Trial: Maggot debridement therapy for full thickness burn injuries

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https://pubmed.ncbi.nlm.nih.gov/37726738/

Larval therapy vs conventional silver dressings for full-thickness burns: a randomized controlled trial

Jasem Gaffari 1, Kamran Akbarzadeh # 1, Mozhgan Baniardalani # 1, Reza Hosseini # 2, Safdar Masoumi 3, Zahra Sadat Amiri 1, Razieh Shabani Kordshouli 1, Javad Rafinejad 4, Mostafa Dahmardehei 5

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Abstract

Background: This is the first clinical trial to investigate the effectiveness of maggot debridement therapy (MDT) for full-thickness burn injuries in comparison to conventional silver dressings.

Methods: Thirty-one cases with full-thickness (grade III based on ICD-10 classifications version 2019) burns were assigned into larval therapy (15 cases) and conventional treatment (16 cases) groups. Participants in the MDT group have received loose larvae on days 0, 2, 4, and 6, while controls received a conventional regimen comprised of sharp debridement, silver sulfadiazine, antibiotic therapy, and offloading every day. The primary and secondary outcomes were defined as the time to debridement (from admission to skin autograft) and time to healing (from admission to complete healing post-skin autograft). Patients in two groups were also compared in terms of necrosis resolution, granulation, and granulation/necrosis (g/n) ratio during study time periods.

Results: Participants who received larvae had significantly decreased necrosis on days 2 (p = 0.028) and 4 (p = 0.023) compared to those who received control treatment. Significant differences (p < 0.001) were also observed for granulation between the two groups in favor of MDT and the fold changes of g/n in the larvae group were 5, 15, and 13 times higher than that for the conventional regimen on days 2, 4, and 6 of treatment, respectively. Strikingly, a subgroup analysis of high necrotic burns (necrosis > 50%) revealed a significant improvement (p < 0.001) for MDT compared to the control treatment. There were also significant differences (p < 0.001) for the time to debridement and time to healing between the two groups. However, bacterial contamination did not show significant changes between the two treatment regimens.

Conclusions: Our findings revealed that MDT has a favorable superiority over conventional regimen for the treatment of grade-III burns, and thus further clinical trials with larger sample size are warranted to confirm these results.

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1. This could be life changing for patients with serious burns. I wonder if it could alleviate

some of the torture of the debridement process.

[AmBlue]

2. A friend had this done

...for a serious toe infection. They were saying he could lose several toes and part of his foot because other treatments weren't working as well as necessary. In the end, he kept his tie and foot. The maggots edficiently got it cleaned out. It sounds gross but it works!

[flying_wahini]

3. Squeamishness aside, people have done this for years and maggots do a fine job.

Kind of surprised that they are just now circling back to this.

Silver works well but is almost impossible to remove, it takes a lot and used to be fairly expensive. Maunual debridment removes healthy tissue too, can be painful and traumatizing to patients.

Maggots are cheap. Years ago we also used slices of papayas to debride decubitus
Ulcers and sometimes sugar to encourage granulation.

Amazing how old therapies come round again, eh?