Eat and heal. Past, present and future of maggot debridement therapy: a narrative review.

Le infezioni in medicina Pub Date : 2025-06-01 eCollection Date: 2025-01-01 DOI:10.53854/liim-3302-11
Omar Simonetti, Verena Zerbato, Francesco Bellinato, Fabio Cavalli, Emanuele Armocida, Roberto Luzzati, Stefano Di Bella
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Abstract

In medicine, fly larvae play a dual role: they can be both harmful causative agents of diseases and therapeutic agents. In fact maggot debridement therapy (biosurgery) is the controlled use of larvae to treat infected wounds and dates back to the beginnings of medicine. Ambroise Paré and Dominique-Jean Larrey pioneered the field of biosurgery before the 19th century, but it was John Forney Zacharias during the American Civil War who officially documented and promoted this medical application. The success of this method was immediate. Nevertheless, germ theory and the postulates of Robert Koch discouraged physicians from using potentially contaminated material such as larvae from the second half of the 19th century onwards. In the first half of the 20th century, however, the practice regained momentum thanks to the sterilization of fly eggs and the success of Dr. Stanton K. Livingston in the treatment of chronic osteomyelitis with biotherapy. The use of larvae for therapeutic purposes was discontinued after the Second World War due to the discovery of penicillin and is now receiving some attention again due to the emergence of antibiotic- resistant bacteria. Although biosurgery is rarely encouraged, the results of systematic reviews and meta- analyzes support its use. Previous and current evidence shows that this practice may be as useful as ever in the age of antibiotic resistance. It is likely that larval therapy will be considered as a stand-alone tool in the near future.

吃了就好。蛆清创治疗的过去、现在与未来:叙述性回顾。
在医学上,蝇幼虫扮演着双重角色:它们既可以是疾病的有害病原体,也可以是治疗剂。事实上,蛆清创疗法(生物外科)是控制使用幼虫治疗感染的伤口,可追溯到医学的开端。在19世纪之前,Ambroise par和Dominique-Jean Larrey是生物外科学领域的先驱,但直到美国内战期间,John Forney Zacharias才正式记录并推广了这一医学应用。这种方法立竿见影。尽管如此,从19世纪下半叶开始,细菌理论和罗伯特·科赫的假设阻止了医生使用可能被污染的材料,比如幼虫。然而,在20世纪上半叶,由于对蝇卵的消毒和斯坦顿·k·利文斯顿博士用生物疗法治疗慢性骨髓炎的成功,这种做法重新获得了动力。第二次世界大战后,由于青霉素的发现,用于治疗目的的幼虫被停止使用,现在由于耐抗生素细菌的出现而再次受到一些关注。虽然很少鼓励生物外科手术,但系统评价和荟萃分析的结果支持其使用。过去和目前的证据表明,在抗生素耐药性时代,这种做法可能一如既往地有用。在不久的将来,幼虫疗法可能会被视为一种独立的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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