Document Type : Clinical Report

Authors

1 Department of Internal Medicine and Clinical Pathology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.

2 Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran.

Abstract

Maggot therapy is the use of sterile fly larvae in the treatment of superficial wounds in humans and animals. Lucilia sericata (Diptera: Calliphoridae) larvae are most commonly used for this purpose. Nowadays, larval therapy is widely used in the treatment of diabetic and infectious human wounds. Larval therapy in veterinary medicine has been used in dogs, cats, horses, and even ruminants. A 5-year-old crossbreed (Arabian and Kurdish) stallion was referred to a veterinary private sector in Tabriz city that suffered from a necrotic wound on its forelimb skin following a snakebite injury. The owner had seen the snake in the horse stable. Skin necrosis was observed on the dorsal of the right forelimb which extended to the ventral of the adjacent neck and chest. Despite this extensive skin injury, the horse was alert with a normal appetite and no sign of lameness was detected. Intravenous fluid therapy, systemic anti-inflammatory, and antibiotics were used for the horse's general condition support and topical oxytetracycline and zinc oxide were administered but had no effect on healing of necrotic wounds. Maggot therapy was performed on the necrotic skin. Unfortunately, the larvae died after inserting less than 24 hours. The maggot therapy was unsuccessful in the treatment of skin necrosis in this experience and the larvae died in this short time. However, more clinical trials on the efficacy of maggot therapy for extensive skin necrosis and studies on the effects of snake venom on the maggots are needed.

