Maggot Therapy for Wound Care in Iran: A Case Series of the First 28 Patients Publisher Pubmed



Mirabzadeh A¹ ; Ladani MJ² ; Imani B¹ ; Rosen SAB³ ; Sherman RA⁴
Source: Journal of Wound Care Published:2017

Abstract

Objective: The need for improved wound care is receiving considerable attention in the Islamic Republic of Iran. Beginning in 2003, maggot therapy (MT) became part of Iran's effort to advance its wound care technology. The first cohort of patients treated with MT was analysed to evaluate the use of this treatment. Method: Patients treated with MT at three hospitals in Tehran were analysed retrospectively. Primary outcomes were time to wound debridement and time to wound healing. Factors potentially influencing primary outcomes were also recorded, including demographic factors (such as age, race, gender), wound characteristics, underlying medical illnesses, and treatment attitudes. Results: We analysed 28 patients with 29 wounds. Most (55%) of the wounds were ischaemic, neuropathic or mixed-pathology foot ulcers in patients with diabetes. Half were considered unsalvageable. All were completely debrided and subsequently healed with MT, without amputation, grafts, or advanced interventions. Osteomyelitis was present in all cases before MT, but appeared to have been eradicated, without recurrence during at least three years' follow-up. The most common adverse events were malodour, with wound pain reported in two patients. All patients and therapists were pleased with their overall experience. Conclusion: Maggot therapy can provide advanced wound care even in resource-limited areas. Maggot therapy was very acceptable to the patients and their therapists. Declaration of interest: Ronald Sherman is on the Board of Directors of the BioTherapeutics, Education and Research (BTER) Foundation, which supports education and research in biotherapy. He is also the Cofounder and Laboratory Director of Monarch Labs, which produces medicinal maggots. However, Monarch Labs was not involved in this research, provided no financial or material support, and does not stand to gain from the success of MT in the Islamic Republic of Iran. Neither does Dr. Sherman's professional career stand to gain from publishing this research, as he has already retired from the University of California. The remaining authors declare no conflicts of interest. © MA Healthcare Ltd.