BIOSURGERY OF CHRONICAL WOUNDS- healling with the larvae of Lucilia sericata

Since ancient times it is known that larvae of certain fly species stimulate healing of infected and gangenous wounds. The first scientific reports of their benificial effect derive from military surgeons. After the first world war the therapy was transferred from battlefields into hospitals, where around 1930 these biosurgical teratments have really expanded. With the advent of antibiotic treatments after second world war the practice of larval treatment declined. In the last decade new problems associated with the emergenece of antibiotic resistant bacterial strains emerged, therefore the larval therapy has undergone a new revival. Today it is successfully used in USA, Germany and Great Britain. The Lucilia sericata larvae act indirectly, through a complex active principle, secreted into wounds. The secretion degrades the wound necrotic tissue through the action of different proteolytic enzymes, it inhibits bacterial growth with so far unknown antimicrobial compounds and acts proliferatively due to insect hormones present during wound healing process. In Slovenia so far the therapy with L. sericata larvae has not been used yet. The aim of the present study is to introduce this biosurgical therapy to Clinical center hospital for the treatment of certain types of chronic wounds. In parallel, an attempt will be made to heal these wounds without the appliactions of larvae, using only the sterile complex secretion as such or bound to a suitable carrier compound.