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Diabetic Foot ulcerations have devastating complications including amputations, poor quality of life, and serious infections. Diabetic wounds can be protracted, take significant time to heal, and can recur after healing. They are costly and consume healthcare resources. These consequences have serious public health and clinical implications. Debridement is often used as a standard of care. Debridement consists of both non-mechanical (autolytic, enzymatic) and mechanical methods (sharp/surgical, wet to dry debridement, aqueous high-pressure lavage, ultrasound, and biosurgery/maggot debridement therapy). Debridement is used to remove nonviable tissue, to facilitate wound healing, and help prevent these serious outcomes. What are the various forms, rationale, and evidence pertaining to debridement? This article comprehensively reviews the science of diabetic foot ulcers, and the science and methods behind the debridement of diabetic foot ulcers.

Myiasis is an infestation of maggots on living tissue in humans and animals all over the world. It is known to occur in wild animals, while no information is reported in forest musk deer (Moschus berezovskii). During our research on the conservation of forest musk deer, we found a new record of traumatic myiasis of an injured forest musk deer. The flies are likely Lucilia caesar (Linnaeus, 1758) according to the results of DNA barcoding technology. We report traumatic myiasis of forest musk deer for the first time, which expands the information on parasite and myiasis of forest musk deer and confirms the potential risk of traumatic myiasis of forest musk deer., Graphical abstract Image 1, Highlights • First report of Lucilia caesar parasitizing forest musk deer. • The myiasis caused by Lucilia caesar occurred in China. • This study will provide new epidemiological information of myiasis of wildlife in China.

The common green bottle blow fly Lucilia sericata (family, Calliphoridae) is widely used for maggot debridement therapy, which involves the application of sterile maggots to wounds. The larval excretions and secretions are important for consuming necrotic tissue and inhibiting bacterial growth in wounds of patients. Lucilia sericata is also of importance as a pest of sheep and in forensic studies to estimate a postmortem interval. Here we report the assembly of a 565.3 Mb genome from long read PacBio DNA sequencing of genomic DNA. The genome contains 14,704 predicted protein coding genes and 1709 non-coding genes. Targeted annotation and transcriptional analyses identified genes that are highly expressed in the larval salivary glands (secretions) and Malpighian tubules (excretions) under normal growth conditions and following heat stress. The genomic resources will underpin future genetic studies and in development of engineered strains for genetic control of L. sericata and for biotechnology-enhanced maggot therapy.

The establishment of low-cost, effective, safe and practical methods is necessary to increase the use of larval therapy in wound care. Although studies on external disinfection of calliphorid eggs have been reported, many studies lack data on the effect of disinfection on egg viability and the microorganisms found before disinfection. Therefore, the main objective of this study was to compare three antiseptic solutions, that is, chlorhexidine (5%), Dakin's solution (0.5% NaOCl) and povidone-iodine (10%), in terms of their ability to disinfect Lucilia sericata eggs. Egg viability after disinfection and microorganisms present on the eggs and larvae before and after treatment were also examined. None of the antiseptics had a significant effect on egg viability. Disinfection of L. sericata eggs with 0.5% NaOCl was the best method, as sterility tests showed no contamination. Escherichia coli, Bacillus subtilis and Proteus mirabilis were present in all cultures isolated from the non-disinfected eggs and larvae, while Enterococcus faecium, Enterococcus faecalis, Morganella morganii, Corynebacterium spp. and Providencia stuartii were isolated from more than half of the same cultures. Sterility testing of medicinal maggots after disinfection is crucial to prevent secondary infections and achieve a positive therapeutic outcome.

Background: A gruesome infection was found in a woman with advanced lung tumor and associated malnutrition. Worldwide, bacteremia with Wohlfartiimonas chitiniclastica was only found in 13 cases yet.Case presentation: This is the first case in Austria and the first case without infestation of maggots.Conclusions: This germ may be considered as an emerging human pathogen not only in patients with poor personal hygiene, difficult social circumstances, alcohol dependence or chronic wounds.AbstraktEine grauenhafte Infektion wurde bei einer Patientin mit fortgeschrittenem Lungentumor und Malnutrition gefunden. Bisher wurden weltweit erst 13 Fälle mit einer Wohlfahrtiimonas chitiniclastica - Bakteriämie beschrieben. Dieser erste Fall in Österreich manifestierte sich ohne eine Infestation mit Maden. Dieses Bakterium kann als neuer Krankheitserreger betrachtet werden, der nicht nur bei Patienten unter mangelnder Hygienebedingungen, schwierigen sozialen Verhältnissen, Alkoholabhängigkeit oder chronischen Wunden auftreten kann.

Cerebral myiasis is a rare condition caused by a parasitic infestation of fly larvae feeding on the host's necrotic or living tissue. Only 16 cases of cerebral myiasis have been published. We presented the case of a 72-year-old man with a neglected infestation of an extensive ulcerative cancer of the scalp. A large cranial lesion, with exposed brain and dura mater and severe Sarcophaga carnaria maggot infestation, was evident. We gently removed the maggots and covered the defect with thick gauze and sodium hypochlorite solution dressing. We additionally present a review of the literature to highlight shared features and suggestions for care management. In all cases, there was an absence of fatal meningitis and encephalitis, which is surprising given the open skull erosion with prolonged cortical exposure and points to the protective effects of larvae wound infestation.

