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Note:
In the United States, Medical Maggots (TM) are regulated by the Food and
Drug Administration as a prescription only
medical device.
Medical Maggots (TM)
brand of medicinal maggots are only indicated for debriding chronic wounds such as pressure ulcers, venous stasis ulcers,
neuropathic foot ulcers and non-healing traumatic or post surgical wounds.
This page discusses maggot therapy in general, including recent research.
Not all of the claims being made by clinicians or researchers apply to Medical Maggots (TM) brand of medicinal maggots.
Monarch Labs is summarizing information found in the literature and on the internet for your information, only.
Monarch Labs does not and cannot claim that any of the benefits described in this article or in the literature also apply to
Medical Maggots (TM) brand of medicinal maggots.
Maggot Debridement Therapy (MDT) is the medical use of live maggots (fly larvae) for treating non-healing wounds.
Maggot therapy can be an effective method of treating chronic,
non-healing wounds. Only specially selected, tested, disinfected
larvae are applied to the wound surface, within a dressing
that prevents the larvae from escaping. They are easily and
completely removed 2 or 3 days later. Sometimes the wound is
completely cleaned by then; sometimes additional treatments may be
necessary. After maggot therapy, the wound may be clean enough to
close, cover, graft, or flap. Your doctor will be able to suggest
the best treatment to follow.
The scientific literature identifies
four primary actions of medical grade maggots on wounds:
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They clean the wounds by dissolving dead and
infected tissue ("debridement");
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They disinfect the wound (kill bacteria);
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They stimulate the growth of healthy tissue.
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They disolve existing biofilm and inhibit the formation of new biofilm.
Since
Medical Maggots (TM)
brand of medicinal maggots are only indicated for debridement, no other action will be discussed here.
If interested in research into the other actions of maggots on wounds, please refer to the
reference section of this site.
The following topics about maggot therapy are detailed below:
History of Maggot Therapy
Maggots have been known for centuries to help heal
wounds. Military surgeons noted that soldiers whose wounds became
infested with maggots had better outcomes than those not infested.
William Baer, while at Johns Hopkins University in Baltimore,
Maryland, may have been the first in the Northern Hemisphere to have
intentionally applied larvae to wounds in order to induce wound
healing. During the late 1920's, he identified specific species,
raised them in the laboratory, and used their larvae to treat
several children with osteomyelitis and soft tissue infections. He
presented his findings at a surgical conference in 1929. Two years
later, after treating 98 children, his findings were published
posthumously.
MDT was successfully and routinely performed by thousands of
physicians throughout the 1930s, but soon it was supplanted by the
new antibiotics and surgical techniques that came out of World War
II. Maggot therapy was occasionally used during the 1970's and
1980's, but only when antibiotics, surgery, and modern wound care
failed to control the advancing wound.
The first modern clinical studies of maggot therapy were initiated
in 1989, at the Veterans Affairs Medical Center in Long Beach, CA,
and at the University of California, Irvine.
Controlled clinical studies set out to compare maggot debridement therapy to the standard therapy
being prescribed by wound care experts in the treatment of chronic pressure ulcers, diabetic foot ulcers,
venous stasis ulcers, post-traumatic wounds, etc.
The results of those controlled comparative studies, and the
many studies and reports that followed, indicate that MDT is still
useful today as a safe and effective treatment tool for some types
of wounds. Those studies also demonstrated that there is no reason
to withhold MDT until all other modalities have been exhausted, nor
use it only as a "last resort." Indeed, while published accounts of
"pre-amputation MDT" show a limb salvage rate of over 40%, the
success of MDT when used earlier in the course of treatment (say, as
a 2nd or 3rd or 4th line treatment) is even more dramatic.
Take a look at some data from just two of the published studies,
demonstrating significant debridement in pressure ulcers and diabetic foot ulcers treated with maggot therapy, compared to control therapy.
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Maggot vs conservative (control) debridement therapy for pressure ulcers.
Average surface area (sq cm) of necrotic tissue for wounds treated with maggot therapy (solid circles; n=43)
decreased faster and greater than that seen with conventional therapy (open circles; n=49).
Error bars indicate standard error; asterisks indicate significant differences in mean surface area (p<0.05) within 3 weeks.
Sherman RA: Wound Repair Regen 2002; 10:208-14
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Maggot vs conservative (control) debridement therapy for diabetic foot ulcers.
Average surface area (sq cm) of necrotic tissue for wounds treated with maggot therapy (solid circles; n=14)
decreased faster and greater than that seen with conventional therapy (open circles; n=14).
Error bars indicate standard error; asterisks indicate significant differences in mean surface area (p<0.05) within 2 weeks.
Sherman RA: Diabetes Care 2003; 26:446-51
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It should be noted the maggots used in these studies were the same species and strain,
from the same culture line, as the breeding stock used now for Medical Maggots (TM) by Monarch Labs.
Current status of maggot therapy
In 1995, only a handful of doctors were using MDT.
By 2004, on the basis of clinical and laboratory data like that described above,
the U.S. Food and Drug Administration (FDA) cleared Medical Maggots (TM) brand of maggots for marketing in the U.S.,
for the purpose of debriding chronic wounds such as pressure ulcers, venous stasis ulcers,
neuropathic foot ulcers and non-healing traumatic or post surgical wounds.
Today, any licensed physician in the U.S. can prescribe maggot therapy. World-wide, approximately
50,000 treatments were applied to wounds in 2008.
Biology of flies and maggots
Maggots are fly larvae, or immature flies, just as caterpillars are
butterfly or moth larvae. A diagram of the life cycle of flies and maggots appears below
(used with permission of the BTER Foundation).
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.
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 are infesting live 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 (=Lucilia) sericata, the green blow fly.
Monarch Labs' Medical Maggots (TM) are a specific strain of P. sericata that was
tested for safety and efficacy over the course of 12 years
For more information about Monarch Labs' Medical Maggots (TM)
brand of medicinal maggots, or any of our other maggot therapy and wound care products, check out our
catalogue of our products and services.
Package Inserts
for our Medical Maggots (TM) and Creature Comforts II (TM) Dressings can be found HERE.
If you have any questions
that have not already been addressed elsewhere in this site, check out our
Frequently Asked Questions page , which will open in a new tab. Or, just
contact us!
Additional resources (including references and web-links) are available through our
support pages.
For additional information about maggot therapy in general or Medical Maggots (TM) in particular,
check out our
support pages,
which contain references, community resources, and answers to frequently asked questions.
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