BioTherapeutics, Education & Research (BTER) Foundation, 36 Urey Court, Irvine, CA 92617, USA.
Evid Based Complement Alternat Med. 2014;2014:592419. doi: 10.1155/2014/592419. Epub 2014 Mar 13.
MEDICINAL MAGGOTS ARE BELIEVED TO HAVE THREE MAJOR MECHANISMS OF ACTION ON WOUNDS, BROUGHT ABOUT CHEMICALLY AND THROUGH PHYSICAL CONTACT: debridement (cleaning of debris), disinfection, and hastened wound healing. Until recently, most of the evidence for these claims was anecdotal; but the past 25 years have seen an increase in the use and study of maggot therapy. Controlled clinical studies are now available, along with laboratory investigations that examine the interaction of maggot and host on a cellular and molecular level. This review was undertaken to extract the salient data, make sense, where possible, of seemingly conflicting evidence, and reexamine our paradigm for maggot-induced wound healing. Clinical and laboratory data strongly support claims of effective and efficient debridement. Clinical evidence for hastened wound healing is meager, but laboratory studies and some small, replicated clinical studies strongly suggest that maggots do promote tissue growth and wound healing, though it is likely only during and shortly after the period when they are present on the wound. The best way to evaluate-and indeed realize-maggot-induced wound healing may be to use medicinal maggots as a "maintenance debridement" modality, applying them beyond the point of gross debridement.
医用蛆虫被认为对伤口有三种主要的作用机制，这是通过化学和物理接触带来的：清创（清除碎片）、消毒和加速伤口愈合。直到最近，这些说法的大部分证据都是轶事性的；但在过去的 25 年里，蛆虫疗法的使用和研究有所增加。现在有对照临床试验，以及在细胞和分子水平上检查蛆虫和宿主相互作用的实验室研究。进行这项综述是为了提取重要数据，尽可能地理解看似相互矛盾的证据，并重新审视我们对蛆虫诱导伤口愈合的范式。临床和实验室数据强烈支持有效和高效清创的说法。临床证据表明伤口愈合加快，但实验室研究和一些小型的、重复的临床研究强烈表明，蛆确实能促进组织生长和伤口愈合，尽管这可能只发生在它们存在于伤口上的时期和之后不久。评估——实际上是实现——蛆虫诱导的伤口愈合的最佳方法可能是将药用蛆虫作为一种“维持清创”的方式，在明显清创之外使用它们。