Chronic wounds caused by underlying physiological causes such as diabetic wounds, pressure ulcers, venous leg ulcers and infected wounds affect a significant portion of the population. In order to treat chronic wounds, a strong debridement, removal of necrotic tissue, elimination of infection and stimulation of granulation tissue are required. Maggot debridement therapy (MDT), which is an alternative treatment method based on history, has been used quite widely. MDT is an efficient, simple, cost-effective and reliable biosurgery method using mostly larvae of Lucilia sericata fly species. Larvae can both physically remove necrotic tissue from the wound site and stimulate wound healing by activating molecular processes in the wound area through the enzymes they secrete. The larvae can stimulate wound healing by activating molecular processes in the wound area through enzymes in their excretions/secretions (ES). Studies have shown that ES has antibacterial, antifungal, anti-inflammatory, angiogenic, proliferative, hemostatic and tissue-regenerating effects both in vivo and in vitro. It is suggested that these effects stimulate wound healing and accelerate wound healing by initiating a direct signal cascade with cells in the wound area. However, the enzymes and peptides in ES are mostly still undefined. Examining the molecular content of ES and the biological effects of these ingredients is quite important to illuminate the molecular mechanism underlying MDT. More importantly, ES has the potential to have positive effects on wound healing and to be used more as a therapeutic agent in the future, so it can be applied as an alternative to MDT in wound healing. WOS:000680590700001 34343386 Q1

Summary Background Myiasis is an infestation of neglected open wounds by fly larvae. Global warming, related climate changes, and increased traveling in tropical countries may contribute to the worldwide diffusion of new fly species. Common risk factors for myiasis are advanced age, poor hygiene, malnourishment, social isolation, diabetes, cancer, and peripheral artery disease. The aim of this study was to review the characteristics of cases of myiasis reported in Europe. Methods A narrative review of cutaneous myiasis was performed using PubMed, EMBASE, Web of Science database, and the search terms “human,” “myiasis,” “cutaneous myiasis,” “maggot,” “Europe,” “wound,” with the combination of “AND” and “OR.” In addition, hospital charts were reviewed to add personal experience to the literature review. Results Overall, 52 articles, both single case reports and case series reporting cutaneous myiasis, were found in the medical literature of the past two decades. A total of 64 patients living in Europe were identified, of whom 36% had wound myiasis. In addition to the literature review, we report the case of a male patient who presented with myiasis within a deep scalp ulcer occurring after radiotherapy for basal cell carcinoma. Conclusion Myasis is rare and possibly under-reported in Europe. The epidemiology of this infestation may be changing in the future due to climate variability, a rise in travel to tropical areas, and the migration of fly species.

Unhygienic conditions attract organisms into the pathological lesion and worsen the condition, here is a case wherein the patient with psoriatic skin lesions took treatment from an unqualified person and in addition his unhygienic habit attracted maggots into the foot eating away a major chunk of his normal tissues. The case was diagnosed and treated in lines with fundamental principles of Sushruta. The case is a best example of maggots destructive and repair effect on the tissue, the wound with maggots presence healed faster than with wound without maggots.

Lucilia sericata bottle fly worms can be used to heal infected, chronic, or necrotic wounds, including those associated with ulceration and diabetic foot. The study aimed to evaluate changes in the microflora in patients treated with L sericata larvae due to leg ulcers and diabetic foot. One hundred twenty‐nine patients diagnosed with lower limb ulceration and diabetic foot were enrolled in the study, of which 80 of them met the eligibility criteria for maggot debridement therapy (MDT). On the contrary, 49 unqualified patients were offered ozone therapy (22 with leg ulcers; 27 with diabetic foot). In each of these patients, a microbiological swab was performed before and after the start of therapy. The group of 80 patients was further divided into four equal groups in terms of the treated area (lower leg vs foot) and the number of larvae/cm2 (5 vs 10). Twenty‐three particular species of bacteria in the infected wound were studied microbiologically in terms of presence/absence within the wound environment before and after treatment of patients with diabetic foot and lower limb ulceration. It was noted that there was a more intensive bacterial accumulation in the feet of patients compared to legs; furthermore, this applies to almost all analysed species. Diabetes status is also a clinical factor that generates a lower chance of bacterial appearance in the wound environment. Densification of MDT larvae per wound area unit also reduced the chance of the presence of Corynebacterium species, Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus MSSA, and Streptococcus coagulase negativa; however, it increased the likelihood of occurrence for Proteus mirabilis and the Proteus species. A microbiological analysis in this non‐reference study shows the efficacy of larval therapy for leg and foot ulcers. Rearrangement of the microflora within the wound has been reported as a result of the therapy.

Bacteremia induced by wound myiasis is uncommon and therefore rarely suspected by clinicians when treating patients with neglected wounds. We present a case of Ignatzschineria larvae bacteremia as a complication of Lucilia sp. maggot wound myiasis in a young male migrant. This is the first reported human case of Ignatzschineria bacteremia in Slovenia and one of the 2 described in the literature where the fly larvae infesting the wounds of the patient with Ignatzschineria bacteremia were not only suspected to be Lucilia sp. but also entomologically identified.

Self-inflicting injuries are common among special children. One of the complications is Oral Myiasis. 11 yr old spastic female reported with pain and swelling in palatal region due to trauma from wooden stick. Oral examination revealed, an ulcerated lesion measuring about 2 cm × 1 cm in relation to 11 and 12. 4 live maggots were removed from the ulcerated wound which after entomological examination was reported as Chrysomya Bezziana. Uniqueness of the case This case describes a non-invasive management of Oral myiasis in a special child with poor socioeconomic condition which demanded out-patient care which was clinically effective and affordable.

The development of the digestive tract organs is closely related to the increased body weight growth in chickens. The present study aimed to determine the effect of using maggot meal as an antibacterial and protein source of fish meal substitution in diets on the relative length of the digestive tract organs, small intestine histomorphology,and the percentage of the native chicken carcass. A total of 140 one-day-old chickens were randomly assigned to one of the five treatments according to a completely randomized design with four replications for each treatment. The treatments included P0 (basal diet + 15% fish meal + 0% maggot meal), P1(basal diet + 11.25% fish meal + 3.75% maggot meal), P2 (basal diet + 7.5% fish meal + 7.5% maggot meal), P3(basal diet + 3.75% fish meal + 11.25% maggot meal), and P4 (basal diet + 0% fish meal + 15% maggot meal). The results showed that the use of maggot meal in P3 had a significant effect (P < 0.05) on the relative length, villi height, depth of duodenal crypt, jejunum and ileum, villi surface area, the density of jejunum and ileum villi, and percentage of thigh and wing weight. Besides, the treatment tended to increase the relative length of the caecum and colon, surface area of the duodenal villi, and chest weight percentage. However, the treatment did not affect the duodenal villi density and percentage of back weight in native chickens. The use of maggot meal up to 11.25% in diets can improve the relative length of intestinal, histomorphology of small intestine’s villi, and the percentage of carcass parts of native chickens.

