References

Lindholm C, Bjellerup M, Ole Christensen, Zederfeldt B. Quality of life in chronic leg ulcer patients. Acta Derm Venereol (Stockh). 1993; 73:440-443

Stadelmann WK, Digenis AG, Tobin GR. Physiology and healing dynamics of chronic cutaneous wounds. Am J Surg. 1998; 176:(2)26S-38S

Schultz GS, Sibbald RG, Falanga V. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003; 11:(S1)S1-S28

Position document: wound bed preparation in practice.: MEP Ltd; 2004

Van Der Plas MJA, Jukema GN, Wai SW Maggot excretions/secretions are differentially effective against biofilms of Staphylococcus aureus and Pseudomonas aeruginosa. J Antimicrobial Chemotherapy. 2008; 61:(1)117-122

Brown A, Blount DG, Horobin A Blow fly Lucilia sericata nuclease digests DNA associated with wound slough/eschar and with Pseudomonas aeruginosa biofilm. Med Veterinary Entomol. 2012; 26:(4)432-439

Pritchard DI, Brown AP. Degradation of MSCRAMM target macromolecules in VLU slough by Lucilia sericata chymotrypsin 1 (ISP) persists in the presence of tissue gelatinase activity. Int Wound J. 2015; 12:(4)414-421

Chambers L, Brown AP, Hall M Degradation of extracellular matrix components by defined proteinases from the greenbottle larva Lucilia sericata used for the clinical debridement of non-healing wounds. Br J Dermatol. 2003; 148:(1)14-23

Van Der Plas MJA, Jukema GN, Wai SW Maggot secretions suppress proinflammatory responses of human monocytes through elevation of cyclic AMP. Diabetologia. 2009; 52:(9)1962-1970

Van Der Plas MJA, Van Dissel JT, Nibbering PH Maggot secretions skew monocytemacrophage differentiation away from a pro-inflammatory to a proangiogenic type. PloS ONE. 2009; 4:(11)

Nygaard MKE, Andersen A, Kristensen H The insect defensin lucifensin from Lucilia sericata. J Biomolecular NMR. 2012; 52:(3)277-282

Dumville JC, Bland M, Cullum N Larval therapy for leg ulcers (VenUS II): randomised controlled trial. BMJ. 2009; 338

Soares MO, Iglesias CP, Bland JM Cost effectiveness analysis of larval therapy for leg ulcers. BMJ. 2009; 338

Mudge E, Price P, Neal W, Harding KG A randomized controlled trial of larval therapy for the debridement of leg ulcers: results of a multicenter, randomized, controlled, open, observer blind, parallel group study. Wound Repair Regen. 2014; 22:(1)43-51

Hall-Stoodley L, Bjarnsholt T, Costerton JW Towards diagnostic guidelines for biofilm-associated infections. FEMS Immunol Med Microbiol. 2012; 65:(2)127-145

Hill KE. Molecular analysis of the microflora in chronic venous leg ulceration. J Med Microbiol. 2003; 52:(4)365-369

Grey JE. Venous and arterial leg ulcers. BMJ. 2006; 332:(7537)

Humphreys ML, Gohel MS, Poskitt KR Management of mixed arterial and venous leg ulcers. Br J Surgery. 2007; 94:(9)1104-1107

Howell-Jones RS, Wilson MJ, Hill KE A review of the microbiology, antibiotic usage and resistance in chronic skin wounds. J Antimicrobial Chemother. 2005; 55:(2)143-149

Andersen S, Joergensen B, Karlsmark T A novel approach to the antimicrobial activity of maggot debridement therapy. J Antimicrobial Chemother. 2010; 65:(8)1646-1654

Margolin L, Gialanella P. Assessment of the antimicrobial properties of maggots. Int Wound J. 2010; 7:(3)202-204

Bjarnsholt T, Høiby N, Givskov M Why chronic wounds will not heal: a novel hypothesis. Wound Repair Regen. 2008; 16:(1)2-10

Parnés A, Lagan KM. Larval therapy in wound management: a review. Int J Clin Practice. 2007; 61:(3)488-493

Cazander G, Nigam Y, Jung W Multiple actions of Lucilia sericata larvae in hard-to-heal wounds. Bioessays. 2013; 35:(12)1083-1092

Harris LG, Mack D, Nigam Y Lucilia sericata chymotrypsin disrupts protein adhesin-mediated staphylococcal biofilm formation. Applied Environmental Microbiol. 2013; 79:(4)1393-1395

Madsen SM, Danielsen L, Rosdahl VT, Westh H. Bacterial colonization and healing of venous leg ulcers. Apmis. 1996; 104:(7–8)895-99

