Efficacy of Maggot Debridement Therapy on Burn Wounds as an Alternative Treatment Modality

摘要

Background: Burns cause devastating injuries and a high incidence of severe physical and psychological impairment. Severe burns require specialized medical professionals and facilities for optimal recovery that require multiple surgeries, long hospital stays and rehabilitation. Surgical debridement and skin grafting is the standard of care for most burn patients. Maggot Debridement Therapy (MDT) is a modality that might be useful as an alternative to surgical debridement for wound bed preparation. This could be an excellent alternative to wound debridement for patients that are not surgical candidates. This review looks at the efficacy of MDT for debridement of acute burn patients.Methods: An exhaustive systematic literature review was performed using MEDLINE-Ovid, Web of Science, CINAHL and Google Scholar utilizing the keywords maggot therapy, larvae therapy and burns.Results: A total of 143 articles were screened with 7 case studies meeting designated criterion reviewed. Maggot debridement therapy was found to be effective in removal of necrotic tissue from these burn wounds in 6 out of 7 cases. The case report where debridement was not successful was due to burn destruction into the knee joint capsule and MDT was terminated secondary to the need for bilateral knee amputation. The number of MDT treatments required to obtain full debridement ranged from 2-5 applications. The overall quality of these studies via the GRADE criteria is very low due to there being no RCTs performed at the time of this review and further studies need to be performed on a larger population of patients with acute burns.Conclusion: Based on these case reports, MDT should be considered for the burn patient population as a rapid, effective, safe and economical alternative modality for wound management. Keywords: Maggot therapy, larvae therapy, burns.