Maggots are dipterous larvae of flies. Infestation of vertebrate animals (including humans) by maggots is termed as Myiasis. Warm and Humid climate, low socio-economic status, lack of knowledge and poor living conditions, malignant wounds predispose the cancer patients to maggot infestation in India. Apart from infestation in the wounds; oral, ophthalmic, nasal, aural, enteric, urogenital, trachea-pulmonary and rectal myiasis have been reported. Maggot infestation of the Intercostal drain (ICD) container without associated pleural myiasis is an extremely rare entity. We describe a rare case report of maggots in the ICD in a patient with metastatic chondrosarcoma femur with ICD in situ for malignant pleural effusion. Early detection and management are the keys to prevent the catastrophic complication of pleural myiasis.

Maggot debridement therapy (MDT) has been used for years in the treatment of chronic wounds and necrotic tissues. We report a case of subtotally amputated third toe that was treated with MDT after reattachment and developing complete necrosis. The necrotic toe was replaced with viable tissue and the wound healed completely after 2 weeks of MDT application. This case points out the regenerative effects of MDT besides its mechanical debridement effect on the necrotic tissue.

Lucilia sericata, one of the most common species of the Calliphoridae family, is found in large numbers around droppings, garbage and carcasses. This fly species is important in medicine, forensics and veterinary medicine. The larvae of the parasite are important both in veterinary medicine and in combating of the animal diseases, as they cause significant losses in animal production. Since they are one of the first fly colonies to settle on corpses, they can also be used in determining the time of death in the field of forensic medicine. L.sericata larvae used in Maggot debridement treatment (MDT) which is a treatment method with fly larvae, help wound healing by destroying necrotic tissues and infectious agents in wounds. While the larvae protect themselves from polymicrobial flora with the proteins they secrete; at the same time, they make an interesting contribution to wound healing with these molecules secreted. One of the most important molecules discovered in recent years is lucimycin which has an antifungal effect. In addition, lucifensin and chymotrypsin secretions have gained importance in recent years due to their antibacterial effects and especially their effects on resistant gram-negative and positive bacteria. There is a need for the discovery of the molecules that can be alternative in the treatment of non-healing wounds or that can be applied together with existing antibiotics. It is necessary to investigate the antimicrobial characterization of the compounds involved in maggot therapy and their mechanisms. The aim of this study was to clone, molecular characterization and analysis of the antigenic structures of lucifensin and chymotrypsin genes, which are important defensin molecules secreted by L.sericata larvae used in MDT. Primarily, the cultivation of L.sericata colonies to be used in molecular studies were performed. Later, RNA isolation and cDNA synthesis from larvae were carried out. Lucifensin and chymotrypsin genes were individually inserted into the pJet1.2 plasmid by cloning reactions. The presence of the recombinant plasmid was confirmed by PCR screening and DNA sequence analysis methods in all steps. Nucleotide and amino acid based molecular characterizations of these two genes, which are important larval components in wound treatment, have been made. Antigenic regions and three-dimensional structures of the proteins were obtained. The isolate numbered MT495795 of the L.sericata lucifensin gene and the isolate numbered MT495794 of the chymotrypsin gene were registered to GenBank. This data reported for the first time in the Republic of Turkey will contribute to the literature. From the beginning of the 20th century until the discovery of the antibiotics, MDT was applied especially on soldiers but did not find much application area after the discovery of the antibiotics. Drug resistance, which is the most important problem encountered in the treatment of the wounds today, has led to the recall of MDT and its mechanism of action. In this study the data, obtained will constitute a source for the multidisciplinary studies of the scientists from different fields on the discovery and applicability of the important molecules in the treatment of the wounds.

Blowfly (Diptera: Calliphoridae) species Lucilia sericata (Meigen) and related species Lucilia cuprina (Wiedmann) are important agricultural pests, assist in forensic fields and also have a therapeutic role in medicine. Both species (though predominantly L. sericata) are utilised in a clinical setting for maggot debridement therapy (MDT) where the larvae ingest necrotic tissue and bacteria from non-healing wounds. Conversely, larvae of L. cuprina feed invasively, as major initiators of sheep myiasis in Australia, New Zealand, and the UK, among other regions. Both species exhibit larval and adult interactions with bacterially rich environments, but the significance of this in the composition of their microbiome has yet to be considered. This study utilised dissected samples of digestive and reproductive organs from both disinfected and non-disinfected adults and larvae of both species for bacterial DNA extraction, followed by 16S rRNA gene sequencing. Sequencing data indicated unsurprisingly that digestive tracts of both genders and female salivary glands from all non-disinfected samples carry the most concentrated amounts of bacteria. Genera Pseudomonas and Corynebacterium were also highly represented within all organs and species analysed. Comparison of bait lures to sample sequence read output of insect specimens showed no correlation with genera such as Pseudomonas present in insects, while absent from wild bait, and in reduced amounts from fleece bait profiles. With this information, future work can focus on key organs such as the spermathecae and salivary glands, while also providing the potential to identify the role these bacteria may play in the blowfly life cycle. KEY POINTS: Genera Pseudomonas appears consistently in the microbiome of Lucilia species. Female spermathecae and salivary glands show the highest microbial diversity. Bacterial profiles of L. sericata and L. cuprina have similar composition.

The effects of replacing O, 33.3, 66.7 or 100% of dietary fish meal (9%) with housefly maggots ( Musca domestica. Linn ) was investigated using broilers from day old to 5 weeks of age. Increasing the dietary level of maggots reduced feed intake and weight gain while increasing the feed; gain ratio (P>0.05). There was however no significant effect of dietary maggots on mortality rate (P>0.05). Replacement of dietary fish meal with maggots caused significant reduction in niti·ogen retention (P 0.05). There was no significant effect of replacing dietary fish meal with maggots on the metabolizable energy value of the diets (P>0.05). It is concluded that maggots could replace only 33% of dietary fish meal (9%) without compromising performance and nutrient retention in broiler chicks. The cost of harvesting and processing maggots is about 15% of equivalent weight of fish meal, making even partial replacement of fishmeal with maggots economical. Key words : Maggots, fishmeal, broiler performance, nutrient retention.

