Blowfly Strike and Maggot Therapy: From Parasitology to Medical Treatment

  • Heike Heuer
  • Lutz Heuer
Part of the Parasitology Research Monographs book series (Parasitology Res. Monogr., volume 1)


Patients, especially elderly and diabetic ones, may develop chronic wounds on the leg and foot, so called ulcers, which are open sores that go through the skin. These often tend not to heal due to insufficient circulation, will eventually get infected, and might result in serious consequences such as amputation. Physicians all over the world are involved in the daily conflict as to how to treat such wounds, which are even when not life threatening very unpleasant for these patients as they usually have a strong smell and produce continuous pain. Within the last 20 years the treatment of wounds has not been based on a dry dressing but on a wet dressing (products such as hydrogel) and healing as the primary goal is obtained in some cases. Chronic wounds will heal only when the insufficient circulation is stopped. Most often it is required that all the dead material is removed from a wound, therefore a debridement of the wound is undertaken. Although there is no clear evidence that debridement is useful for wound healing at all, several techniques are in use. One of these is forced myiasis, MDT. Maggot debridement therapy (MDT) is a very efficient debridement technique and otherwise necessary amputations are avoided in some cases. For this therapy Lucilia spec. are the least invasive fly larvae tested for MDT and Lucilia sericata is in use in most places of the world. Other, more frequently found species of Lucilia are in use in some countries as well.

As maggots are fly larvae and they live on the patients wound they usually do not distinguish between dead and vital tissue and must be used in correct doses. Therapy should be stopped when pain occurs or bleeding is observed. The fly larvae combat some multiresistant bacteria, for example MRSA, but many gram-negative bacteria are contra-indicated as they might kill the fly larvae. The spit of the fly larvae contains a powerful mixture of enzymes and protein-based antibiotics, both of which are under evaluation for their use as a pharmaceutical drug. Either these compounds isolated from maggots or well-dosed fly larvae can be used for debridement of chronic wounds. Acute dehiscent wounds can be debrided efficiently by maggots and closed afterwards by other standard techniques for fast healing.

Larval treatment costs are in the same range or slightly higher compared to standard treatment when used for leg ulcers. Compared to products such as hydrogel no additional benefit was found in all available randomized clinical studies on fly larvae treatment on chronic wounds. Therefore, MDT should be used for selected patients only, especially as there is no full market authorization in Europe or anywhere else in the world apart from USA.


Chronic Wound Necrotizing Fasciitis Pharmaceutical Drug Dead Tissue Maggot Debridement Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Altincicek B, Vilcinskas A (2009) Septic injury-inducible genes in medicinal maggots of the green blow fly Lucilia sericata. Insect Mol Biol 18(1):119–125. doi: 10.1111/j.1365-2583.2008.00856.x PubMedCrossRefGoogle Scholar
  2. Amendt J, Krettek R, Zehner R (2004) Forensic entomology. Naturwissenschaften 91:51–65. doi: 10.1007/s00114-003-0493-5 PubMedCrossRefGoogle Scholar
  3. Andersen AS (2010) personnel communication to the authors, Copenhagen Wound Healing Center, Bispebjerg Hospital & ABMP, Statens Serum Institut, DenmarkGoogle Scholar
