Maggot Therapy in Chronic Wounds: New Approaches to Historical Practices

Abstract Blowfly larvae of Lucilia sericata (Meigen) (Diptera: Calliphoridae) are well established as debridement agents in nonhealing wounds. Maggot therapy (MT) experienced reduced application following adoption Penicillin and other antibiotics, but the advent antibiotic resistance growing global wound burden have boosted demand for new therapies. The mechanisms action accepted, with debridement, disinfection, biofilm destruction, inhibition, stimulation tissue growth uniformly acknowledged a remarkable biotherapy. action, while well-recognized, still being examined. efforts to understand isolated aspects complex system, resulted tendency approach field from simplified viewpoints that remove holistic system larvae. Furthermore, clinical studies conflated healing definitions ‘success’. Thus, both vitro reported mixed results, presenting some uncertainty regarding utility MT prohibits routine adoption. This review builds generally accepted basic justify future encompasses larval-bacterial symbioses basis system. Symbioses documented Insecta, literature supports existence symbiotic associations provide enhanced action. requires consideration biological confers antimicrobial on when selective pre-exposure carefully selected symbionts is adopted. In treating contemporary infections, there much be gained reflecting natural biology organism, was used success long before we sterilized