The economics of production of broiler chickens considered for 0-35 days, 35-56 days, and 0-56 days was compared for fishmeal (FM) and maggot meal (MM) diets. The maggot meal diet had a replacement of the fish meal at 75%> on protein basis. Replacing FM at 75% with MM resulted in reduced cost of feed as well as cost /kilogramme weight gain of broiler chicken at starter, finisher and the overall production period. Consequently, net returns was raised by 15.79%, 12.28% and 13.63% respectively at the starter, finisher and during the overall production period. The increase in net returns are encouraging as the least cost diet had no negative effect on the performance of the birds. Therefore the profit-maximising objective of commercial broiler enterprises is achieveably by MM utilization in broiler feed as replacement for FM under this condition of reduced cost of production. Keywords: Economics of production, maggot meal, fishmeal, net returns

Myiasis is caused by the presence of dipterous larvae in humans and animals. It is usually associated with poor hygienic conditions. A urologist rarely comes across myiasis. We report a case of myiasis around a recently placed nephrostomy tube. A 55-year-old male farmer from a rural area underwent right percutaneous nephrolithotomy. The procedure was terminated because of bradycardia and arrhythmia. There were residual calculi. A nephrostomy was kept. His relook nephroscopy was planned, but he was not willing. Hence, he was discharged with an indwelling nephrostomy tube. Two weeks later, he presented with severe pain around the right nephrostomy tube with surrounding pruritus. The wound hygiene was poor. He was found to have maggots around the nephrostomy tube. These were treated by local instillation of turpentine oil and oral and topical ivermectin, followed by manual removal of the maggots.

Background Feral swine (Sus scrofa) are highly invasive and threaten animal and human health in the Americas. The screwworm (Cochliomyia hominivorax) is listed by the World Organization for Animal Health as a notifiable infestation because myiasis cases affect livestock, wildlife, and humans in endemic areas, and outbreaks can have major socioeconomic consequences in regions where the screwworm has been eradicated. However, a knowledge gap exists on screwworm infestation of feral swine in South America, where the screwworm is endemic. Here, we report screwworm infestation of feral swine harvested in Artigas Department (Uruguay), where the Republic of Uruguay shares borders with Brazil and Argentina. Methods Myiasis caused by the larvae of screwworm were identified in feral swine with the support and collaboration of members of a local feral swine hunting club over a 3-year period in the Department of Artigas. Harvested feral swine were examined for the presence of lesions where maggots causing the myiasis could be sampled and processed for taxonomic identification. The sites of myiasis on the body of infested feral swine and geospatial data for each case were recorded. The sex and relative size of each feral swine were also recorded. Temperature and precipitation profiles for the region were obtained from public sources. Results Myiases caused by screwworms were recorded in 27 of 618 the feral swine harvested. Cases detected in males weighing > 40 kg were associated with wounds that, due to their location, were likely caused by aggressive dominance behavior between adult males. The overall prevalence of screwworm infestation in the harvested feral swine was associated with ambient temperature, but not precipitation. Case numbers peaked in the warmer spring and summer months. Conclusions This is the first report on myiasis in feral swine caused by screwworm in South America. In contrast to myiasis in cattle, which can reach deep into host tissues, screwworms in feral swine tended to cause superficial infestation. The presence of feral swine in screwworm endemic areas represents a challenge to screwworm management in those areas. Screwworm populations maintained by feral swine may contribute to human cases in rural areas of Uruguay, which highlights the importance of the One Health approach to the study of this invasive host species–ectoparasite interaction. Graphical Abstract

In this study, the effect of three different sources of maggot meals was conducted to evaluate the performance and slaughter characteristics of broiler chickens. Five diets were formulated to include Diet 1 (control) which contained 3.5 % fish meal, while Diets 2, 3 and 4 contained 3.5% maggot meal from broiler droppings (BMM),maggot meal from layers droppings (LMM) and maggot meal from rabbit faeces (RMM) respectively. Eighty (80) dayold unsexed Marshall Broilers were randomly allotted to four dietary treatments in a completely randomized design (CRD). Thedietary treatments had 20 birds each with two (2) replicates. Data were generated on proximate analysis and performance indices including feed intake and weight gain, slaughter characteristics and mortality rate. They were subjected to analysis of variance (ANOVA) and means significantly different were separated using Duncan's Multiple Range Test (DMRT) at 5% probability level. Results from proximate analysis showed that maggots from layer droppings had the highest crude protein and ether extract. Results on performance indices showed that birds fed on diet 3 (layer maggot meal) had significantly (P

Searching for least cost feed component should be extended to unconventional feedstuffs that are locally available and cheaper to come by. Therefore, an eight-week experiment was carried out to determine the effect of different protein sources (maggot, termite, grasshopper and lizard meal) on performance of broiler chickens. A total of one hundred and fifty (150), one day-old broiler chicks of Marshall Breed were used for the experiment. An eight-weekstudy was conducted to evaluate the performance of broiler chickens fed the four different sources of animal protein. Diet I contained 5% fish meal while Diets 2, 3, 4 and 5 contained 5% maggot meal, termite meal, grasshopper meal and lizard meal, respectively at the starter phase. The finisher phase contained 2.5kg each of the protein sources respectively. The chicks were allotted to five dietary treatments each replicated thrice with ten birds perreplicate in a completely randomized design (CRD). Proximate composition of the test ingredients showed that lizard meal had the highest (55.66%) crude protein and crude fibre (5.53%). Termite meal exhibited highest (26.46%) ether extract followed by maggot meal (9.79%) with the lowest (4.02%) from lizard meal. The feed intake value (4700.16g) in birds fed diet 1 was significantly (P

Objective: In critical limb ischaemia (CLI), first-line therapy is revascularisation, but alternative treatment options are needed in certain cases. Maggot debridement therapy (MDT) is historically considered to be contraindicated in ischaemic ulcers. Wound care in patients with CLI is becoming increasingly diverse with the development of novel revascularisation strategies; therefore, CLI now needs to be reconsidered as an indication for MDT. Method: We retrospectively reviewed five legs with CLI (five male, one female) treated with MDT between January 2013 and December 2017. Changes in skin perfusion pressure (SPP) around the ulcer before and after MDT were evaluated. One or two cycles of MDT were performed (eight in total). We also evaluated the proportion of necrotic tissue in the ulcer and the presence of exposed necrotic bone. The proportion of necrotic tissue in the ulcer was classified as NT 1+ (75%). Results: When the proportion of necrotic tissue was >50%, with no exposed necrotic bone in the wound, an increase in SPP was observed after five (62.5%) of eight cycles of MDT. And with a proportion of necrotic tissue of Conclusion: Effective MDT with increased SPP requires an ulcerative state of necrotic tissue grade > NT 3+, with no exposed necrotic bone.