  4. Andersen AS, Joergensen B, Bjarnsholt T, Johansen H, Karlsmark T, Givskov M, Krogfelt KA (2010) Quorum-sensing-regulated virulence factors in Pseudomonas aeruginosa are toxic to Lucilia sericata maggots. Microbiology 156:400–407PubMedCrossRefGoogle Scholar
  5. Arora S, Sing LC, Babtista C (2010) Antibacterial activity of Lucilia cuprina maggot extracts and its extraction techniques. Int J Integr Biol 9:43–48Google Scholar
  6. Barnes KM, Gennard DE (2010) The effect of bacterially-dense environments on the development and immune defences of the blowfly Lucilia sericata. Physiol Entomol. doi: 10.1111/j.1365-3032.2010.00759.x. Accessed 2010-11-30 Google Scholar
  7. Barnes KM, Gennard DE, Dixon RA (2010) An assessment of the antibacterial activity in larval excretion/secretion of four species of insects recorded in association with corpses, using Lucilia sericata Meigen as the marker species. Bull Entomol Res. doi: 10.1017/S000748530999071X PubMedGoogle Scholar
  8. Bekins L (2010) Thesis, Maggot Therapy for Removal of Non-healing Wounds, School of Physician Assistant Studies, Pacic UniversityGoogle Scholar
  9. Bell-Syer S (2010) Managing Editor for the Cochrane Wounds Group, personnel communication to the authors.Google Scholar
  10. Berger M (2006) Thesis, Identifizierung biologisch aktiver Peptide und Proteine in den Sekreten von Lucilia sericata im Wundheilungsgeschehen, University of CologneGoogle Scholar
  11. Bexfield A, Nigam Y, Thomas S, Ratcliffe NA (2004) Detection and partial characterisation of two antibacterial factors from the excretions/secretions of the medicinal maggot Lucilia sericata and their activity against methicillinresistant Staphylococcus aureus (MRSA). Microbes Infect 6:1297–1304PubMedCrossRefGoogle Scholar
  12. Bexfield A, Bond AE, Roberts EC, Dudley E, Nigam Y, Thomas S, Newton RP, Ratcliffe NA (2008) The antibacterial activity against MRSA strains and other bacteria of a <500 Da fraction from maggot excretions/secretions of Lucilia sericata (Diptera: Calliphoridae). Microbes Infect 10:325–333PubMedCrossRefGoogle Scholar
  13. Bexfield A, Bond AE, Morgan C, Wagstaff J, Newton RP, Ratcliffe NA, Dudley E, Nigam Y (2010) Amino acid derivatives from Lucilia sericata excretions/secretions may contribute to the beneficial effects of maggot therapy via increased angiogenesis. Br J Dermatol 162(3):554–562PubMedCrossRefGoogle Scholar
  14. BingHong X, LiPing Z, YuChuan A, MingZhu S, XianJun Y, JinFen L (2004) Induction and characterization of antibacterial substances in the blowfly Lucilia sericata. Chin J Zoonoses, 2004, 06-017Google Scholar
  15. Blum K, Mendez S, Miller-Cox D (2010), Uncommon applications of maggot therapy for common an problematic wounds. In: 8th International Conference on Biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  16. Bunkis J, Gherini S, Walton RL (1985) Maggot therapy revisited. West J Med 142:554–556PubMedGoogle Scholar
  17. Cazander G, van Veen KEB, Bernards AT, Jukema GN (2009) Do maggots have an influence on bacterial growth? A study on the susceptibility of strains of six different bacterial species to maggots of Lucilia sericata and their excretions/secretions. J Tissue Viab 18:80–87. doi: 10.1016/j.jtv.2009.02.005 Google Scholar
  18. Čeřovský V, Zdarek J, Fučík V, Monincová L, Voburka Z, Bém R (2010) Lucifensin, the long-sought antimicrobial factor of medicinal maggots of the blowfly Lucilia sericata. Cell Mol Life Sci 67:455–466. doi:  10.1007/s00018-009-0194-0 Google Scholar
  19. Çetinkaya M, Özkan H, Köksal N, Coşkun SZ, Hacımustafaoğlu M (2008) Neonatal myiasis: a case report. Turk J Pediatr 50:581–584PubMedGoogle Scholar