Keywords

Main Subjects

  1. Fleischmann W, Grassberger M, Sherman R. Maggot therapy: A handbook of maggot-assisted wound healing. Georg Thieme Verlag, 2004.
  2. Sherman RA. Blow fly larvae. FDA. Available at: https://www.fda.gov/media/74541/download. Accessed: October 11, 2020.
  3. Kenawy M, Abdel-Hamid Y. Maggot therapy “use of fly larvae for treatment of wounds”- A review. Egyptian Academic Journal of Biological Sciences, E. Medical Entomology & Parasitology, 2020;12(2):1-10.
  4. Sherman RA, Hall MJR, Thomas S. Medicinal maggots: An ancient remedy for some contemporary afflictions. Annual Review of Entomology, 2000;45(1):55–81.
  5. Wang TY, Wang W, Li FF, Chen YC, Jiang D, Chen YD, Yang H, Liu L, Lu M, Sun JS, Gu DM, Wang AP. Maggot excretions/secretions promote diabetic wound angiogenesis via miR18a/19a – TSP-1 axis. Diabetes Research and Clinical Practice, 2020;165(1):108–140.
  6. Yan L, Chu J, Li M, Wang X, Zong J, Zhang X, Song M, Wang S. Pharmacological properties of the medical maggot: A novel therapy overview. Evidence-based Complementary and Alternative Medicine, 2018;2018(1):11.
  7. Nezakati E, Hasani MH, Zolfaghari P, Rashidan M, Sohrabi MB. Effects of Lucilia sericata maggot therapy in chronic wound treatment: A randomized clinical trial. Chronic Wound Care Management and Research, 2020;7:11–17.
  8. Wang R, Luo Y, Lu Y, Wang D, Wang T, Pu W, Wang Y. Maggot extracts alleviate inflammation and oxidative stress in acute experimental colitis via the activation of Nrf2. Oxidative Medicine and Cellular Longevity, 2019;2019(1):18.
  9. Mirabzadeh A, Ladani MJ, Imani B, Rosen SAB, Sherman RA. Maggot therapy for wound care in Iran: A case series of the first 28 patients. Journal of Wound Care, 2017;26(3):137–143.
  10. Zubir MZM, Holloway S, Noor NM. Maggot therapy in wound healing: A systematic review. International Journal of Environmental Research and Public Health, 2020;17(17):1–12.
  11. Choudhary V, Choudhary M, Pandey S, Chauhan VD, Hasnani JJ. Maggot debridement therapy as primary tool to treat chronic wound of animals. Veterinary World, 2016;9(4):403–409.
  12. Durán D, Galapero J, Frontera E, Bravo-Barriga D, Blanco J, Gómez L. Histological and immunohistochemical study of wounds in sheep skin in maggot therapy by using Protophormia terraenovae (Diptera: Calliphoridae) larvae. Journal of Medical Entomology, 2020;57(2):369–376.
  13. Sherman R A, Stevens H, Ng D, Iversen E. Treating wounds in small animals with maggot debridement therapy: A survey of practitioners. Veterinary Journal, 2007;173(1):138–143.
  14. Dicke RJ. Maggot therapy of actinomycosis. Journal of Economic Entomology, 1953;46(4):706–707.
  15. Lepage OM, Doumbia A, Perron-Lepage MF, Gangl M. The use of maggot debridement therapy in 41 equids. Equine Veterinary Journal, 2012;44(43):120–125.
  16. Morrison S. Maggot debridement therapy for laminitis. Veterinary Clinics of North America - Equine Practice, 2010;26(2):447–450.
  17. Bras RJ, Morrison S. Retrospective case series of 20 horses ( 2002 – 2009 ) sustaining puncture wounds to the navicular bursa with maggot debridement therapy as an adjunctive treatment. Proceedings. American Association of Equine Practitioners, 2009;241–250.
  18. Sherman RA, Morrison S, Ng D. Maggot debridement therapy for serious horse wounds - A survey of practitioners. Veterinary Journal, 2007;174(1):86–91.
  19. Morrison SE. How to use sterile maggot debridement therapy for foot infections of the horse. Proceedings. American Association of Equine Practitioners, 2005;461.
  20. Ahmadnejad M, Kaboudari A. Maggot therapy-related zoonotic diseases and modern larval therapy solutions to ensure safety Journal of Zoonotic Diseases, 2020;4(4):1–8.
  21. Constable P, Hinchcliff K, Done S, Grünberg W. Veterinary medicine-e-book: a textbook of the diseases of cattle, horses, sheep, pigs and goats. 11th edn. Saunders, Philadelphia, US, 2017.
  22. Ferreira JF, Albuquerque ALH, Amorim RM, Ferreira RS, Takahira RK, Borges AS, Oliveira-Filho JP. Clinical and therapeutic aspects of brazilian native bothrops envenomation in nine horses. Journal of Equine Veterinary Science, 2020;94:103245.
  23. Machado M, Wilson TM, Ribeiro de Sousa DE, Lopes Câmara AC, Furlan FH, Silva Almeida e Macêdo JT, Pupin RC, Amaral de Lemos RA, Armién AG, Barros SS, Riet-Correa F, Botelho de Castro M. Fatal lancehead pit viper (Bothrops spp.) envenomation in horses. Toxicon 2019;170:41–50.
  24. Nacapunchai D, Laohavichit K. Human myiasis caused by Chrysomya bezziana larvae in gangrenous wound following snake bite. Mahidol Medical Journal, 1999;6(6):81–83.
  25. Dehghani R, Sedaghat M, Bidgoli MS. Wound Myiasis due to Musca domestica (Diptera: Muscidae) in Persian horned viper, Pseudocerastes persicus (Squamata: Viperidae). Journal of Arthropod-borne Diseases, 2012;6(1):86–89.
  26. van der Plas MJA, Dambrot C, Dogterom-Ballering HC M, Kruithof S, van Dissel JT, Nibbering PH. Combinations of maggot excretions/secretions and antibiotics are effective against Staphylococcus aureus biofilms and the bacteria derived therefrom. Journal of Antimicrobial Chemotherapy, 2010;65(5):917–923.
  27. PTK. Medical maggots used in snake bite! - Experts Forum. Available at: http://www.venomousreptiles.org/forums/Experts/48900. Accessed November 5, 2020).
  28. Gilliam L. Horses & Snake Bites. Oklahoma State University. Available at: https://news.okstate.edu/articles/veterinary-medicine/2015/horses-snake-bites.html. Accessed November 5, 2020.
  29. Checroun C, Millard A, Goudey-Perriere F. Acute toxicity of some venoms for adult males Blattella germanica and larvae Calliphora sp. Toxicon 1998;12(36):1733.
  30. Calderón-Arguedas Ó, Belfort K, Troyo A, Del Mar Gamboa M. Maggot therapy with Lucilia eximia (Diptera: Calliphoridae) of Costa Rica in an experimental model. Revista Chilena de Entomología, 2014;39:57–65.