Cutaneous myiasis is an infestation of the skin by fly larvae, which usually occurs in adults. We present a case of cutaneous myiasis caused by Chrysomya megacephalain a 3-month-old infant with psoriasis vulgaris. In this case report, we highlight the clinical, histopathologic, taxonomic identification, and treatment of cutaneous myiasis occurring in psoriatic skin.

The aim of the study to find out low cast herbal preparation to control myiasis in pig. The pigs were examined for the presence of myiasis and Tamarind seed coat powder was prepared to control myiasis in pigs. A total 56 pigs (White Yorkshire and crossbred pigs) were examined for the presence of maggot infestation at Livestock Research Station, Kattupakkam, Kanchipuram district, Tamil Nadu. Overall prevalence of myiasis in pig was 48.21%. The efficacy of Tamarind seed coat (TSC) powder was carried out in 27 pigs which were naturally infested with maggot wound at Livestock Research Station, Kattupakkam, Tamil Nadu. In all the pigs, no maggots observed after 4-5th day after treatment with Tamarind seed coat powder and complete healing of the wound was noticed after 7-8th day, indicating the application of Tamarind seed coat was effective in treating maggot wound on pigs.

This study investigated the relationships between numbers of Delia species (Delia spp. Rob.-Desv., Diptera: Anthomyiidae) flies or eggs and root injury levels of Brassica napus L. and Brassica rapa L. (Brassicaceae) canola (oilseed rape), and between root injury levels and canola seed yields. Wild-collected Delia species adult flies or laboratory-obtained Delia radicum (L.) eggs were introduced into laboratory or field cages containing B. napus or B. rapa plants. The degree of root injury was strongly associated with infestation level using both flies and eggs. Linear response curves between numbers of Delia flies and root injury levels and quadrilinear response curves between numbers of D. radicum eggs and root injury levels showed that root damage increased with increasing levels of infestation; at high egg infestation levels, root damage levelled off in both Brassica species. Seed yield was not clearly related to fly or egg infestation rate, nor to ensuing root damage. No consistent yield relationship in B. napus ‘AC Excel’ was found with levels of root damage seen in the investigation. Conversely, B. rapa cultivar ‘AC Boreal’ seed yields tended to increase above uninfested controls when feeding damage was light but decreased with increased root injury. Despite procedures used to prevent infestation in Delia-free control cages, some root maggot damage was found in control cages in all 4 yr of the field study. Changes in climate, land use patterns, and cropping systems could influence the economic impact of this pest complex on canola in the future.

To present an overview of the advantages of maggot debridement therapy as a treatment for chronic wounds through the review of several larval properties.This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.After participating in this educational activity, the participant will be able to:1. Summarize the use, process, and precautions for maggot debridement to treat chronic wounds.2. Synthesize the results of the bibliographic review of the use of maggot debridement to treat chronic wounds.Maggot debridement therapy (MDT) is effective for ulcer debridement, achieving it in less time than other therapies. It offers a benefit to healing. However, it is unclear whether maggots reduce treatment time and there is considerable controversy around the treatment's potential antimicrobial action and cost-effectiveness. Nevertheless, it can be effective in preventing amputations and reducing the need for systemic antibiotics. This bibliographic review assesses the advantages of MDT as a treatment for chronic wounds through the review of several larval properties. The review was carried out by consulting biomedical databases including CINAHL, MEDLINE (PubMed), and Scopus, and concludes that MDT is an effective debridement and potential technique to facilitate healing. However, more data is needed on the wound type application frequency and the efficacy of treatment.Maggot debridement therapy (MDT) is effective for ulcer debridement, achieving it in less time than other therapies. It offers a benefit to healing. However, it is unclear whether maggots reduce treatment time and there is considerable controversy around the treatment's potential antimicrobial action and cost-effectiveness. Nevertheless, it can be effective in preventing amputations and reducing the need for systemic antibiotics. This bibliographic review assesses the advantages of MDT as a treatment for chronic wounds through the review of several larval properties. The review was carried out by consulting biomedical databases including CINAHL, MEDLINE (PubMed), and Scopus, and concludes that MDT is an effective debridement and potential technique to facilitate healing. However, more data is needed on the wound type application frequency and the efficacy of treatment.

The present study was carried out to evaluate the hematology, serum biochemistry, immune responses and oxidative damage of growing beagles fed a diet supplemented with housefly (Musca domestica) maggot meal (MM). Weanling beagles (initial body weight 2.69 ± 0.17 kg) were fed a control diet (0% MM) or experimental diet (5% MM) for 42 days. The results indicated that the diet supplemented with 5% MM had no significant effects on the hematology and serum biochemistry of growing beagles (P>0.05). Meanwhile, neither the serum concentrations of lysozyme and C-reactive protein nor the serum antibody responses to canine distemper virus and canine parvovirus were influenced by dietary MM supplementation (P>0.05). However, dogs in the experimental group had lower serum levels of malondialdehyde and protein carbonyl than those in the control group (P