  20. Chambers L, Woodrow S, Brown AP, Harris PD, Phillips D, Hall M, Church JCT, Pritchard DI (2003) Degradation of extracellular matrix components by defined proteases from the greenbottle larva Lucilia sericata used for the clinical debridement of non-healing wounds. Br J Dermatol 148:14–23PubMedCrossRefGoogle Scholar
  21. Chan DCW, Fong DHF, Leung JYY, Patil NG, Leung GKK (2007) Maggot debridement therapy in chronic wound care. Hong Kong Med J 13:382–386PubMedGoogle Scholar
  22. Church JC (2010) personnel communication to the authorsGoogle Scholar
  23. Courtenay M, Church JC, Ryan TJ (2000) Larva therapy in wound management. J R Soc Med 93:72–74PubMedGoogle Scholar
  24. Daeschlein G, Hoffmeister B, Below H, Kramer A (2006) GMS Krankenhaushygiene Interdisziplinär, 1(1), ISSN 1863–5245Google Scholar
  25. Derraik JGB, Heath ACG, Rademaker M (2010) Human myiasis in New Zealand: imported and indigenously-acquired cases; the species of concern and clinical aspects. NZMJ 123(1322). doi:
  26. Dossey L (2002) Maggots and leeches: when science and aesthetics collide. Altern Ther Health Med 8:12–17Google Scholar
  27. Dumville JC, Worthy G, Bland JM, Cullum N, Dowson C, Iglesias CP, Mitchell JL, Nelson EA, Soares MO, Torgerson DJ (2009a) Fly larvae therapy for leg ulcers (VenUS II) randomized controlled trial. BMJ 338:b773. doi: 10.1136/bmj.b773 PubMedCrossRefGoogle Scholar
  28. Dumville JC, Worthy G, Soares MO, Bland JM, Cullum N, Dowson C, Iglesias C, McCaughan D, Mitchell JL, Nelson EA, Torgerson DJ on behalf of the VenUS II team (2009b) VenUS II: a randomized controlled trial of larval therapy in the management of leg ulcers Health Technology Assessment 2009; Vol. 13: No. 55 DOI:  10.3310/hta13550.
  29. Dunn C, Raghavan U, Pfleiderer AG (2002) The use of maggots in head and neck necrotizing fasciitis. J Laryngol Otol 116:70–72PubMedCrossRefGoogle Scholar
  30. Edwards J, Stapley S (2010) Debridement of diabetic foot ulcers. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD003556. doi:  10.1002/14651858.CD003556.pub2
  31. Fine A, Alexander H (1934) Maggot therapy: technique and clinical application. J Bone Joint Surg 16:572–582Google Scholar
  32. Fleischmann W (1999) Verbandmaterial mit dem Sekret von Fliegenlarven, EP 1020197B1 (1999-12-31)Google Scholar
  33. Fleischmann W, Grassberger M, Sherman R (2004) Maggot therapy. Thieme, Stuttgart, New York. ISBN 3-13-136811-xGoogle Scholar
  34. Geary MJ, Russell RC (2010) Maggot debridement therapy (MDT)- not a ‘fly by night’ therapy, vol 17. Centre of Infectious Diseases and Microbiology, pp 1–2Google Scholar
  35. Gohar YM, Tantawi TI, El-Ghaffar HA, El-Shazly BMA (2010) The antibacterial acidity of medicinal maggots of the blow fly Lucilia cuprina against multidrug-resistance bacteria frequently infected diabetic foot ulcers in Alexandria, Egypt: a preliminary in vitro study. In: 8th International Conference on Biotherapy, Los Angeles, CA, USA, 2010-11-12Google Scholar
  36. Golinko MS, Joffe R, Maggi J, Cox D, Chandrasekaran EB, Tomic-Canic RM, Brem H (2008) Operative debridement of diabetic foot ulcers. J Am Coll Surg 207:E1–E6PubMedCrossRefGoogle Scholar
  37. Grassberger M (2002) Entomologie und Parasitologie, Fliegenmaden: Parasiten und Wundheiler, Denisia 6. Neue Folge 184:507–534Google Scholar
  38. Gray P (2008) Is larval (Maggot) debridement effective for removal of necrotic tissue from chronic wounds? J Wound Ostomy Continence Nurs 35:378–384. doi: 10.1097/01.WON.0000326655.50316.0e PubMedCrossRefGoogle Scholar
  39. Gupta A (2008) A review of the use of maggots in wound therapy. Ann Plastic Surg 60:224–227. doi: 10.1097/SAP.0b013e318053eb5e CrossRefGoogle Scholar
