Wound Healing By Maggots

Written by: MITCHELL MARTHA ARUFINU. Class of 2028.

This blog is about the importance of the use of maggots for healing of wounds and ways in which they are used.

INTRODUCTION

This is done through a procedure called Maggot Therapy which is also known as Larval Therapy or Debridement Therapy. Maggot Therapy utilizes larvae of green[1]bottle fly which applied to an infected wound in order to destroy infected and necrotic tissues. In addition to that they maintain clean wound after debridement. Maggots are manufactured in a particular unit by well trained staff at Biomonde a company with many years of experience in wound management

 WHAT AFFECTS WOUND HEALING?

It is affected by intrinsic and extrinsic factors that can be divided into systematic or local such as gender and age, sex hormones, stress, ischemia, obesity, alcoholism, smoking, chemotherapy, uraemia, jaundice, fibrosis just to mention a few.              

HOW CAN YOU INTRODUCE MAGGOTS.

They can be introduced in two ways on infected wound

1 FREE RANGE MAGGOTS

This can also be called direct method since the maggots are introduced directly to the wound and a special dressing system is used to retain them. It is usually kept for 3 day.

2 BIOBAG DRESSING

The larvae is placed inside a dressing pouch which is sealed with a foam which aids to the growth of maggots. It is only at the completion of treatment that the maggots dressing is opened. This procedure takes about four days but it is also possible for the dressing to be removed daily after a daily check up. The maggots size is generally smaller than that of a grain of rice but during the treatment it can increase to 12mm.

HOW CAN YOU INTRODUCE MAGGOTS ?

Chronic wounded patients such as those with soft tissue wounds ( neuropathic foot ulcer, leg ulcers, non-healing traumatic or post-operative wounds and pressure ulcers) and non-healing necrotic skin. In addition to that only patients who have given their full consent without any objections to this therapy are eligible.

VENOUS LEG ULCERS

 It is approximated that 2℅ of population in developing countries experience chronic wound which is a hidden phenomenon that increases with aging population. Fortunately maggots are easily found there. It is a important to note that chronic wound is a silent epidemic. Apart from that 6.6 ℅ of Malaysia by 2030 it is expected to have reached a period of an aging population. The patients that would have given their full consent and have no objections to this therapy thus no ethical barriers will be bridged.

 ADVANTAGES OF MAGGOTS THERAPY

1.       They facilitate the more effective way of removal of non- viable tissues.

2.       Rapid maturation of tissue granulation.  

3.       Faster reduction of wound surface compared to conventional dressing ( hydrogel dressing).

4.       It is safe, efficient and simple to use.

DISADVANTAGES OF MAGGOTS THERAPY

1.       Does not have any effect on disinfection or any complete healing of the wound.

2.       It requires evidence before including it in the patient's treatment.

 EFFECTS OF MAGGOTS THERAPY ON A WOUND SITE

It is expected to have a unique scent due to the chemicals released by maggots when they feed on the nonviable tissues. Apart from that there is an appearance of a pink discharge which usually makes the wound site is wet this must not alarm you for it expected during this procedure.

 It has been said that most patients do not feel anything during the treatment, they are usually comfortable but patients in particular with poor circulation usually feel pain. In addition to that the pain reduces significantly after the treatment on the infected wound.

 WHAT SHOULD NOT BE DONE DURING THIS TREATMENT

Do not wash the wound or douse it in water. Do not sit with the site of the wound where the maggots were applied. Do not sit too close to the heat such as radiation and fire, for it may lead to the drying up of the maggots tissues and their death.

 IN CONCLUSION

In October 2014 an electrical literature was performed using midline, Emabase and Cumulative Index of Nursing and Allied Health Literature. The eligible patients had chronic wound with an intervention involved in the comparison of different maggot species with hydrogel dressings such as those with diabetic foot ulcers.