Introduction: Myiasis is common in tropical regions, but now increasing incidence is seen in the west due to international travel. Otorhinolaryngological myiasis is uncommon and is seen in diabetics, alcoholics or patients unable in self-care.Objectives: To study presentations of otorhinolaryngological myiasis, identify associated risk factors and species of flies causing myiasis.Methods: Clinical findings and co-morbidities of 67 myiasis cases were noted. Maggots were identified, manually removed, and patients were managed with topical treatment, systemic ivermectin and antibiotics.Findings: Thirty-three nasal myiasis, 13 aural myiasis and 5 patients with oral myiasis were noted. Seven patients with head neck wounds myiasis and nine patients of tracheostome myiasis were recorded.Discussion: Warm humid climate of tropical regions is a major concern along with co-existing conditions like poor sanitation, alcoholism, psychiatric diseases and neuropathies. Hesitancy is seen in attendants and health care professionals to deal with myiasis.Conclusion: Awareness about risk factors is important in avoiding myiasis along with prompt treatment which reduces morbidity. Tracheostome myiasis is an under-documented entity rather than a rare presentation.Keywords: Myiasis, Ivermectin, screwworm, Chrysomya bezziana, Musca domestica, Lucilia sericata.Funding: None

Fournier's Gangrene is a fulminating necrotizing fasciitis of the perineum and genitalia. Standard treatment involves immediate excision of all necrotic tissue, aggressive antibiotic coverage, and supportive medical care. Still, the infection is commonly fatal or disfiguring. Wound treatment with disinfected blowfly larvae (maggot debridement therapy or MDT) has been shown to be highly effective, with multiple studies demonstrating effective debridement, disinfection, and promotion of granulation tissue. MDT also has been associated with preservation of viable tissue and minimised blood loss. This report describes a prospective clinical study of MDT for Fournier's gangrene aimed to test the hypothesis that early use of maggots could decrease the number of surgical treatments required to treat Fournier's gangrene. Subjects were provided with one initial surgical excision, followed by debridement using only medical grade Lucilia sericata larvae. Only two subjects were enrolled, both diabetic men. Intensive care and culture‐directed antimicrobial coverage were administered as usual. Maggot debridement was associated with the disappearance of necrotic tissue, control of infection and granulation tissue growth. In both subjects, wounds healed without requiring further surgical resection or anatomical reconstruction. Maggot therapy decreased the number of surgical procedures that otherwise would have been necessary, and led to favourable outcomes.

Myiasis is defined as follows; some flies lay their eggs and larvae on live organs and tissues or on cavities of nose, eye, ear and etc of humans or animals and the larvae develop there and cause pathological disorders. One of the rare types of myiasis is the urogenital myiasis. This condition has been associated with covering urogenital area with clothes in almost all populations and therefore, less chance for flies to reach this site and lay their eggs. Low socio-cultural level and poor hygiene conditions are stated as the most important risk factors of myiasis. On the other hand, toilets within the human living spaces are ideal environments for fly larvae that are fed on bacteria as they contain moisture and a microbial environment. It is stated that especially in case of the presence of an underlying infection, flies are more prone to lay their eggs or larvae on this area due to the bad smell. In this case report, a patient with a moderate sociocultural level with no underlying chronic disease, no open wound in the genital area and no urinary tract infection was presented. A 53-year-old female patient living with her family in an apartment flat in the city center of Konya admitted to the outpatient clinic of infectious diseases with the complaint of moving worms in her urine. The patient stated that she had seen maggots while urinating for two weeks and that she passed her urine into a container to be sure that the maggots were coming from her urine, upon seeing the maggots there she has admitted to the hospital. The Larvae were defined as the fourth stage larvae of Psychoda spp. No open lesions or wounds were seen in genitourinary area of the patient who had no complaints other than mild urinary burning. Complete blood count test results of the patient were normal and there was no growth in her urine culture. It was stated that other family members whom she lived with did not have similar complaints. The patient was diagnosed as genitourinary myiasis caused byPsychoda spp. and informed about the relationship between hygiene and the disease. And urinary antiseptics were initiated as the treatment for the patient. After the treatment, no larvae were seen in the urine of the patient. In conclusion, many regions are suitable for Psychoda type of adult flies to live in our country due to the climate conditions. It is considered that infestation may develop in patients with less risk factors in terms of urogenital myiasis, that larvae may increase in number of patients who are not treated or followed up and that the infestation may become chronic and results in more serious clinical conditions. The necessary treatment and follow-up must be performed in such cases and the patients should be educated about the relationship between infestation and hygiene.

Several chronic wounds require alternative therapy in addition to the conventional ones. Maggot therapy (MT) is one of these alternatives. MT is one form of animal-based treatment options known as Biotherapy (medicinal use of live organisms). MT or Maggot debridement therapy (MDT) is the medical use of live maggots for cleaning chronic, non-healing wounds or certain wounds that are not amenable to other forms of therapy. MT is achieved through maggots' secretion of proteolytic enzymes that liquefy the necrotic tissues and then feed on such tissues (wound debridement activity), wound disinfection (antimicrobial) activity and growth-promoting (wound healing) activity. MT has been used for centuries. Occasionally used since the 1930’s and early 1940’s and then in 2004, the Food and Drug Administration (FDA) approved maggots as a medical device that has been prescribed for patients in more than 200 hospitals in the United States. This article presents a review of published articles on the different aspects of MT (mainly the past and current uses, maggots used, how to apply maggots for wound treatments, advantages and disadvantages, problems and adverse reactions and its application in Egypt) that serves as a guide to health professionals who may be users of this form of treatment now and in the future

Growth performance, feed utilization, survival and body indices of African catfish Clarias gariepinus juveniles fed diets containing maggot meal as replacement of fish meal was evaluated for 42 days. Sixty fingerlings of Clarias gariepinus, average weight of 10 g were randomly distributed into six circular tanks at the rate of 10 fish per tank. There were two treatments, DT1(maggot meal-based diet) and DT2 (fish meal-based diet). The fish were fed twice daily. Water quality parameters were monitored on a weekly basis throughout the experimental period. Growth, nutrient utilization and body indices parameters were evaluated at the end of the experiment. Crude protein, crude lipid and ash were higher in the fish meal-based diet (34.65%, 7.33% and 18.03% in DT2 as against 28.70%, 7.20% and 11.0.1% in DT1 respectively), while crude fibre was higher in maggot meal-based diet. The selected water quality parameters: temperature, dissolved oxygen, ammonia and pH were slightly lower in maggot meal based treatment, but none of them was differently significant. Mean weight gain, specific growth rate, protein intake, protein efficiency ratio, lipid intake and lipid efficiency ratio (17.25±0.70 g, 2.39±0.06 %/day, 95.50±1.27 g, 1.81±0.06, 23.96±0.32 g and 7.20±0.24 respectively) were all significantly higher in DT2. The feed conversion ratio was higher significantly in DT1. Survival, hepatosomatic index and condition factor were similar between the two treatments. Though the aforementioned body indices indicated that the total replacement of fish meal with maggot meal is not harmful to the fish, a partial replacement may be better for optimum output

