USE OF FLY LARVAE (MAGGOTS) IN CANCER TREATMENT
GETAT Kongreleri 2024 Congresses of T&CM, 7 Ekim - 19 Aralık 2024, ss.33-34, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Sayfa Sayıları: ss.33-34
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
- ABSTRACT Maggot therapy, also known as larval therapy, larval treatment, biodebridement, therapeutic myiasis, or biosurgery, refers to Maggot Debridement Therapy (MDT), a debridement method used worldwide and in our country for the treatment of chronic and infected wounds. MDT involves the use of disinfected larvae of flies belonging to the Calliphoridae family for “biodebridement” and “biosurgery” in wound care. Among this family, the most widely preferred species is the green bottle fly, Lucilia sericata.
- Historically, Ambroise Paré discovered the beneficial effects of these larvae on wounds in the 16th century. Baron Larrey, who served as chief surgeon in Napoleon’s army, and Joseph Jones, who served during the American Civil War, observed that maggots on soldiers’ wounds destroyed only necrotic tissue. William Baer (1931) was the first to deliberately apply larvae in the treatment of suppurative skin infections. Ronald Sherman (1990) reintroduced the clinical use of MDT in modern medicine. In 2004, the FDA (U.S. Food and Drug Administration) approved and regulated the production of medical-grade larvae for use in non-healing wounds.
- In clinical practice, maggots are primarily used in wound treatment for debridement, which is the removal of wound-healing inhibitors such as eschar, exudate, bacterial biofilm, crusts, foreign bodies, callus, and necrotic tissue. MDT offers several advantages: in suitable patients, it can provide surgeons with debridement efficacy comparable to surgical debridement. Moreover, MDT enables selective debridement, removing necrotic tissue without damaging ligaments, tendons, blood vessels, or nerves—thus aiding healing without organ or functional loss. Importantly, larvae debride necrotic tissue while sparing viable structures such as granulation tissue.
- Larvae achieve debridement through the secretion of various enzymes. These include collagenolytic enzymes identified by Hobson; trypsin, leucine aminopeptidase, and carboxypeptidase A and B-like activities described by Vistnes et al.; and three predominant serine proteases classified by Chambers et al. In addition to these, the secretion of multiple other enzymatic activities provides what can be considered highly effective debridement. Beyond debridement, larvae contribute throughout all stages of wound healing through disinfection, antibacterial effects, biofilm removal, and anti-inflammatory properties.
- Keywords: Larvae, Lucilia sericata, MDT, biodebridement, biosurgery