  40. Heuer H, Heuer L (2010a) Deutsche Apotheker Zeitung 150:394–395Google Scholar
  41. Heuer H, Heuer L (2010b) Pain release drugs in MTD – Uncover the physiological interaction. In: 8th International Conference on Biotherapy, Los Angeles, CA, USA, 2010-11-12Google Scholar
  42. Horobin AJ, Shakesheff KM, Pritchard DI (2006) Promotion of human dermal fibroblast migration, matrix remodelling and modification of fibroblast morphology within a novel 3D model by Lucilia sericata larval secretions. J Invest Dermatol 126:1410–1418PubMedCrossRefGoogle Scholar
  43. Hsiao FC, Chen Y, Chang LW (2008) Umbilical myiasis in a healthy adult. South Med Assoc 101(10):1054–1055Google Scholar
  44. Hubermann L, Gollop N, Mumcuoglu KY, Block C, Galun R (2007a) Antibacterial properties of whole body extracts and haemolymph of Lucilia sericata maggots. J Wound Care 16:123–127Google Scholar
  45. Hubermann L, Gollop N, Mumcuoglu YK, Breuer E, Bhusare SR, Sha Y, Galun R (2007b) Antibacterial substances of low molecular weight isolated from the blowfly, Lucilia sericata. Med Vet Entomol 21:127–131. doi: 10.1111/j.1365-2915.2007.00668.x CrossRefGoogle Scholar
  46. Jaklič D, Lapanje A, Zupančič K, Smrke D, Gunde-Cimerman N (2008) Selective antimicrobial activity of maggots against pathogenic bacteria. J Med Microbiol 57:617–625. doi: 10.1099/jmm.0.47515-0 PubMedCrossRefGoogle Scholar
  47. Kawabata T, Mitsui H, Yokota K, Ishino K, Oguma K, Sano S (2010) Induction of antibacterial activity in larvae of the blowfly Lucilia sericata by an infected environment. Med Vet Entomol 24:375. doi: 10.1111/j.1365-2915.2010.00902.x PubMedCrossRefGoogle Scholar
  48. Kerridge A, Lappin-Scott H, Stevens JR (2005) Antibacterial properties of larval secretions of the blowfly, Lucilia sericata. Med Vet Entomol 19:333–337PubMedCrossRefGoogle Scholar
  49. Kondakcia GO, Bulbula O, Shahzada MS, Polatb E, Cakana H, Altuncula H, Filoglu G (2009) STR and SNP analysis of human DNA from Lucilia sericata fly larvae’s gut contents. Forensic Sci Int Genet Suppl 2(1):178–179CrossRefGoogle Scholar
  50. Lederle Laboratories (1932) Council on Pharmacy and Chemistry, Surgical Maggots-Lederle, Journal of the American Association (JAMA), advert 1932Google Scholar
  51. Margolin L, Gialanella P (2010) Assessment of the antimicrobial properties of maggots. Int Wound J 7(3):202–204PubMedCrossRefGoogle Scholar
  52. Maude Adverse Event Report (2009) Monarch labs, LLC. Medical maggots with Leflap dressing. Lot Number MM-090406/CCII-090 Event Date 04/13/2009 Event Type Injury Patient Outcome HospitalizationGoogle Scholar
  53. Mehlhorn H, Schmidt J, Walldorf V (2005) Zucht von Lucilia-, Phormia-, Sarcophaga- und Calliphora-Larven und Puppen auf Pflanzenextrakten, DE10328102A1 20.01.2005Google Scholar
  54. Mirabzadeh A, Ladani MJN, Brojerdi SS, Imani B (2010) Maggot therapy in Iran. In: 8th International conference on biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  55. Mitsui H, Kawabata T, Ugaki S, Fujii Y, Sakrai S, Sano S (2010) Maggot debridement therapy for treating diabetic foot ulcers in Japan. In: 8th international conference on biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  56. Mumcuoglu KY, Ingber A, Gilead L (1999) Maggot therapy for the treatment of intractable wounds. Int J Dermatol 38(8):623–627PubMedCrossRefGoogle Scholar