Arthropods collected off the corpse or at a crime scene can be used to determine the presence of toxins in a body at the death time. This study was planned and objected at examining the possible use of fly larvae as indicators for detecting rabbit poisoning with Warfarin rodenticide. For this, Warfarin was examined in blood samples of an intoxicated rabbit carcass and maggots that were collected off such remain using the High-Performance Liquid Chromatography. The blood of the intoxicated rabbit was positive. The maggots showed two different results: (1) Positive that may refer to the feeding of larvae upon the rabbit liver which retains the toxin for 90 days post-mortem and (2) Negative that may be due to that this toxin is highly degraded after 18 hours of ingestion while the maggots started to invade the carcass after 48 hours of death. The controls of both rabbit and maggots were negative. Our results confirmed the reliability of entomological specimens for qualitative analyses of the toxins.

Maggot therapy, also known as maggot debridement therapy, larval therapy, biodebridement, or biosurgery, is a type of biotherapy involving the intentional application of live, disinfected fly larvae or maggots into the nonhealing wound of a human or animal to debride the necrotic wound, reduce bacterial contamination of the wound as well as enhance the formation of healthy granulation tissue and stimulate healing in nonhealing wounds. In addition, van der Plas et al reported that the use of the medicinal larvae as natural remover of necrotic and infected tissue had prevented amputation in 11 selected patients. In Malaysia, Aaron et al had demonstrated prevention of amputation in 25 patients.

Skin wounds have been extensively studied as their healing represents a critical step towards achieving homeostasis following a traumatic event. Dependent on the severity of the damage, wounds are categorized as either acute or chronic. To date, chronic wounds have the highest economic impact as long term increases wound care costs. Chronic wounds affect 6.5 million patients in the United States with an annual estimated expense of $25 billion for the health care system. Among wound treatment categories, active wound care represents the fastest‑growing category due to its specific actions and lower costs. Within this category, proteases from various sources have been used as successful agents in debridement wound care. The wound healing process is predominantly mediated by matrix metalloproteinases (MMPs) that, when dysregulated, result in defective wound healing. Therapeutic activity has been described for animal secretions including fish epithelial mucus, maggot secretory products and snake venom, which contain secreted proteases (SPs). No further alternatives for use, sources or types of proteases used for wound healing have been found in the literature to date. Through the present review, the context of enzymatic wound care alternatives will be discussed. In addition, substrate homology of SPs and human MMPs will be compared and contrasted. The purpose of these discussions is to identify and propose the stages of wound healing in which SPs may be used as therapeutic agents to improve the wound healing process. Fil: Avila Rodríguez, María Isabela. Instituto Tecnologico de Monterrey. Escuela de Ingenieria y Ciencias.; México Fil: Meléndez Martínez, David. Instituto Tecnologico de Monterrey. Escuela de Ingenieria y Ciencias.; México Fil: Licona Cassani, Cuauhtemoc. Instituto Tecnologico de Monterrey. Escuela de Ingenieria y Ciencias.; México Fil: Aguilar Yañez, José Manuel. Instituto Tecnologico de Monterrey. Escuela de Ingenieria y Ciencias.; México. Scicore Medical SAPI de CV; México Fil: Benavides, Jorge. Instituto Tecnologico de Monterrey. Escuela de Ingenieria y Ciencias.; México Fil: Sanchez, Mirna Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto Multidisciplinario de Biología Celular. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto Multidisciplinario de Biología Celular. Universidad Nacional de La Plata. Instituto Multidisciplinario de Biología Celular; Argentina

Maggot therapy's success is partly due to the ingestion and killing of living microorganisms. The aim of this study was to investigate the antibacterial activities of maggots’ crude extracts (DMSO and PBS extracts) and excretion/secretion of Chrysomya albiceps (Diptera: Calliphoridae). The excretion/secretion (E/S) and crude extracts were collected from third larval instars of C. albiceps. The extracts were tested against Escherichia coli and Pseudomonous aeruginosa, as Gram-negative bacteria and Staphylococcus aureus and Bacillus subtilis as Gram-positive bacteria. Antimicrobial activity was done by calculating the reduction percentage of the colony's growth. The E/S was appeared the highest antibacterial activities against Gram-positive and Gram-negative bacteria, while the PBS extract has appeared the lower antibacterial activities. Generally, the E/S of C. albiceps maggot was found to be more effective as antibacterial agents than crude extracts (DMSO and PBS extracts).

A 2.5 year old dobermann bitch was presented to veterinary clinics with owner complaint of protrusion of mass through vulva since 10 days and it was in heat about 2 weeks ago and mated subsequently. The mass was contaminated with dust and dirt. On clinical examination, protruded mass was involved everted cervix and vagina with presence of maggot wound at ventral aspect. The prolapsed mass was thoroughly washed with antiseptic solution and removed maggots. The mass was proper repositioned and replaced by using glass test tube. Purse string sutures were applied around the vagina with cotton thread. The animal was treated with LH analogue, antibiotic, analgesic and laxative for 3-5 consecutive days.

