First Report on the Use of Larvae of Cochliomyia macellaria (Diptera: Calliphoridae) for Wound Treatment in Veterinary Practice

Case series of maggot debridement therapy demonstrates safety and efficacy for treating problematic wounds in cats and dogs in Mexico

Wound care is a common problem in small animals. Antimicrobial resistance, biofilm, time constraints, and the cost of surgery or specialized dressings hinder efforts to deliver prompt wound healing. Maggot therapy has been very effective in human and equine wound care, but very little research has evaluated its safety and efficacy in dogs and cats. This study was initiated to evaluate the utility, efficacy, and safety of maggot debridement therapy for wound care in a small animal veterinary practice in Mexico. Six cats and four dogs were treated with maggot debridement therapy when their wounds failed to respond to conventional therapy. Treatment was administered by applying 8-10 larvae per cm2 surface area directly on the wound bed and covering the wound with a sterile polyester mesh, sutured to the skin. These were left on the wound for cycles of approximately 48 h (24-72 h); the cycles were repeated if >20 % necrotic tissue remained after treatment. Review of these cases revealed that 80 % of treated wounds achieved 100 % debridement within 48-96 h of treatment. An additional 10 % (one wound) achieved 80 % debridement within only 24 h of treatment. One animal failed to show improvement: a 3-year-old cat with an infected bite wound, which drained voluminously and drowned the maggots. This animal was deemed not to be an appropriate candidate for maggot debridement therapy, and treatment was terminated after just 12 h. Ultimately, this wound was debrided and closed surgically. No complications were encountered other than mild discomfort in one cat. These results support claims that maggot debridement therapy is relatively safe and effective for treating problematic dog and cat wounds. Veterinarians should consider including maggot debridement among their treatment options for problematic wounds. Controlled clinical trials should be performed.

Larval therapy from the patient’s perspective

Objective: to describe the perception of the patient undergoing larval therapy. Method: qualitative, exploratory-descriptive study, using oral history as a data collection technique and methodological framework, in the form of oral life history. Six patients with difficult-to-heal wounds participated in the study, followed by the dressing committee of a teaching hospital in Natal, Rio Grande do Norte, undergoing larval therapy. Results: the testimonies of the patients/collaborators point to various values, such as belief, fear, acceptance, improvement of the wound and pain. They revealed that there is no major objection and that clarification regarding the treatment instituted proved to be important in the acceptance decision. Conclusion: the feelings expressed by the patients, such as improvement of the wound, reduction of pain and odor, optimization of the healing process, emergence of sparks of hope regarding the return to their life, among others, translate the benefits of Larval Therapy (LT). Despite the seizure caused by the animal’s movement over the affected area and the disgust it causes to some professionals and people, LT was considered wonderful, especially for its effectiveness in cleaning the wound without the need for new invasive procedures such as cutting and surgical debridement.

Terapia larval sob a ótica do paciente

Objetivo: descrever a percepção do paciente submetido à terapia larval. Método: estudo qualitativo, exploratório-descritivo, tendo como técnica de coleta de dados e referencial metodológico a historia oral, na modalidade da história oral de vida. Participaram do estudo seis pacientes com feridas de difícil cicatrização, acompanhados pela comissão de curativos de um hospital escola em Natal, Rio Grande do Norte, submetidos à terapia larval. Resultados: os depoimentos dos pacientes/colaboradores apontam diversos valores, como crença, medo, aceitação, melhora da ferida e da dor. Revelaram que não há grande objeção e que o esclarecimento em relação ao tratamento instituído mostrou-se importante na decisão de aceitação. Conclusão: os sentimentos expressos pelos pacientes, como melhora da ferida, diminuição da dor e odor, otimização do processo de cicatrização, surgimento de centelhas de esperança quanto ao retorno à sua vida, dentre outros traduzem os benefícios da Terapia Larval (TL). Apesar do fervilhamento provocado pelo movimento do animal sobre a área acometida e da repulsa que causa a alguns profissionais e pessoas, a TL foi considerada maravilhosa, especialmente por sua eficácia na limpeza da ferida sem a necessidade de novos procedimentos invasivos como desbridamento cortante e cirúrgico.