Varnost in klinična učinkovitost izločkov ličink muhe Lucilia sericata pri zdravljenju okužb ran (Slovene)

Treatment of wounds with maggots was well known in remote history. More recently it was used during the war conflicts in 20th century. Again, the maggot treatment is re-gaining its popularity because of increasing antimicrobial resistance. On individual level, antimicrobial resistance is most challenging in patients with chronic problems and repetitive antibiotic treatment such as patients with chronic wounds. Studies have shown that the efficacy of the maggots depends upon the bioactive ingredients of excretions/secretions (E/S). The E/S has proteolytic, antibacterial, and antifunfal activity. Besides, the E/S stimulates the wound healing. The study on clinical efficacy and safety of E/S in the treatment of chronic wounds is the first clinical trial which shows that the maggot treatment may be replaced by the treatment with the topical application of the E/S. The study confirms the in vitro results pointing out that not maggots themselves but the E/S are responsible for the activity in the wound treatment. The study confirms some other in vitro tests of the E/S: proteolysis seems to be the most prominent effect, the antibacterial effect was most prominent against Gram-positive bacteria. The healing effect was least visible although not absent. Clinical proof of the efficacy of E/S in chronic inflammed wounds without live maggots represents stimulation for further investigation of E/S ingredients and their mechanisms of action.

The E/S alginate gel for topical wound treatment was prepared under experimental conditions in university laboratories. Optimisation of the procedures, which would standardize the procedures and make them less expensive, might lead to the development of commercially available medical device for wound treatment.