The utilization of entomological specimens such as larvae (maggots) for the estimation of time since oviposition (i.e., egg laying) for post mortem interval determination, or for estimation of time since tissue infestation (in investigations of elder or child care neglect and animal abuse cases), requires accurate determination of insect species identity. Because the larvae of multiple species are visually highly similar and difficult to distinguish, it is customary for species determination of maggots to be made by rearing them to maturity so that the gross morphological features of the adult can be used to accurately identify the species. This is a time-consuming and resource-intensive process which also requires that the sample be viable. The situation is further complicated when the maggot mass being sampled is comprised of multiple species. Therefore, a method for accurate species identification, particularly for mixtures, is needed. It is demonstrated here that direct analysis in real time-high resolution mass spectrometric (DART-HRMS) analysis of ethanol suspensions containing combinations of maggots representing Calliphora vicina, Chrysomya rufifacies, Lucilia coeruleiviridis, L. sericata, Phormia regina, and Phoridae exhibit highly reproducible chemical signatures. An aggregated hierarchical conformal predictor applied to a hierarchical classification tree that was trained against the DART-HRMS data enabled, for the first time, multispecies identification of maggots in mixtures of two, three, four, five, and six species. The conformal predictor provided label specific regions with confidence limits between 80 and 99% for species identification. The study demonstrates a novel, rapid, facile, and powerful approach for identification of maggot species in field-derived samples.

Between 1996 and 2003 field studies were conducted in wild blueberry, Vaccinium angustifolium Aiton (Ericales: Ericaceae) to determine action thresholds for the blueberry maggot fly, Rhagoletis mendax Curran (Diptera: Tephritidae). Thresholds were based upon cumulative fly trap captures on baited Pherocon AM traps. The cumulative numbers of R. mendax flies captured over time was a significant predictor of infested fruit levels (maggots/liter blueberries). Fifty percent of the variance in fruit infestation is explained by fly captures. Based upon this relationship, the University of Maine Cooperative Extension has recommended action threshold of 10 cumulative fly captures/trap. However, this threshold is liberal in terms of risk as only 50% of the variance in fruit infestation is explained by fly captures. The dynamics of colonization rate and fly physiological status entering fruit-bearing fields might partially explain the variance in the action threshold. The majority of flies emerge from pruned fields or along forest scrub/shrub field edges, and it takes between 1 and 10 d (mean = 4.1 ± 0.9 d) for the populations to enter adjacent fruit-bearing fields. Flies dispersed from pruned fields at a decreasing rate the farther they dispersed. The rate of dispersal into fruit-bearing wild blueberry fields also depends upon the overwintering site quality. Sites with fruit exhibited both delayed colonization and lower colonization rates into fruit-bearing fields than adjacent pruned fields with no fruit. We also found that as the season progressed the proportion of flies capable of laying eggs varied greatly by location and year.

CASE DESCRIPTION A 3-year-old 27-kg female spayed American Bulldog with severe burn injuries caused by a gasoline can explosion was evaluated. CLINICAL FINDINGS The dog had extensive partial- and full-thickness burns with 50% of total body surface area affected. The burns involved the dorsum extending from the tail to approximately the 10th thoracic vertebra, left pelvic limb (involving 360° burns from the hip region to the tarsus), inguinal area bilaterally, right medial aspect of the thigh, and entire perineal region. Additional burns affected the margins of the pinnae and periocular regions, with severe corneal involvement bilaterally. TREATMENT AND OUTCOME The dog was hospitalized in the hospital’s intensive care unit for 78 days. Case management involved provision of aggressive multimodal analgesia, systemic support, and a combination of novel debridement and reconstructive techniques. Debridement was facilitated by traditional surgical techniques in combination with maggot treatment. Reconstructive surgeries involved 6 staged procedures along with the use of novel treatments including applications of widespread acellular fish (cod) skin graft and autologous skin cell suspension. CLINICAL RELEVANCE The outcome for the dog of the present report highlighted the successful use of maggot treatment and applications of acellular cod skin and autologous skin cell suspension along with aggressive systemic management and long-term multimodal analgesia with debridement and wound reconstruction for management of severe burn injuries encompassing 50% of an animal’s total body surface area.

Background Myiasis is caused by dipterous larvae, and rarely affects the mouth. Diagnosis by traditional means is easy to be confused with other similar species. Here, we report a case of oral myiasis, in a 5-month-old infant who was diagnosed by morphological examination and molecular biological methods. Case presentation A 5-month old infant with acute myeloid leukemia was admitted due to recurrent skin masses for more than 4 months. The infant had lip swelling, which prevented him from closing the mouth and membranes were present in his mouth and there were also oral ulcers and erosions. Ten maggots were found in the mouth and one in the ear canal with pus flowing out and were confirmed as the third stage larvae of Sarcophaga ruficornis by morphological examination and a comparison of sequence of cytochrome oxidase subunit 1 (COX1) gene. After removal of the maggots and chemotherapy, the infant ’s condition was gradually improved. Conclusions To the best of our our knowledge, this is the first neonatal oral myiasis case reported in China and its diagnosis requires a high index of suspicion. Microscopy combined with specific DNA sequence analysis is an effective technological tool to provide rapid diagnoses of the larva specimen and cases of rare diseases, as illustrated in the current case.

Background: Maggot debridement therapy (MDT), or the use of maggots in dead tissue removal, has been shown to be beneficial in wound healing. Yet MDT in the US is often only used once conventional debridement methods have failed. Method: In this study, nine health professionals, experienced in MDT, were interviewed in order to identify and analyse the perceived societal barriers to MDT acceptance and usage in the US. Results: Through qualitative analysis, using the grounded theory framework, this study found that among those interviewed, insurance reimbursement restrictions and stigmatisation of medicinal maggots were the factors driving resistance to MDT use. Conclusion: Specifically, the ‘yuck’ factor and the perception of MDT as an ‘ancient’ modality contributed towards MDT stigma; in addition, lack of outpatient insurance coverage deterred MDT use. These findings provide useful information regarding the perceptual and systemic barriers that prevent greater acceptance of MDT. Ultimately, these barriers must be understood if we are to facilitate MDT implementation and improve MDT usage in the future.

We present a case of a young woman with a mangled leg, that could be salvaged with a combination of negative pressure wound therapy, Matriderm® augmented split-skin grafting, and maggot biodebridement. The aim of this case report is to outline alternative treatment options in severe soft tissue injuries.

Salvage of a mangled limb can be a long and strenuous way, but it is feasible even with rather simple techniques such as augmented split‐skin grafting and maggot biodebridement.