MAGGOT THERAPY

MAGGOTS
Maggots are fly larvae, or immature flies, just as caterpillars are butterfly or moth larvae. Maggots hatch from eggs which are laid by adult female flies. It was believed about 150 years ago that they appear by themselves. Not all species of flies are safe and effective as medicinal maggots. There are thousands of species of flies, each with its own habits and life cycle. Some fly larvae feed on plants or animals, or even blood (i.e., mosquitoes). Others feed on rotting organic material. Those flies whose larvae feed on dead animals will sometimes lay their eggs on the dead parts (necrotic or gangrenous tissue) of living animals. When maggots live on living animals, that condition is called "myiasis." Some of those maggots will feed only on dead tissue, some only on live tissue, and some on live or dead tissue. The flies used most often for the purpose of maggot therapy are "blow flies" (Calliphoridae); and the species used most commonly is Phaenicia sericata, the green blow fly.

HISTORY OF MAGGOTS USED FOR THERAPY

Fly maggots WERE USED since ages to heal the wounds. This therapy was first introduced first in the USA In 1931 and had been routinely used there until mid 1940 in more than 300 hospitals. This therapy was then used rarely with the advent of antibiotics. In 1990s it was again introduced in USA.These days it is again used in over 30 countries world wide. Over 20000 patients are being treated in over 2000 institutes in the last 20 years

THE MAGGOT THERAPY PROCEDURE (MDT)

Lucilia sericata a green bottle fly are used for MDT. Around 1000 sterile maggots are introduced in the wound and left for at least 1-3 days. Maggots are applied by a cage like dressing. Here the maggots are concealed within the netting. This prevents the maggot from escaping and also allows the air circulation to facilitate the drainage through the top of the dressing of the liquefied necrotic tissue.

A new method called the BIOBAG METHOD was recently introduced foe MDT.
Here the maggots are enclosed between the two layers of polyvinyl alcohol hydro sponge netting. They are glued together over a small cube of a spacial amaterial.Here the maggots are able to feed through the dressing and their secretions reach the wound in order to control the infection.

The advantage claimed for this method is
>No need for the cage like dressing.
>less pain
>maggots cannot escape the biobag, which becomes very acceptable with the patients.

WHO CAN USE MAGGOT THERAPY

MDT could be used for any kind of purulent wound on the skin independent of the location on the body and the underlying disease.
It has been used successfully for the abscesses, burn, cellulites, gangrene and ulcers due to arterial disease venous statis osteomyletis,mastoiditis,thall assemia,polythemia,demaentia,a nd basal cell carcinoma. diabetic foot ulcers and pressure ulcers.

ADVANTAGES

>separates the necrotic tissue from the living tissue, making the surgical debridement easier
>immediate amputation could be prevented because of MDT
>an effective method in cleaning chronic wounds and initiating granulation
>simple, efficient, safe and cost effective compared to conventional methods.

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