title: [Effect of maggot therapy on minimally necrotic tissues: characterization of larval enzymatic excretion/secretion].
abstract: BACKGROUND
  Chronic leg ulcers are a burden for the health system and impact quality of life. The infections, the necrotic tissue and the difficult treatment affects the prognosis and healing time. Maggot therapy is presented as an acceptable alternative for the debridement and treatment of this pathology.
  
  
  OBJECTIVE
  The larval therapy was assessed on chronic leg ulcers with little necrotic tissue. Larval excretion and secretion (E/S) was characterized with respect to hemolymph (HL) enzymatic content. Materials and methods. Three patients with chronic leg ulcers and low necrotic tissue were treated with larval therapy and were assessed with the PUSH (pressure ulcer scale for healing) and Wound Bed Score. E/S and HL content was evaluated by SDS PAGE and zymogram.
  
  
  RESULTS
  The clinical aspect of the wounds showed improvement, and the scores demonstrated an average decrease of 2.3 for the PUSH and an average increase of 2.7 for the Wound Bed Score. A wide diversity of enzymatic activity in the E/S was demonstrated with major activity belonging to serine protease family.
  
  
  CONCLUSIONS
  Maggot therapy proved an effective treatment in cases with minimal tissue necrosis and can be considered a viable treatment option.
authors.affiliation: Grupo de Inmunología Molecular, Centro de Investigaciones Biomédicas, Facultad de Medicina, Universidad del Quindío.
authors.forename: Germán Alberto
authors.initials: GA
authors.lastname: Téllez
authors.forename: Mónica Alejandra
authors.initials: MA
authors.lastname: Acero
authors.forename: Luz Adriana
authors.initials: LA
authors.lastname: Pineda
authors.forename: Jhon Carlos
authors.initials: JC
authors.lastname: Castaño
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001691:Biological Therapy; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods*; D017719:Diabetic Foot / Q000473:pathology / Q000628:therapy*; D004175:Diptera / Q000201:enzymology / Q000254:growth & development; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D006458:Hemolymph / Q000201:enzymology; D006801:Humans; D019476:Insect Proteins / Q000032:analysis* / Q000378:metabolism; D007814:Larva / Q000201:enzymology*; D008297:Male; D009336:Necrosis; D059408:Pain Management; D010447:Peptide Hydrolases / Q000032:analysis* / Q000378:metabolism; D012720:Severity of Illness Index; D014647:Varicose Ulcer / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents; D019476:Insect Proteins; D010447:Peptide Hydrolases