show that it has proven effective in the management of diabetic wounds more than conventional medical practices.