Have you ever stooped by the side of the bush defecating and then you see house flies buzzing on your faeces. Not long from that time, you might notice some whitish insect on your faeces; these whitish creepy insect are breeded by the flies and are called larvae.

You might have also seen worms on rotten food you left somewhere around the house, and you asked yourself this rhetorical question; Where did this worms come from? Don't worry, I'm here to answer that question. The simple answer is that, they come from the eggs of a common house fly; which is hatched into larvae and formed the worms in that rotten food.

This larvae produced from the egg of the fly is a perfect practical example of what we refer to as worms or maggots. But in the case of maggot therapy; the larvae of the fly will be sterilized, and then the larvae gotten from the eggs is qualified to be therapeutically beneficial.

Yes, this tiny creepy crawling animal may seem irritating to our visual sense, but believe me; it is not irritating to some of the wounds on our body. This is seemingly because, it can sometimes be unbelievably beneficial medically; by healing up chronic wounds.

Maggot Therapy is a medical term that involves the controlled application of live maggots, gotten from sterilized eggs of a fly to the wound of human and animal so as to consume the dead and unhealthy tissues that may be present in the wound.

Introduction to Maggot Therapy - History, Applications, Benefits and Risks

The infestation of infected wounds by maggots have been in existence since ancient times from verses written in the Old Testament of The Christian Holy Bible.

My Flesh is clothed with worms and lumps of dust; my skin is broken, and become sickening. Job 7:5.

Maggot Therapy has been an unusual traditional method of healing wounds, which was found to be practiced by the indigenous aboriginal Australians and the Mayan Native doctors of central America in the olden days.

The Napoleon's army physician stated a report on the wholesomeness of some soldiers who sustained injury in the transition period between the medieval and the modern times, during the Napoleonic war. However, The wounds of some soldiers was infested with maggots and others doesn't have maggots. Thus, he noticed that the former is healthier than the latter.

American surgeon, William Bear was the first person to use maggot therapeutically during World War I. This was after he noticed on arrival of a soldier, with a severe wound which has been infested with maggots that the soldier had less infection and healed better than normal. Chronic wounds are healed using maggot in World War II, by the prisoners from America.

The application of disinfected maggot on human and animal is medically beneficial in the treatment of pressure ulcers, venous stasis ulcers, diabetic foot ulcers. It can further be useful for the complete healing of Neuropathic foot ulcer, post surgical wounds and severe burns. The application of maggots to wounds reduces its smell and increases disinfection by dissolving the dead tissues present in the wound.

Ooops!!! Despite all the benefits that maggot therapy offers, there are still some problems in its treatment application. "But I have a good news for you guys" These problems can be effectively controlled without stress. The problems and their solutions are stated below:

A reduction in the supply of blood to a wound during treatment can cause pain in some patients, but this can be controlled by using painkillers or by stopping the treatment. Maggots should be removed in the case of a bleeding wound during treatment, though, this is very uncommon. A boundary cream or dressing can be done to prevent the skin from irritation during treatment. A scarce increase in body temperature may also arise but no much attention should be given to that.

Is Maggot Therapy an approved medical device for healing?

In the 1940s, the application of maggot therapy was questioned by the arrival of antibiotics (such as penicillin). Thereby, reducing its usage in the healing of wounds. There was need to revive the use of maggot therapy, however, due to the increasing bacteria that are resistance to the use of those antibiotics in the 1990s.

The physical action of the maggots over wounds then brought about its worldwide recognition and approval, in the marketing and application of maggots, as a medical treatment device not until 14 years ago, by the United States Food and Drug Administration.

Conditions suitable for the application of maggot therapy

Not all kinds of wounds are suitable for the application of maggots Therapy. Maggot Therapy can be suitably used for the treatment of oxygenated damp, exudating wounds. Open wounds of body cavities is resistance to the activity of maggot therapy. A dry wound, however, can be fully immersed in a fluid containing dissolved salt for 2 days, to make it suitable for the application of maggot therapy.

