Maggots as effective as traditional treatment for leg ulcers
Maggots as effective as traditional treatment for leg ulcers
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Friday, 20, Mar 2009 08:07
Larval (maggot) therapy has been proved to have similar health benefits as standard treatment for leg ulcers, experts claim.
The use of larvae compared to hydrogels in terms of time to ulcer healing though it not quite as obvious, a report published on BMJ online states.
In the study scientists looked at the clinical and cost-effectiveness of larval therapy on wound healing.
Current treatment of leg ulcers, caused by diseased veins in the legs, involves debridement - the removal of dead tissue from the ulcer surface.
Previous research has suggested however, larval therapy debrides wounds more swiftly, as well as stimulating healing and reducing infection.
In the study outlined in the BMJ, researchers looked at 267 participants who had at least one venous or mixed venous/arterial leg ulcer with dead tissue covering at least a quarter of the wound.
Participants were then randomised to receive loose larvae, bagged larvae or
hydrogel during the debridement phase, followed by standard treatment.
They were then monitored for up to 12 months, during which time the date of
complete healing of the ulcer was recorded by trained nurses.
Date of debridement was also recorded, as were bacterial levels, adverse events and ulcer-related pain. Participants completed a health-related quality of life questionnaire at the start of the study, and then again at three, six, nine and 12 months.
After compiling the results, the researchers found larval therapy significantly reduced the time to debridement compared with hydrogel.
There was no real evidence of a difference in time to ulcer healing though; half of patients allocated to the larvae group were healed by 236 days compared with 245 days for the hydrogel group.
There was also no difference between larvae and hydrogel groups in health-related quality of life or in bacterial load (including MRSA).
The authors of the report therefore concluded that, although larval therapy is a more effective debriding agent than hydrogel, it shouldn’t be recommended for routine use on leg ulcers with the aim of speeding healing or reducing bacterial load.
They suggest instead that further research is required to explore the relationship between wound debridement, healing and microbiology, and to better understand the value of debridement from the patient perspective.