Potential Research Interest in Nursing: Maggot Debridement Therapy (MDT)
Arguably, the complexity associated with chronic wounds continues to challenge healthcare providers throughout the world. Notably, standard treatment of such wounds like antibiotics gives poor outcomes, therefore, prompting health practitioners to seek alternative biological liberal options. Such treatments include apitherapy, maggots, and leeches based treatments. However, this paper will be explicitly based on Maggot Debridement Therapy (MDT) since it is one of the most controversial pressure wound therapy yet posting incredible results.
The increasing prevalence in chronic wounds is partly due to the medical advances that have increased the life expectancy converting life threatening diseases to chronic wounds. In addition, the antibiotic miracle drug is no longer relevant in most skin and soft tissue infections because of the antibiotic resistant microbe’s prevalence. Desperate to advance the wound healing science, researchers looked in the past for methods that might have worked before the influx of antibiotic. Maggot therapy was one of the most practical results that practitioners sought. Heitkamp, Peck, and Kirkup, (2012) suggest that several ancient cultures reveal the use of maggots to help heal wounds. Western civilization embraced the use of maggot therapy after soldiers found them in their wounds. Afterwards, a field surgeon, William S. Baer experimented with sterilized worms that gave incredible results since it eliminated cases of tetanus and gangrene which would be caused by contaminated eggs. However, the period of popularity was halted after penicillin became widely distributed eliminating the need of maggots. It was not until the discovery of antibiotic bacteria in the 1990’s did they begin rethinking the benefits and use of maggots for wound patients.
However, not all maggots’ species are safe and effective for MDT as some will feed on human tissue. The most frequently used species belong to the Family Calliphoridae which only feed on necrotic tissue. In medicine, a hole in the hydrocolloid dressing is made and dressing is applied to the wound. According to Du Plessis and Pretorius (2011), this protects the skin from proteolytic enzymes of the maggots. The rehabilitation can be used in conjunction with antibiotic treatments and they are not affected by X-rays.
Du Plessis and Pretorius (2011) state that maggots use certain mechanisms to stimulate healing. The larvae ingest the necrotic tissue as well as secreting proteolytic enzymes that liquefy these tissues. Their physical presence promotes washing out of bacteria. Thirdly, their secretions stimulate healing. Finally, the crawling action stimulates tissue granulation that is vital for tissue regeneration.
Unfortunately, Čeřovský and Bém (2014) indicate that larvae are resistant in combating other types of bacteria and fungi. However, the Lucilia sericata and the Lucilia caprina have been discovered to contain unique abilities that kill some of Gram-Positive, Gram-Negative as well as Pseudomonas sp. and Acinetobacter sp., therefore, enhancing host immunity and overall effectiveness for MDT.
In conclusion, maggot therapy is still considered as a last result yet evidence suggests that it deliver positive results. The assumption that suggests that use of maggots be revolting to patients also remains unfounded. Scientific evidence today demonstrates the efficacy and safety of maggot therapy for a variety of wounds and, therefore, it should be more embraced as it would result to a decrease in antibiotic use that would prevent the spread of antibiotic resistant bacteria. Finally, the cost of MDT remains very affordable compared to other options embraced to treat chronic wounds in the medical world today.
Čeřovský, V., & Bém, R. (2014). Lucifensins, the Insect Defensins of Biomedical Importance: The Story behind Maggot Therapy. Pharmaceuticals, 7(3), 251- 264.
Du Plessis, H. C., & Pretorius, J. P. (2011). The utilization of maggot debridement therapy in Pretoria, South Africa. Wound Healing Southern Africa, 4(2), 80-83.
Heitkamp, R. A., Peck, G. W., & Kirkup, B. C. (2012). Maggot Debridement Therapy in Modern Army Medicine: Perceptions and Prevalence. Military Medicine, 177(11), 1411-1416.