Maggot therapy and standard treatment have equal benefits for leg ulcers

March 20th, 2009 - 2:45 pm ICT by ANI  

London, Mar 20 (ANI): Maggot (larval) therapy for leg ulcers has the same health benefits and costs as a standard treatment for the problem, according to two studies.

Published in the online edition of the British Medical Journal, the studies describe leg ulcers as chronic wounds most commonly caused by diseased veins in the legs.

And a common part of ulcer management is the removal of dead tissue from the ulcer surfacea technique called debridement, which is widely viewed as having a role in promoting wound healing.

Debridement can be undertaken with a hydrogel, but many scientists have said that larval therapy debrides wounds more swiftly, along with stimulating healing and reducing infection.

Now, UK researchers have conducted the first randomised controlled trial to investigate the clinical and cost-effectiveness of larval therapy on wound healing.

The 267 participants in the trial had at least one venous or mixed venous/arterial leg ulcer with dead tissue (sloughy and/or necrotic tissue) covering at least a quarter of the wound.

All the participants were randomised to receive loose larvae, bagged larvae or hydrogel during the debridement phase, followed by standard treatment.

The researchers monitored them for up to 12 months and, during that time, trained nurses recorded the date of complete healing of the ulcer.

It was found that larval therapy significantly reduced the time to debridement compared with hydrogel.

However, there was no evidence of a difference in time to ulcer healing (half of patients allocated to the larvae group were healed by 236 days compared with 245 days for the hydrogel group).

Also, no difference was found between larvae and hydrogel groups in health-related quality of life or in bacterial load (including MRSA).

Larval therapy was found to be linked with twice as much pain in the 24 hours before the removal of the first application compared with hydrogel.

The authors concluded 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. (ANI)

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