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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

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

02 February 2019
Volume 3 · Issue 1


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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