Free Essay Example: Maggot Debridement Therapy of Infected Ulcers

According to Steenvoorde, Jacobi, Doorn & Oskam (2007), many chronic ulcers have been known to persist upon the application of significant measures and antibiotic treatment. The latter has been attributed to bacterial colonization and infections. As such, researchers have integrated their efforts to establish an ulcer treatment method that is less painful and quite effective (Naik & Harding, 2017). In light of this, Maggot debridement therapy (MDT) was established, which involves the application of disinfected live maggots in an infected ulcer of an animal or human being to disinfect the wound as well as clear the necrotic tissues (Sherman, 2003).

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Albeit the effectiveness of the newfound ulcer treatment intervention, the mechanism of working has been a bit challenging. However, the intervention is known to have mechanical effects on the person undergoing treatment; the method champions tissue growth effects and the production of antibacterial factors that are responsible for enhanced healing (Steenvoorde, Jacobi, Doorn, & Oskam, 2007). Besides, a proposed mechanism of working has been postulated that explains how bacteria are directly killed in the alimentary tract of the applied live maggots.

In the bid to test the efficacy of MDT, randomized control trials whose results were compared, established an 80-90% success rate upon application of the treatment approach on slowly healing infected ulcers (Naik & Harding, 2017). To ensure that the success of the treatment method is achieved, there is a technique usually followed in maggot’s application. Patients are advised to seek medical help twice a week to ensure that maggots are changed and for placement. The application of the live maggots takes place early in the morning perpetually until a visible debridement is observed. The latter is the emblem of healing, a process that is usually less painful, as reported by a significant number of patients.

As previously mentioned, the removal of dead skin from an infected ulcer is the ultimate treatment that the MDT applies. The dead skin is the reason why healing is impeded in infected ulcers, in addition to diabetic wounds. The maggots used by doctors on a patient experiencing an ulcer produce enzymes that are responsible for the digestion of the dead skin in the alimentary canal of the maggots (Sherman, 2003). Disinfection of the ulcers occurs in three ways: the maggots ensure the death of the microbes in their gut through consumption, secreting antimicrobial atoms on the affected area of an animal or a patient, and dissolution of all the organisms impeding healing on the surface of the wound. The maggots are interested and attracted to dead skin. As such, when they dissolve the necrotic skin in the injury of an ulcer-infected person, they move in search of dead skin (Steenvoorde et al., 2007). Once the host is clear from all dead tissues, the maggots will leave in search of a new host. For this reason, the maggots should be placed on the infected ulcer twice a week to ensure that they do not leave the specific area where treatment is being done. However, a wound dressing is also necessary to physically stop the maggots from leaving the targeted site.

Several benefits of the researched treatment intervention exist. Firstly, the disinfection of the wound is enabled. The latter is achieved through the secretions of maggots since they produce chemicals known to have a broad-spectrum bactericidal effect (Sherman, 2003). The other significant chemical produced by the maggots is ammonia, which ensures that the wound is alkaline, a condition that inhibits bacterial growth in the infected ulcers. Among the bacteria destroyed by maggots include streptococcus pathogens, anaerobic strains, gram-positive aerobic bacteria, and S. pneumoniae (Naik, & Harding, 2017). The treatment is effective and reliable as it was used in ancient times by the Hill people of Myanmar, Central America. As such, it is a treatment method that has been in existence even before the introduction of antibiotics for the treatment of wounds.

Regarding leg ulcers, a randomized control trial was carried out to analyze the cost-effectiveness of MDT. According to Ronald (2014), the therapy involving maggot use was approximated to cost similarly to the standard hydrogel treatment. However, despite the similarity in the costs of the two treatment methods, MDT was found more accepted and slightly quicker regarding the healing process. A second randomized trial proved that MDT time-to-debridement was higher than that of the hydrogel treatment, a modernized method of treating leg ulcers in the contemporary world (Ronald, 2014). As such, MDT remains to be a vital form of treatment for ulcers in terms of cost and effectiveness. Unlike the standard hydrogel treatment intervention, MDT can be administered together with antibiotics to prevent severe tissue destruction. However, the best antibiotic selection is necessary as a majority of antibiotics inhibit the survival of maggots. Ampicillin, mezlocillin, clindamycin, and vancomycin are among the best antibiotics that do not affect the survival of larvae.

The dosage of maggots in a wound is also critical. It has been researched that ten maggots are required to cover a square centimeter area (Yazdanpanah, 2015). In terms of dead tissue, 100 maggots should be inserted in 50g necrotic tissue, and dress the wound for four days. In doing the latter, the best results would be obtained, which is the main aim of all treatment interventions.

References

Naik, G., & Harding, K. (2017). Maggot debridement therapy: the current perspectives. Chronic Wound Care Management and Research, Volume 4, 121–128. https://doi.org/10.2147/cwcmr.s117271

Ronald, S. (2014). Mechanisms of Maggot-Induced Wound Healing: What Do We Know, and Where Do We Go from Here? Evidence-Based Complementary and Alternative Medicine, 2014, 1–13. https://doi.org/10.1155/2014/592419

Sherman, R. A. (2003). Maggot Therapy for Treating Diabetic Foot Ulcers Unresponsive to Conventional Therapy. Diabetes Care, 26(2), 446–451.

Steenvoorde, P., Jacobi, C. E., Doorn, L. V., & Oskam, J. (2007). Maggot Debridement Therapy of Infected Ulcers: Patient and Wound Factors Influencing Outcome – A Study on 101 Patients with 117 Wounds. The Annals of The Royal College of Surgeons of England, 89(6), 596–602. https://doi.org/10.1308/003588407x205404

Yazdanpanah, L. (2015). Literature review on the management of diabetic foot ulcers. World Journal of Diabetes, 6(1), 37. https://doi.org/10.4239/wjd.v6.i1.37