Sunday, March 03, 2013

French Sterile Maggot Debridement Study Finds 93% Efficacy for Equine Wounds

The French study is illustrated with this photo of maggots at work on a wound.
A press release from the Equine Veterinary Journal arrived at The Hoof Blog this week. It heralds a French study that documented the successful use of sterile maggot debridement therapy in treating wounds in horses. 

It's great to see this study of more than 40 cases treated with maggots. 

Almost ten years ago, Hoofcare and Lameness published the first contemporary article about the use of maggots in horses with the documentation of foot infection cases treated with maggots by Dr Scott Morrison at Rood and Riddle Equine Hospital in Lexington, Kentucky. We're posting the article here for you to download for your library.

Please remember when you read this article that the research used what are commonly called "sterile" or "surgical" maggots that are laboratory-raised for medical use.

Here's the 2013 update of that article, which includes using maggots for more than foot infections. The entire paper, which accompanied a presentation at the 2012 convention of the American Association of Equine Practitioners, is available as an open-access download from the EVJ web site.

The Hoof Blog has also supplied the archived Hoofcare and Lameness article for specific reference to foot cases.

The French study is illustrated with this photo of maggots at work on a wound.
Maggots can play an integral role in modern veterinary care for a variety of wounds in horses, concludes a new study (1), published in the Equine Veterinary Journal’s (EVJ) special American Association of Equine Practitioners supplement recently.

The study assessed the efficacy of maggot debridement therapy in a diversity of equine lesions and found that the method was beneficial in 93% of cases.

Maggots have been used for the treatment of wounds for hundreds of years. Freshly emerged, germ-free larvae of the common green bottle fly are usually used for the purpose. Their wound-healing action is attributed to a debridement effect, an antiseptic effect, a direct effect on cytokine and cell proliferation involved in wound healing and breakdown of biofilm formation.

Maggots also destroy and digest bacteria and may also be beneficial in the fight against multi-drug-resistant bacteria such as MRSA.

The study involved the retrospective analysis of 41 horses with various lesions: foot injury, limb laceration, soft tissue abscesses and musculoskeletal infection. Depending on the type, size and location of the wound, the maggots were applied either with direct or indirect contact.

In some cases a second maggot application was necessary to reach the desired level of healing. Debridement, disinfection and healing occurred in all but three cases in less than one week. Of the three that did not respond, two were complicated by the presence of tumors and one by pre-existing damage to the underlying bone.

Olivier Lepage of the University of Lyon in France, who led the study, concluded: “These results show that maggot debridement therapy potentially has an integral place in modern veterinary wound care. It can be used to treat many types of lesions, although not those involving tumors or bone sequestration. Associated high costs present a limiting factor but maggot debridement therapy should certainly be considered for lesions that fail to respond to conventional methods.”

The same wound, after the maggots have done their work.
Professor Celia Marr, editor of the EVJ, said, “Horses often suffer from non-healing wounds, particularly in the limbs where the skin is under continuous movement and there is very little subcutaneous tissue.

"Although at first glance this study might seem counter-intuitive and we might think of maggots as being the last thing one would want on a clean wound, it shows that maggots can be an effective way to clear damaged tissue and this is an important adjunctive approach in equine wound management.”

(1) The use of maggot debridement therapy in 41 equids OM Lepage, A Doumbia, MF Perron-Lepage and M Gangl. EVJ ISSN 0425-1644 DOI: 10.1111/j.2042-3306.2012.00609.x  (Free download of complete new paper at that link)

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