Vol.3 No.4 – 3: Clinical and microbiological efficacy of medicinal maggots in the treatment of pressure ulcers in Egypt

By : Tarek I. Tantawi, Yousry M. Gohar, Soheir G. William, Mamdouh M. Kotb, Nesreen A. Abou Zeid

Abstract

Pressure ulcers are a significant public health problem, especially for patients in long term care facilities. The aim of this study was to assess the clinical and microbiological efficacy of maggot therapy in the treatment of pressure ulcers. The study was conducted on 14 bed-bound patients with 14 pressure ulcers at Alexandria Main University Hospital, Alexandria, Egypt. The blow fly Lucilia sericata was used for maggot therapy. Each ulcer was treated by one maggot cycle of 3 days per week. The ulcers were investigated weekly for changes in their size, the size of necrotic tissue, and the bacterial burden before and after each maggot cycle. Of the 14 ulcers treated with maggot therapy, three ulcers were completely debrided of which one ulcer needed only one cycle and two ulcers were debrided by two cycles. Nine ulcers had > 50% of their size occupied by a red healthy granulation tissue during a mean period of 2.14 weeks. The mean of initial bacterial burden of ulcers was significantly decreased from 4.86 ´ 10⁸ CFU/ml exudate to 1.92 ´ 10⁴ CFU/ml exudate (p=0.01814) below the 10⁵ threshold of natural healing after the first maggot cycle. The clinical and microbiological outcomes demonstrate that maggot therapy is a rapid, simple, efficient, and cost-effective tool for treating pressure ulcers which do not respond to conventional treatment and surgical intervention.

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