Summary
During the last years an increasing number of patients suffering from therapy refractory chronic wounds which are frequently infected by multi-resistant bacteria – e.g. methicillin-resistant Staphylococcus aureus – have led to an increasing interest in the treatment using larvae or maggots of the blow fly species Lucilia sericata. Maggots are responsible for necrectomy and they have antimicrobial activity in particular against grampositive bacteria like a disinfectant of the wound. It is concluded that maggots debridement therapy (MDT) using larvae of the species Lucilia sericata in non-healing chronic ulcers of the lower legs successfully leads to cleaning, debridement, reduced bacterial load, and improved wound granulation. A review is given on the clinical use of maggots, their mechanism of action and clinical efficacy for wound healing.
Zusammenfassung
Eine Zunahme von Patienten mit Therapie-refraktären chronischen Wunden, die häufig mit Antibiotika-resistenten Bakterien – u. a. Methicillin-resistenter Staphylococcus aureus – infiziert sind, hat das Interesse an der Behandlung mit Maden oder Larven der Fliegenspezies Lucilia sericata in den letzten Jahren wieder verstärkt. Die Maden bewirken eine Nekrosektomie sowie über die antimikrobielle Wirksamkeit vorzugsweise gegenüber grampositiven Bakterien eine Verringerung der bakteriellen Kolonisation der Wunden. Aus zahlreichen Patientenbeschreibungen sowie aktuellen Studien ergibt sich, dass die Biochirurgie mit Fliegenmaden der Spezies Lucilia sericata bei schlecht heilenden und bakteriell kolonisierten Wunden zur Reinigung der Ulzerationen, Wundgrundkonditionierung und Granulationsförderung bis hin zur Anregung der Angiogenese möglich und erfolgreich ist. Es wird ein aktueller Überblick zum Einsatz von Fliegenmaden, deren Wirkmechanismus und die klinische Wirksamkeit in der Wundheilung gegeben.
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Nenoff, P., Herrmann, A., Gerlach, C. et al. Biochirurgisches Débridement mittels Lucilia sericata-Maden – ein Update. Wien Med Wochenschr 160, 578–585 (2010). https://doi.org/10.1007/s10354-010-0806-1
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DOI: https://doi.org/10.1007/s10354-010-0806-1
Keywords
- Maggots
- Lucilia sericata
- Chronic wounds
- Leg ulcer
- Maggot debridement therapy
- Bacterial contamination
- Pseudomonas aeruginosa