Pritchard DI, Nigam Y. Maximising the secondary beneficial effects of larval debridement therapy. J Wound Care. 2013; 22:(11)610-11

Telford G, Brown AP, Seabra R Degradation of eschar from venous leg ulcers using a recombinant chymotrypsin from Lucilia sericata. Br J Dermatol. 2010; 163:(3)523-531

Burnand KG, Whimster I, Naidoo A, Browse NL. Pericapillary fibrin in the ulcer-bearing skin of the leg: the cause of lipodermatosclerosis and venous ulceration. Br Med J (Clin Res Ed). 1982; 285:(6348)1071-1072

Schultz GS, Wysocki A. Interactions between extracellular matrix and growth factors in wound healing. Wound Repair Regen. 2009; 17:(2)153-162

Telford G, Brown AP, Kind A Maggot chymotrypsin I from Lucilia sericata is resistant to endogenous wound protease inhibitors. Br J Dermatol. 2011; 164:(1)192-196

Bode W, FernandezCatalan C Insights into MMP-TIMP Interactions. Ann New York Acad Sci. 1999; 878:(1)73-91

Trengove NJ, Stacey MC, Macauley S Analysis of the acute and chronic wound environments: the role of proteases and their inhibitors. Wound Repair Regen. 1999; 7:(6)442-452

Serra R, Buffone G, Daniela F Chronic venous leg ulcers are associated with high levels of metalloproteinases-9 and neutrophil gelatinase-associated lipocalin. Wound Repair Regen. 2013; 21:(3)395-401

Rayment EA, Upton Z, Shooter GK Increased matrix metalloproteinase-9 (MMP-9) activity observed in chronic wound fluid is related to the clinical severity of the ulcer. Br J Dermatol. 2008; 158:(5)951-961

Schultz GS, Ladwig G, Wysocki A. Extracellular matrix: review of its roles in acute and chronic wounds.: World Wide Wounds; 2005

Clark R, Singer AJ. Cutaneous wound healing. New Engl J Med. 1999; 341:(10)738-746

Agren MS, Eaglstein WH, Ferguson MW Causes and effects of the chronic inflammation in venous leg ulcers. Acta dermato-venereologica Supplementum. 1999; 210:3-17

Greenhalgh T. How to read a paper: the basics of evidence-based medicine, 5th ed. : Wiley Blackwell; 2014

Tandara AA, Mustoe TA. Oxygen in wound healing–more than a nutrient. World J Surgery. 2004; 28:(3)294-300

Jonsson K, Hopf HW, Hunt TK Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients. Ann Surgery. 1991; 214:(5)

Igari K, Inoue Y, Jibiki M Maggot debridement therapy for peripheral arterial disease. Ann Vascular Dis. 2013; 6:(2)145-149

Maeda TM, Ichimura KI, Kimura CK, Takahashi KT. Increase in skin perfusion pressure after maggot debridement therapy for critical limb ischaemia. Clin Experimental Dermatol. 2014; 39:(8)911-914

Benefits of maggot debridement therapy on leg ulcers: a literature review

02 February 2019
Volume 3 · Issue 1

Abstract

Maggot debridement therapy (MDT) is an effective method for debriding wounds such as leg ulcers, supporting the concept of wound bed preparation.12,13,14 New evidence is emerging to suggest that maggots might contribute to wound healing in other ways. For example, the reduction of biofilms and disinfection of wounds5,6,7 plus regulation of protease levels.8,9,10 This review will discuss research exploring new benefits of maggots in the management of individuals with chronic leg ulcers.

Chronic leg ulcers are known to cause physical and psycho-social complications that may impact the quality of life of patients.1 Thus, research has sought to identify factors that might answer why wounds may not heal in an orderly manner.2,3 The European Wound Management Association (EWMA) developed a document to guide clinicians to assess wounds and help plan effective wound management. This document explains the TIME framework: T referring to tissue management, I for infection and inflammation, M for moisture and E for edges and epithelialisation. It explains how different factors might delay wound healing. One major component of this framework is the need for wound bed preparation, which seems to be the first step to revert a chronic wound back to its acute phase, thus aiding wound healing.4

New evidence is emerging to suggest that maggots might contribute to wound healing in other ways. For example, the reduction of biofilms and disinfection of wounds5,6,7 plus regulation of protease levels.8,9,10 These effects might contribute to wound healing and even reduce the need for antibiotics.11 However, these effects are still considered controversial by many clinicians who limit the use of maggots to debridement only without considering other potential benefits from this therapy. This review will discuss research exploring new benefits from maggots in the management of individuals with chronic leg ulcers.

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