It takes not more than 3 days for maggots to stay on wound when they are directly applied on wound within dressing. During the application of maggot therapy, maggot can also be applied onto wound in an opaque polymer bag within dressing for not more than 5 days to avoid it from sight.

The Mechanisms of Action of Maggot Therapy on wounds

• Debridement
• Disinfection
• Stimulation of Growth

Debridement

Debridement is a very effective and faster method of healing wounds compared to performing surgical operation on such wounds. Disinfected maggots are applied on such wounds, so that they consume the dead and unhealthy tissues in the wound. The maggots secretes and excrete a proteolytic digestive enzymes, which serves the purpose of melting the dead and unhealthy tissues into a semi-liquid. The maggots then easily suck up the liquefied tissue.

It takes each maggot not more than a day to liquefy about 25mg of dead tissues. The maggot extension of its alimentary secretions and excretions in its physical movement on the wound tissue helps dissolve the dead cells into a semi-liquid.

In the treatment of venous stasis leg ulcer, conducted by Wayman and colleagues; result showed that the wounds treated using maggot therapy Debrided faster than wounds treated using the standard wound care.

Disinfection

Disinfection of wound is a mechanism of action whereby maggots are physically used to remove and destroy the pathogenic bacteria present in the wounds. The maggot can clean wounds by ingesting and destroying the pathogenic bacteria within their gut through the secretion and excretion of some antimicrobial molecules such as Phenylacetic acid, Urea, Calcium carbonate and so on. Antimicrobial molecules secreted or excreted outside the body of the maggots can also kill the microbes outside the maggot's gut.

Do you know that you can easily remove dental biofilms just by brushing your teeth ?

I know the question on your mind right now would be; what is biofilms? Well! Biofilms is a group of closely shielded bacteria cells, which are tenacious to living and non-living surfaces in an enclosed and organized manner. Maggots, however, are believed to act as antibiofilms when their rough bodies are made to crawl on wounds.

In vitro, the growth of Staphylococcus aureus and Staphylococcus epidermidis biofilms can be prevented with the application of live maggots.

Wounds infected with Biofilms, however, can be effectively disinfected by physically eroding the biofilms; which is the backbone behind the removal of dental biofilms just by teeth brushing.

Stimulation of Growth

The growth of healthy tissues are stimulated by the underlying killing of pathogenic bacteria and removal of dead cells and biofilms in wounds. The crawling action of the maggots on wounds also encourage the growth of healthy tissues.

An increase In the growth of healthy tissues therefore, stimulates the rapid healing of wounds (i.e. The higher the growth of healthy tissues In wounds, the faster the wounds get healed)

Life Science of flies and maggots

Maggots are those white larvae hatched out of flies egg. Flies completely metamorphize from fertilized eggs to larvae, then larvae to pupa and finally to adult. Some maggots breed on the dead part of live animals, despite the fact that they use their pair of hook to tear dead animals for food, and to draw the maggot along.

The only tissue that some maggots can dissolve are the dead or unhealthy tissues, some can dissolve only the live or healthy tissues, while others can dissolve either dead or live tissues. The green bottle fly which is a common species of the blow fly is the most suitable fly for the application of maggot therapy.

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CONCLUSION

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The use of maggot for the treatment of wound is an approved medical device which have been in practice since ancient times. The use of maggot for treatment might sound irritating but it is very effective in such a way that, the maggots dissolve dead tissues present in the wound.

There are 3 mechanism of actions for the application of maggot therapy which include debridement, disinfection and growth stimulation. With the application of maggot therapy, we can therfore be assured of quick disinfection and healing of wounds.

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REFERENCES

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• Medical maggots

• New science shows how maggots heal wounds

• Teabags filled with maggots that heal wounds

• maggot therapy

• how maggots heal wounds

• Larvae therapy from antiquity to the present day

• Mechanisms of Maggot-induced wound healing by Ronald Sherman

• Larvae therapy - Sandwell and West Birmingham hospital

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