Maggots

(USAN, rINN)
Synonyms: Larvas; Sterile Larvae.
Cyrillic synonym: Личинки.

Profile

Maggots used in wound management are the live sterile larvae of Lucilia sericata, the common greenbottle fly. Larval therapy (sometimes called biosurgery) may be used for debridement of infected or necrotic wounds, including diabetic foot ulcers. Maggots produce a mixture of proteolytic enzymes that breaks down the necrotic tissue while leaving the healthy tissue unharmed, and kill or prevent the growth of micro-organisms, particularly Gram-positive bacteria. The movement of the maggots also appears to stimulate the growth of granulation tissue. The maggots are applied to the surface of the wound and kept in place with dressings for up to 3 days. They are removed with the dressing, and the wound is irrigated with sodium chloride solution; any remaining maggots are removed with forceps. Maggots should not be applied to wounds that have a tendency to bleed easily, or that communicate with a body cavity or any internal organ. Pain has been reported with larval therapy and some patients may require analgesics.
1. Courtenay M, et al. Larva therapy in wound management. J R Soc Med 2000; 93: 72–4
2. Jukema GN, et al. Amputation-sparing treatment by nature: "surgical" maggots revisited. Clin Infect Dis 2002; 35: 1566–71
3. Sherman RA, Shimoda KJ. Presurgical maggot debridement of soft tissue wounds is associated with decreased rates of postoperative infection. Clin Infect Dis 2004; 39: 1067–70
4. Armstrong DG, et al. Maggot therapy in "lower-extremity hospice" wound care: fewer amputations and more antibiotic-free days. J Am Podiatr Med Assoc 2005; 95: 254–7
5. Steenvoorde P, et al. Maggot debridement therapy: free-range or contained? An in-vivo study. Adv Skin Wound Care 2005; 18: 430–5.

Preparations

Proprietary Preparations

UK: LarvE.
Published December 23, 2018.