The Availability of Maggot in Chronic Wound

J Korean Wound Management Soc > Volume 4(1); 2008 > Article

Original

Journal of the Korean Wound Management Society 2008;4(1): 41-45.

만성 창상에서 의료용 구더기의 유용성

이동근

충북대학교 의과대학 성형외과학교실

The Availability of Maggot in Chronic Wound

Dong Geun Lee

Department of Plastic and Reconstructive Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea

Published online: 31 May 2008.

ABSTRACT

Chronic wound problem has been a complex difficulty in wound management. Especially in person with medical problem such as a diabetes, peripheral vascular disease, and burn injury, it is a life-threatening to patient or an important problem of demanding a sacrifice of his or her foot. It has been known that maggots have potent debriding ability of removing necrotic tissue. In the early 20th century, the Maggot debridement therapy (MDT) had been an important treatment in all kinds of wounds all over the US and Europe. With the advent of antimicrobials, maggot therapy became rare until the early 1990s. However with the appearance of antimicrobial resistant organism, it was re-introduced. And so we performed a study to observe the effect of MDT in chronic wound and wound characteristics influencing outcome of healing. In the period between September 2007 and March 2008, patients with chronic wound including diabetic foot, burn wound, pressure ulcer or necrotic tissue who seemed suited for MDT were enrolled in the study. In total, 10 patients with 10 lesions were treated. Most wounds were worst-case scenarios, in which maggot therapy was a treatment of last choice. Sterile maggots of Lucilia (Phaenicia) sericata, are used for treatment. Up to 200 maggots are introduced in the wound and stayed for 2 to 3 days. In all of the cases, significant debridement of necrotic tissue was achieved. The majority of patients do not complain of any discomfort during the application of maggot except for a tickling or itching sensation. But 2 patients complained of their wound pain during the MDT and are treated with analgesics. In total, all wounds of 10 patients were converted to acute wound after application of MDT. Six patients were received a soft reconstructive surgery right after MDT. After surgery the wound were cured completely or significantly. In the other patients who not to receive a surgery, the wounds have maintained a good condition to help a normal healing process. In our study, MDT has been proven to be an effective modality for managing chronic wounds and initiating wound healing process. And also MDT have played a good role in converting a characteristics of chronic wound into an acute wound. MDT is a simple and cost-effective modality for the treatment of chronic wound, which do not respond to conventional treatment and surgical intervention. (J Korean Wound Management Soc 2008;4:41-45)

Key Words: Chronic wound, Maggot, Maggot debridement treatment (MDT)