  57. Mumcuoglu K, Davidson E, Gilead L (2010a) Pain related to maggot debridement therapy. In: 8th international conference on biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  58. Mumcuoglu K, Gilead L, Ingber A (2010b) The use of maggot debridement therapy in the treatment of chronic and acute wounds in hospitalized and ambulatory patients of the Hadassah University Hospital Jerusalem. In: 8th international conference on biotherapy, Los Angeles, CA, USA, 12 NovGoogle Scholar
  59. Namias N, Varela JE, Varas RP, Quintana O, Ward CG (2000) Biodebridement: a case report of maggot therapy for limb salvage after fourthdegree burns. J Burn Care Rehab 21:254–257CrossRefGoogle Scholar
  60. Nenoff P, Herrmann A, Gerlach C, Herrmann J, Simon JC (2010) Biochirurgisches Débridement mittels Lucilia sericata-Maden – ein Update, Wien Med Wochenschr 1–8. doi:  10.1007/s10354-010-0806-1
  61. Nigam Y, Dudley E, Bexfield A, Bond AE, Evans J, James J (2010) The physiology of wound healing by the medicinal maggot, Lucilia sericata. Adv Insect Physiol 39:39–81CrossRefGoogle Scholar
  62. Nuesch R, Rahm G, Rudin W, Steffen I, Frei R, Rufli T, Zimmerli W (2002) Clustering of bloodstream infections during maggot debridement therapy using contaminated fly larvae of Protophormia terraenovae. Infection 30:306–309PubMedCrossRefGoogle Scholar
  63. Park SO, Shin JH, Choi WK, Park BS, Seok Oh J, Jang A (2010) Antibacterial activity of house fly-maggot extracts against MRSA (Methicillin-resistant Staphylococcus aureus) and VRE (Vancomycin-resistant enterococci). J Environ Biol 31(5):865–871Google Scholar
  64. Paul AG, Ahmad NW, Lee HL, Ariff AM, Saranum M, Naicker AS, Osman Z (2009) Maggot debridement therapy with Lucilia cuprina: a comparison with conventional debridement in diabetic foot ulcers. Int Wound J 6(1):39–46.  10.1111/j.1742-481X.2008.00564.x/pdf. Accessed 19 Sept 2010Google Scholar
  65. Pavillard ER, Wright EA (1957) An antibiotic from maggots. Nature 180:916–917PubMedCrossRefGoogle Scholar
  66. Petherick ES, O'Meara S, Spilsbury K, Iglesias CP, Nelson EA, Torgerson DJ (2006) Patient acceptability of larval therapy for leg ulcer treatment: a randomised survey to inform the sample size calculation of a randomised trial. BMC Med Res Methodol 6:43. doi: 10.1186/1471-2288-6-43 PubMedCrossRefGoogle Scholar
  67. Poetker DM, Cristobal R, Smith TL (2006) Head & Neck Surgery – Otolaryngology, 4th edn. Lippincott Williams & Wilkins, BaltimoreGoogle Scholar
  68. Post K, Riesner D, Walldorf V, Mehlhorn H (1999) Fly fly larvae and pupae as vectors for scrapie. Lancet 354(9194):1969–1970PubMedCrossRefGoogle Scholar
  69. Prete PE (1997) Growth effects of Phaenicia sericata larval extracts on fibroblasts: mechanism for wound healing by maggot therapy. Life Sci 60(8):505–510PubMedCrossRefGoogle Scholar
  70. Pritchard DI (2001) Protease from Lucila sericata and its use in treatment of wounds, WO/2001/031033Google Scholar
  71. Pritchard DI (2006) Treatment of wounds, US 7144721 B1Google Scholar
  72. Pritchard D (2010) The Greenbottle Pharmacy Project: Next generation wound debridement products. In: 8th international conference on biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  73. Pritchard DI, Horobin AJ, Brown A (2009) Larval polypeptides having a nuclease activity, US020090304668A1Google Scholar
  74. Pritchard DI, Horobin AJ, Brown A (2010) Chymotrypsin from Lucilia sericata fly larvae and its use for the treatment of wounds, US20100008898Google Scholar
  75. Probst W, Vasel-Biergans A (2010) Wundmanagement. WVG, Stuttgart, p 337 ff.Google Scholar
  76. Rufli T, Rudin W (2002) Biochirurgie: Bewährtes Verfahren in der Wundbehandlung. Dtsch Arztebl 99:A2038–A2039Google Scholar
  77. Schmidt M (2009) Madentherapie statt Amputation, ph Nr. 23 Dezember 2009, pp 30–32Google Scholar
