Effects of Lucilia sericata Maggot Therapy in Chronic Wound Treatment: A Randomized Clinical Trial

Ehsan Nezakati,1 Mohammad Hossain Hasani,2 Pouneh Zolfaghari,3 Marjan Rashidan,4 Mohammad Bagher Sohrabi5 1Department of Infectious Diseases, Imam Hossain Center for Education, Research and Treatment, Shahroud University of Medical Sciences, Shahroud, Iran; 2Department of Internal Medicine, Islamic Azad University, Shahroud Branch, Shahroud, Iran; 3Vice-Chancellery of Health, Shahroud University of Medical Sciences, Shahroud, Iran; 4Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran; 5Education Unit, School of Medicine, Shahroud University of Medical Sciences, Shahroud, IranCorrespondence: Mohammad Bagher Sohrabi Tel +982 332395054Fax +982 332394800Email mb.sohrabi@yahoo.comBackground: Chronic ulcers are one of the challenges of treatment today and cost a lot to the health system. The present study was conducted to investigate the effect of Lucilia sericata maggot therapy in chronic wound treatment.Materials and Methods: This study was conducted as a clinical trial study with 90 eligible patients. Patients were randomly assigned to two equal intervention and control groups. Both groups received routine treatments for chronic ulcers. Patients in the intervention group received maggot therapy with larvae of Lucilia sericata. For all patients, a smear and culture of wound discharges were acquired. The condition of wound healing, the type of infection, and the reduction of microorganisms were compared between the two groups.Results: Staphylococcus aureus was present in 68.9% of the patients and was the most abundant infection among all patients. Results of culturing after larval treatment at different times revealed a decrease in the number of all bacteria, especially Pseudomonas aeruginosa, Escherichia coli, and S. aureus, but the response rate for Enterococcus was the lowest. Also, the wound healing rate and reduction in necrotic tissue at the end of the second week (p=0.041) and the third week (p=0.012) was significantly higher in the intervention group.Conclusion: Larvae of L. sericata have the highest effects on P. aeruginosa and had the least effect on the growth of Enterococcus. Also, our results showedlarvae of L. sericata therapycan significantly improve wound healing rate.Keywords: chronic ulcers, maggot therapy, larvae of Lucilia sericata, wound healing