Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in...

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Pros and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková 1 , Milan Kozánek 1 & Peter Takáč 1,2 1 Institute of Zoology, Slovak Academy of Sciences 2 Scientica, s. r. o. 8 th Central European Dipterological Conference 28.-30. september 2015 Kežmarské Žľaby, Slovakia

Transcript of Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in...

Page 1: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Pros and cons of the use of Lucilia sericata eggs in maggot

debridement therapy

Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

1 Institute of Zoology, Slovak Academy of Sciences2 Scientica, s. r. o.

8th Central European Dipterological Conference28.-30. september 2015 Kežmarské Žľaby, Slovakia

Page 2: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Maggot debridement therapy in modern medicine

- an established treatment option for non-healing wounds

- medicinally induced myiasis

-L. sericata larvae secrete a wide range of biologically active substances

Page 3: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Application of maggots

loose (free-range) bagged

Page 4: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Traditional preparation of larvae

Upon call from a doctor:

disinfection

sterility test

hatching on sterile medium

...

(overnight)

(overnight)

Page 5: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Traditional preparation of larvae

Upon call from a doctor:

disinfection

sterility test

hatching on sterile medium

...

It may take more than 48 hours to prepare and deliver the larvae to healthcare facility

(overnight)

(overnight)

Page 6: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Is there a way to speed up this process?

Page 7: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

When using L. sericata eggs:

Upon call from a doctor:

disinfection

sterility test

hatching on sterile medium

...

Page 8: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

When using L. sericata eggs:

Upon call from a doctor:

disinfection

sterility test

hatching on sterile medium

...

It would take 24 hours to prepare and deliver the larvae to healthcare facility

Page 9: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Aims

- to show that the growth of larvae would be comparable when using eggs compared to standard preparation of maggots

- to verify possibilities of storage

Page 10: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

- loose and bagged L. sericata eggs subject to simulated transport and incubation on pork at 35° C

bagged loose

Materials & Methods

Page 11: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

incubation on pork at 35 °C

Materials & Methods

Page 12: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

incubation on pork at 35 °C

Page 13: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

0

2

4

6

8

10

12

Containment type

Ma

gg

ot

len

gth

(m

m)

Results – larval growth after 48 h

maggots- loose

eggs- loose

maggots- bagged

eggs- bagged

Page 14: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

0

2

4

6

8

10

12

Containment type

Ma

gg

ot

len

gth

(m

m)

Results – larval growth after 48 h

maggots- loose

eggs- loose

maggots- bagged

eggs- bagged

Page 15: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Results – survival after storage at 7-8 °C

transp t+1d t+2d t+3d t+4d t+5d0

10

20

30

40

50

60

70

80

90

100

maggots (loose)

maggots (bagged)

eggs (bagged)

eggs (loose)

Storage treatment

Ma

gg

ot

surv

iva

l (%

) a

fte

r 4

8 h

incu

ba

tion

Page 16: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Eggs vs. larvae of L. sericata in wound treatment

Pros: Faster preparation

(24 h) Easier handling Longer shelf life

ConsNeed for rapid sterility testsSensitive to transport temperatureSensitive to wound conditions (moisture...)Egg chorions in wounds?

Page 17: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Conclusions

- L. sericata eggs are much more easier to prepare and use compared to maggots

- a number of problems need to be solved before introduction into clinical practise

Page 18: Lucilia sericata eggs in maggot debridement therapy and cons of the use of Lucilia sericata eggs in maggot debridement therapy Helena Čičková1, Milan Kozánek1 & Peter Takáč1,2

Thank you!This research was funded by the Operational Program of Research

and Development and confinanced with the European Fund for Regional Development (EFRD), Grant No. ITMS 26240220030: Research and development of new biotherapeuthic methods

and their application in the treatment of some illnesses.

„Podporujeme výskumné aktivity na Slovensku/Projekt je spolufinancovaný zo zdrojov EÚ“.