  78. Sherman RA (2002) Maggot versus conservative debridement therapy for the treatment of pressure ulcers. Wound Rep Reg 10:208–214CrossRefGoogle Scholar
  79. Sherman RA (2003) Maggot therapy for treating diabetic foot ulcers unresponsive to conventional therapy. Diabetes Care 26:446–451PubMedCrossRefGoogle Scholar
  80. Sherman RA (2009) Maggot therapy takes us back to the future of wound care: new and improved maggot therapy for the 21st century. J Diabetes Sci Technol 3:336–344PubMedGoogle Scholar
  81. Sherman RA (2010a) Antimicrobially-primed medicinal maggot therapy, WO 2010/011611 A2Google Scholar
  82. Sherman RA (2010b) In search of pain-free MDT: Effects of lidocaine on the debridement capacity of medicinal maggots. In: 8th international conference on biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  83. Sherman RA (2010c) In search of pain-free MDT: Healing properties of maggot therapy – What is the evidence? In: 8th international conference on biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  84. Sherman RA, Tran JMT, Sullivan R (1996) Maggot therapy for venous stasis ulcers. Arch Dermatol 132:254–256PubMedCrossRefGoogle Scholar
  85. Sherman RA, Hall MJR, Thomas S, Maggots M (2000) An ancient remedy for some contemporary afflictions. Annu Rev Entomol 45:55–81PubMedCrossRefGoogle Scholar
  86. Simmons S (1935) A bacteriocidal principle in excretions surgical maggots which destroys important etiological agents of pyrogenic infections. J Bacteriol 30:253–267PubMedGoogle Scholar
  87. Sneddon J, Lee JA, Soutar GN (2010) An exploration of ethical consumers’ response to ‘animal friendly’ apparel labelling. J Res Consumers 18:1–10Google Scholar
  88. Soares MO, Iglesias PC, Bland JM, Cullum N, Dumville JC, Nelson EA, Torgerson DJ, Worthy G on behalf of the VenUS II team (2009) Cost effectiveness analysis of larval therapy for leg ulcers. BMJ 338:b825. doi: 10.1136/bmj.b825
  89. Steenvoorde P (2008) Maggot debridement therapy Surgery, Thesis, 9 Jan 2008Google Scholar
  90. Steenvoorde P, Jacobi C, Wong C, Jukema G (2007) Maggot debridement therapy in necrotizing fasciitis. Methods Wounds 19:73–78Google Scholar
  91. Stevens J, Wall R (1997) The evolution of ectoparasitism in the genus Lucilia (Diptera: Calliphoridae). Int J Parasitol 27:51–59PubMedCrossRefGoogle Scholar
  92. Susan SV (2008) In: Capinera JL (ed) Encyclopedia of entomology, Band 4, Maggot Therapy, page 2257Google Scholar
  93. Takac P, Majtan J, Novak P, Bohova J, Cambal M, Kozanek M (2010) Antimicrobial Factors – Lucilia sericata. In: 8th international conference on biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  94. Tantawi TI, Gohar YM, Kotb MM, Beshara FM, El-Naggar MM (2007) Clinical and microbiological efficacy of MDT in the treatment of diabetic foot ulcers. J Wound Care 16:379–383PubMedGoogle Scholar
  95. Tantawi TI, Williams KA, Villet MH (2010) An accidental but safe and effective use of Lucilia cuprina (Wiedemann) (Diptera: Calliphoridae) in maggot debridement therapy in Alexandria, Egypt. In: 8th international conference on biotherapy, Los Angeles, CA, USA, 12 Nov 2010Google Scholar
  96. Telford G, Brown AP, Seabra RAM, Horobin AJ, Rich A, English JSC, Pritchard DI (2010) Degradation of eschar from venous leg ulcers using a recombinant chymotrypsin from Lucilia sericata. Br J Dermatol. doi: 10.1111/j.1365-2133.2010.09854.x Google Scholar
  97. Thomas S, Andrews AM, Hay NP, Bourgoise S (1999) The anti-microbial activity of maggot secretions: results of a preliminary study. J Tissue Viab 9(4):127–131Google Scholar
