Reducing bioburden in chronic wounds : maggot therapy compared to conventional therapy

Abstract

Overview: Chronic wounds, wounds that do not heal, are a great burden worldwide both for patients and healthcare practitioners posing a financial and social problem. These are currently treated by conventional methods. This review aims to outline any benefits provided by maggot therapy, the application of sterile L. sericata larvae to the wound for antimicrobial purposes. The Research Question: Is there a difference in the bioburden of a chronic wound if it is treated conventionally or with maggot therapy? PICO Elements: Population: adult males and females with chronic wounds, Intervention: Maggot Therapy, Comparison: Conventional Therapy, Outcome: Lowered bioburden inferred by time to healing, healing rate and antibiotic free days. Method: The key elements of the PICO question were used for a guided search of the literature over several databases, such as ScienceDirect, using various search engines such as HyDi. This was made clear through the use of a PRISMA flow chart. The 5 key studies found were then critiqued using the respective CASP checklist. Results: 2 Meta-analyses, 2 RCT’s and a prospective Cohort Study were found. Conclusion: Though still uncertain, maggot therapy has been shown to decrease bioburden in chronic wounds however, further, more specific research is required. Recommendations: Further research should be carried out on maggot therapy and its antimicrobial properties. Maggot therapy should be provided by stakeholders as a possible treatment.