The work described in this thesis focussed on the modes of action of maggot therapy in chronic wounds, especially related to the inflammatory phase of wound healing. For this purpose, the effect of... Show moreThe work described in this thesis focussed on the modes of action of maggot therapy in chronic wounds, especially related to the inflammatory phase of wound healing. For this purpose, the effect of maggot excretions and/or secretions on microbiological, haematological and immunological processes was investigated. The results showed that maggot excretions/secretions breakdown biofilms of both Gram-positive and Gram-negative bacteria, exposing them to the immune system, antibiotics, and ingestion and subsequent degradation by the maggots. Furthermore, proteases in maggot secretions enhance debridement by increasing the fibrinolytic activity of wound components and by degrading matrix components directly. Additionally, maggot secretions inhibit the pro-inflammatory responses of phagocytes but do not affect their ability to ingest and intracellularly kill micro-organisms. Finally, secretions induce the production of growth factors essential for angiogenesis. In conclusion, the results described in this thesis provide new insights into the modes of action of maggot therapy in chronic wounds. The success of maggot therapy may be explained by the broad spectrum of processes that are modulated by maggot secretions. Show less