  98. US Army (1982) Special Forces Medical Handbook, ST 31-91B, United States Army Institute for Military Assistence, 1982-03-01. Accessed 10 Oct 2010
  99. van der Plas MJA, van der Does AM, Baldry M, Dogterom-Ballering HCM, van Gulpen C, van Dissel JT, Nibbering PH, Jukema GN (2007) Maggot excretions/secretions inhibit multiple neutrophil pro-inflammatory responses. Microb Infect 9:507–514CrossRefGoogle Scholar
  100. van der Plas MJ, Jukema GN, Wai SW, Dogterom-Ballering HC, Lagendijk EL, van Gulpen C, van Dissel JT, Bloemberg GV, Nibbering PH (2008) Maggot excretions/secretions are differentially effective against biofilms of Staphylococcus aureus and Pseudomonas aeruginosa. J Antimicrob Chemother 61:117–122PubMedCrossRefGoogle Scholar
  101. van der Plas MJA, Baldry M, van Dissel JT, Jukema GN, Nibbering PH (2009a) Maggot secretions suppress pro-inflammatory responses of human monocytes through elevation of cyclic AMP. Diabetologia 52:1962–1970PubMedCrossRefGoogle Scholar
  102. van der Plas MJA, van Dissel JT, Peter H, Nibbering PH (2009b) Maggot secretions skew monocyte-macrophage differentiation away from a pro-inflammatory to a pro-angiogenic type. PLoS One 4(11):e8071PubMedCrossRefGoogle Scholar
  103. van der Plas MJA, Dambrot C, Dogterom-Ballering HC, Kruithof S, van Dissel JT, Nibbering PH (2010) Combinations of maggot excretions/secretions and antibiotics are effective against Staphylococcus aureus biofilms and the bacteria derived therefrom. J Antimicrob Chemother 65:917–923PubMedCrossRefGoogle Scholar
  104. Vilcinskas A (2011) Insect biotechnology, biologically-inspired systems, vol 2, Part 1. From traditional maggot therapy to modern biosurgery. Springer, Heidelberg, pp 67–75. doi:  10.1007/978-90-481-9641-8_4; Accessed 01 Dec 2010
  105. Vistnes L, Lee R, Ksander A (1981) Proteolytic activity of blowfly fly larvae secretions in experimental burns. Surgery 90:835–841PubMedGoogle Scholar
  106. Wayman J, Nirojogi V, Walker A, Sowinski A, Walker MA (2000) The cost effectiveness of larval therapy in venous ulcers. J Tissue Viab 10(3):91–94Google Scholar
  107. Whitaker IS, Twine C, Whitaker MJ, Welck M, Brown CS, Shandall A (2007) Larval therapy from antiquity to the present day: mechanisms of action, clinical applications and future potential. Postgrad Med J 83(980):409–413. doi: 10.1136/pgmj.2006.055905 PubMedCrossRefGoogle Scholar
  108. Wolff H, Hansson C (2005) Rearing fly larvae of Lucilia sericata for chronic ulcer treatment–an improved method. Acta Derm Venereol 85(2):126–131PubMedCrossRefGoogle Scholar
  109. Wolff Echeverri MI, Rivera Álvarez C, Herrera Higuita SE, Wolff Idárraga JC, Escobar Franco MM, Lucilia eximia (2010) (Diptera: Calliphoridae), una nueva alternativa para la terapia larvaly reporte de casos en Colombia. IATREIA 23(2)Google Scholar
  110. Wollina U, Liebold K, Schmidt WD, Hartmann M, Fassler D (2002) Biosurgery supports granulation and debridement in chronic wounds – clinical data and remittance spectroscopy measurement. Int J Dermatol 41:635–639PubMedCrossRefGoogle Scholar
  111. Zhen Z, Shouyu W, Yunpeng D, Jianing Z, Decheng L (2010) Fatty acid extracts from Lucilia sericata fly larvae promote murine cutaneous wound healing by angiogenic activity. Lipids Health Dis 9:24. doi: 10.1186/1476-511X-9-24 CrossRefGoogle Scholar
  112. Ziffren SE, Heist HE, May SC, Womack NA (1952) The secretion of collagenase by maggots and its implication. Ann Surg 1953:932–934Google Scholar
  113. Zumpt F (1965) Myiasis in man and animals in the old world. Butterworths, London, UKGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Fa. Agiltera GmbHDormagenGermany

Personalised recommendations