Gupta Amit
Lok Nayak Hospital, India.
Ann Plast Surg. 2008 Feb;60(2):224-7. doi: 10.1097/SAP.0b013e318053eb5e.
Chronic wounds have been defined as those that do not follow the orderly manner of healing, and thus do not achieve closure. Such wounds are notoriously difficult to treat and the number of treatments around attest to the fact that management of chronic wounds is not possible with one agent and definitely never achieves the most satisfactory results in a period short enough to satisfy the patient. Maggots had been used sparingly initially and are gradually finding their way into a more acceptable system of wound management. A review of some of the most relevant literature regarding maggot therapy makes it clear that some factors beg a final conclusion such as patient and physician factors regarding maggot therapy, care of larvae, the indications, benefits and precautions of maggot debridement therapy (MDT). MDT has been given the fashionable name of myasis or "bio-surgery." Maggots used in MDT are not the same as that of the house fly (Musculus sp.) but are now specially bred larvae of the Lucilia sericata species. These larvae have the property of not damaging healthy dermis and subcutaneous tissue but can destroy healthy epithelium; thus, epithelium protection is mandatory in MDT. Several of these factors will be discussed in the review of some of the most important literature available on maggots and their use to the wound specialty.
慢性伤口被定义为那些未遵循有序愈合方式、因而无法实现闭合的伤口。这类伤口 notoriously 难以治疗，周围的治疗方法数量证明了一个事实，即单一药物无法管理慢性伤口，而且在短到足以让患者满意的时期内绝对无法取得最令人满意的效果。蛆虫最初使用较少，现在正逐渐进入一个更易被接受的伤口管理体系。对一些与蛆虫疗法最相关的文献进行回顾后发现，一些因素需要得出最终结论，比如患者和医生关于蛆虫疗法的因素、幼虫护理、蛆虫清创疗法（MDT）的适应症、益处和预防措施。MDT 有了一个时髦的名字——蝇蛆病或“生物外科”。MDT 中使用的蛆虫与家蝇（Musculus sp.）不同，而是现在专门培育的丝光绿蝇物种的幼虫。这些幼虫具有不损害健康真皮和皮下组织但能破坏健康上皮的特性；因此，在 MDT 中保护上皮是强制性的。在回顾一些关于蛆虫及其在伤口专科应用的最重要文献时，将讨论其中的几个因素。
