Larval (maggot) therapy has similar health benefits and costs
compared with a standard treatment for leg ulcers, find two
studies published on the British Medical Journal website.
Leg ulcers are chronic wounds most commonly caused by diseased
veins in the legs. Debridement (the removal of dead tissue from
the ulcer surface) is a common part of ulcer management and is
widely viewed as having a role in promoting wound healing.
Debridement can be undertaken with a hydrogel, but it has been
suggested that larval therapy debrides wounds more swiftly, as
well as stimulating healing and reducing infection.
A team of UK researchers have carried out the first randomized
controlled trial to investigate the clinical and
cost-effectiveness of larval therapy on wound healing.
The trial involved 267 participants who |
had at least one venous or mixedvenous/arterial leg ulcer with dead tissue (sloughy
and/or necrotic tissue) covering at least a quarter of the
wound.
Participants were randomized to receive loose larvae, bagged
larvae or hydrogel during the debridement phase, followed by
standard treatment. People were monitored for up to 12 months,
during which time the date of complete healing of the ulcer was
recorded by trained nurses.
Larval therapy significantly reduced the time to debridement
compared with hydrogel, but there was no evidence of a
difference in time to ulcer healing.
There was no difference between larvae and hydrogel groups in
health-related quality of life or in bacterial load (including
MRSA). Larval therapy was associated with twice as much pain in
the 24 hours prior to removal of the first application compared
with hydrogel. |
The authors conclude that, although larval therapy is a more
effective debriding agent than hydrogel, there is no evidence
from this trial that it should be recommended for routine use on
sloughy leg ulcers with the aim of speeding healing or reducing
bacterial load. They suggest 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.
In a separate analysis, the researchers calculate that larval
therapy is likely to have similar cost-effectiveness to hydrogel.
As such, they conclude that healthcare decision makers should
generally be indifferent when recommending these two therapies
for the debridement of sloughy leg ulcers.
BMJ-British Medical Journal (2009, March 23).
Maggot Therapy
Similar To Standard Care For Leg Ulcers. ScienceDaily.
Retrieved May 12, 2009 |
