Maggot Debridement Therapy: An Effective and Accessible Biotherapeutics

With an ageing population and increased prevalence in diabetic onset, predisposition to chronic wounds including bed sores and diabetic foot ulcers poses a challenging situation for severe wound care management. Maggot Debridement Therapy (MDT), the oldest form of medicine has now re-emerged to be a promising treatment modality for chronic wounds.

A biological tool, MDT serves as an alternative to surgical debridement. This involves the clinical use of sterile blowfly maggots to remove devitalized or necrotic tissues and reduce pathogen load. Topically applied to the chronic wound bed, this dressing facilitates better absorption, thereby providing an edge over existing interventions that lead to eventual amputations.

Available in 2 forms, caged and uncaged, this live biodressing utilises natural biochemical processes of the blowfly larvae to conduct debridement that is comparable or better than conventional techniques in reducing critical wound healing time window. Uniquely designed to be used in both inpatient and outpatient settings, the biodressing enable surgical level debridement bedside, revolutionizing wound care with their precision and versatility.

The technology provided include specifications on the operation of an ISO13485 laboratory, the Standard Operating Procedure (SOP) required for clinical usage of MDT as well as provision of training to the local clinicians on the use of MDT.

The technology provider is looking to work with medical companies as well as government/medical institutions that are looking to have their patients under MDT to improve surgical outcomes, reduce the strain on the healthcare team and minimize costs associated with chronic wound care.

• Provision of SOP, Risk Assessment of an ISO13485 certified laboratory and insectary for the development of biodressing as a medical device globally. 
• Required documentation for local country registration, as per medical regulations.
• Provision of training for staff on the management of laboratory and insectary as per international standards (ISO13485).
• Comprehensive clinical documentation consisting of the placement, management, usage, and disposal of maggots.
• Techniques on the identification of local blowfly species, collection from habitat and method of laboratory sterilisation provided.
• Provision of essential QA techniques for the verification of biodressing to be safe and pathogen-free during both manufacture and transportation.
• Providing training to clinicians on the appropriate use and management of the biodressing.

Clinical data obtained from the implementation of MDT shows promising patient outcomes and acceptance amongst the following:

• Patients deemed too high risk of surgery (i.e., poor blood supply)
• Diabetic patients with chronic wounds
• Non-healing wounds (i.e., ulcer injuries)
• Patients contraindicated for antibiotics

With MDT, we are able to drive down amputation rates and clinically acquired infections to prepare the wound bed for accelerated healing and reduce time spent at the hospital.

According to MarketsandMarkets, the global diabetes care devices market is poised to reach $4.3 Billion by 2025, growing at a CAGR of 16.2% from 2020 to 2025. With MDT, research studies have shown a threefold decrease in amputation rates. The effectiveness of MDT is evident through local clinical data that has demonstrated a limb salvage rate of 90.9% and a wound closure rate of 45.5% in a challenging patient population.

With timely medical assistance rendered, risk of amputations is reduced, leading to a higher life expectancy and the element of quality being restored in their lives with confidence and independence. 

• Maggots exhibits accuracy and precision in the preparation of chronic wound beds, where it indiscriminately feeds on the necrotic tissues while leaving the healthy intact.
• Clinical studies on maggot therapy have shown that wounds are cleaned up to 18 times faster when compared to conventional methods that has increased rates of human error.
• Available in 2 forms: Free Range Larvae and Baggots (Maggots are enclosed within a sterile pouch with pores in the dressing to provide direct contact between larvae and wound bed). 
• Secretions from maggots have been reported to help reduce chronic inflammation and speed up the healing process.
• Cycling between MDT and Negative Pressure Wound Therapy (NPWT), the rate of wound healing is optimised, while reducing inflammatory exudate and promoting tissue granulation.
• MDT has been proven beneficial for high-risk patients with chronic wounds that does not respond well to surgical/conventional modes of wound debridement. This is backed up by statistics that shows a successful debridement after 4 weeks of MDT while necrotic tissues were observed even after 5 weeks of conventional therapies.
• Able to reach areas that are a challenge to access mechanically.
• Can be administered on patients outside the confinements of a healthcare facility.