It has been known for centuries that the application of larvae is useful to heal certain
wounds by facilitating
debridement of necrotic tissue,(1) yet the efficacy of
larval therapy continues to be debatable. This study compared the clinical effectiveness of a
larval therapy dressing (BioFOAM) with a standard
debridement technique (Purilon gel;
hydrogel) in terms of time to
debridement of venous (VLU) or mixed arterial/venous (MLU)
leg ulcers. Data analyses were conducted on 88 subjects. Sixty-four subjects completed the full study. Of these, 31 of the 32 (96.9%) patients who completed treatment in the larvae arm debrided fully, compared with 11 of the 32 (34.4%) patients who completed the
hydrogel arm. In addition, 42 (48%)
ulcers fully debrided within the 21-day intervention phase, 31 (67.4%) from the larvae arm (n = 46), and 11 (26.2%) from the
hydrogel arm (n = 42), which was statistically significant (p = 0.001) in support of larvae. A statistically significant difference was also observed between treatment arms with regard to numbers of dressing changes during the intervention phase of the study (p < 0.001) in that subjects in the larvae arm required significantly fewer dressing changes(mean = 2.83) than those in the
hydrogel arm (mean = 5.40). There were no statistically significant differences in the clinical condition of the
wound bed and surrounding skin by intervention. Subjects in the larvae arm experienced more
ulcer-related
pain or discomfort than subjects in the
hydrogel arm (p < 0.001). This study provided good evidence to show that
larval therapy, in the form of a BioFOAM dressing, debrided VLU and MLU considerably more quickly than a
hydrogel, although the possibility of resloughing should be closely monitored.