. Future Study Recommendations. Many questions remain
about wound healing, in general, and maggot therapy in
particular. Several of these questions might be answered
by a single well-designed clinical study. This review was
undertaken to help design the next study or at least offer an
initial proposal for what that study might look like.
Evidence of maggots’ debridement efficacy is irrefutable.
Clarity is still needed regarding maggot therapy’s role in
promoting wound closure. When maggot therapy has been
used for debridement alone, some studies have shown faster
overall healing, others have not. Those studies that have
suggested or demonstrated significantly faster wound closure
have looked at short-term findings: healing that occurs
during or shortly after maggot therapy is administered.
Studies that have looked at healing rates months after maggot
debridement was terminated have not demonstrated any
difference in healing rates. This is likely the key, for we now
understand that maintenance debridement and maintenance
disinfection can promote wound healing. We also now recognize
that healthy-looking wounds can deteriorate quickly,
especially when chronic, or when there are impediments to
wound healing. The physical effects of maggots on the wound
and the bioactive molecules that they secrete do not last
long after therapy, so wounds that do not heal immediately
after maggot debridement will be at risk for recolonization,
infection, stagnation, and necrosis.
. Future Study Recommendations. Many questions remain
about wound healing, in general, and maggot therapy in
particular. Several of these questions might be answered
by a single well-designed clinical study. This review was
undertaken to help design the next study or at least offer an
initial proposal for what that study might look like.
Evidence of maggots’ debridement efficacy is irrefutable.
Clarity is still needed regarding maggot therapy’s role in
promoting wound closure. When maggot therapy has been
used for debridement alone, some studies have shown faster
overall healing, others have not. Those studies that have
suggested or demonstrated significantly faster wound closure
have looked at short-term findings: healing that occurs
during or shortly after maggot therapy is administered.
Studies that have looked at healing rates months after maggot
debridement was terminated have not demonstrated any
difference in healing rates. This is likely the key, for we now
understand that maintenance debridement and maintenance
disinfection can promote wound healing. We also now recognize
that healthy-looking wounds can deteriorate quickly,
especially when chronic, or when there are impediments to
wound healing. The physical effects of maggots on the wound
and the bioactive molecules that they secrete do not last
long after therapy, so wounds that do not heal immediately
after maggot debridement will be at risk for recolonization,
infection, stagnation, and necrosis.
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