title: The use of larval therapy to reduce the bacterial load in chronic wounds.
abstract: OBJECTIVE
  To ascertain the effect of larval therapy against bacteria associated with infected chronic wounds, and determine if larvae therapy actively reduces the bacterial load in chronic wounds.
  
  
  METHODS
  An extended literature review was undertaken using online databases: Athens, Medline, EMBASE, British Nursing Index and Allied and Complementary Medicine via OV ID and Cumulative Index to Nursing and Allied Health. Key terms were searched worldwide from 1950 to 2011.
  
  
  RESULTS
  Four themes emerged: Gram-positive and Gram-negative bacteria, MRSA, quorum sensing: biofilm consideration and bacterial burden. This suggests larvae debridement therapy is differentially effective against both Gram-positive and Gram-negative bacterial strains, namely Staphylococcus aureus, Pseudomonas aeruginosa and meticillin-resistant Staphylococcus aureus.
  
  
  CONCLUSIONS
  The evidence supports the use of antimicrobial properties of larvae therapy against the bacteria of infected chronic wounds.
  
  
  BACKGROUND
  There were no external sources of funding for this literature review. This paper is based on an independent study submitted as part of the BSc Health Care Studies, (Tissue Viability), University of Nottingham, UK. The authors have no competing or financial interest to declare and ethical approval and funding were not required to undertake the study.
authors.affiliation: Nottingham University Hospitals, UK. d-blue@hotmail.co.uk
authors.forename: D
authors.initials: D
authors.lastname: Blueman
authors.forename: C
authors.initials: C
authors.lastname: Bousfield
mesh_terms: D000818:Animals; D018441:Biofilms; D002908:Chronic Disease; D016905:Gram-Negative Bacterial Infections / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000628:therapy; D006801:Humans; D007814:Larva / Q000502:physiology; D055624:Methicillin-Resistant Staphylococcus aureus; D013203:Staphylococcal Infections / Q000628:therapy; D014946:Wound Infection / Q000382:microbiology*