Biotherapy

By Ron Sherman MD, MSC, DTM&H

This week I was asked about using maggot therapy for treating a tumor that eroded through the skin, causing a foul-smelling, necrotic draining wound. This is not an uncommon question, and it touches upon several important elements of biotherapy, as well as palliative wound care in general. This is also a timely subject because of the upcoming (third) Annual Palliative Wound Care Conference.

By Ron Sherman MD, MSC, DTM&H

Numerous controlled studies of maggot therapy have been published during the past 20 years, each one demonstrating equality or superiority over standard care methods for debridement. It is almost as though we are trying to compensate for the previous 60 years of extensive clinical use supported only by case histories, but no clinical trials.

By Aletha Tippett MD

Biotherapy is the use of living creatures for the diagnosis or treatment of a human ailment. Creatures most commonly used include service animals (such as guide dogs or therapeutic horses), fly larvae (maggots), leeches, honey bees, and even viruses (phages). How does this relate to us in the wound care community?

By Ron Sherman MD, MSC, DTM&H

As far back as 1930, clinicians and researchers had a pretty good understanding of what “the right kind of maggots” could do for a wound. Those maggots are now known generically as “medicinal maggots” or “medical grade maggots.” Largely as the result of careful observations by William Baer (Chief, Orthopedic Surgery, Johns Hopkins, Baltimore) and others, we now describe the beneficial effects of medicinal maggots as being: 1) debridement; 2) disinfection; and 3) growth promotion. What is the evidence for these effects, and why is it that the only brand of medicinal maggots cleared by U.S. Food and Drug Administration (FDA) for marketing in the US (Medical Maggots™ by Monarch Labs, Irvine, CA) lists only debridement among its indications?

By Ron Sherman MD, MSC, DTM&H

Although maggot therapy has been with us for nearly 100 years, many wound care specialists are still unfamiliar with it. Therefore, we should step back and briefly review the history and general concepts underlying maggot therapy, before delving into the recent scientific literature on this method of biotherapy.

By Ron Sherman MD, MSC, DTM&H

This being the first in a series of WoundSource blogs about biotherapies, it seems appropriate to use this opportunity to define the discipline of biotherapy. After all, even within the biotherapy community, the definition is still evolving.