TIME management by medicinal larvae

Pritchard, David I. and Cerovsky, V. and Nigam, Y. and Pickles, S.F. and Cazander, G. and Nibbering, P.H. and Bultemann, A. and Jung, W. (2015) TIME management by medicinal larvae. International Wound Journal, 13 (4). pp. 475-484. ISSN 1742-481X

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Abstract

Wound bed preparation (WBP) is an integral part of the care programme for chronic wounds. The acronym TIME is used in the context of WBP and describes four barriers to healing in chronic wounds; namely, dead Tissue, Infection and inflammation, Moisture imbalance and a non-migrating Edge. Larval debridement therapy (LDT) stems from observations that larvae of the blowfly Lucilia sericata clean wounds of debris. Subsequent clinical studies have proven debriding efficacy, which is likely to occur as a result of enzymatically active alimentary products released by the insect. The antimicrobial, anti-inflammatory and wound healing activities of LDT have also been investigated, predominantly in a pre-clinical context. This review summarises the findings of investigations into the molecular mechanisms of LDT and places these in context with the clinical concept of WBP and TIME. It is clear from these findings that biotherapy with L. sericata conforms with TIME, through the enzymatic removal of dead tissue and its associated biofilm, coupled with the secretion of defined antimicrobial peptides. This biotherapeutic impact on the wound serves to reduce inflammation, with an associated capacity for an indirect effect on moisture imbalance. Furthermore, larval serine proteinases have the capacity to alter fibroblast behaviour in a manner conducive to the formation of granulation tissue.

Item Type: Article
Keywords: Chronic wound; Infection; Larval debridement therapy; TIME; Tissue regeneration
Schools/Departments: University of Nottingham, UK > Faculty of Science > School of Pharmacy
Identification Number: 10.1111/iwj.12457
Depositing User: Pickles, Samantha
Date Deposited: 18 Oct 2017 08:57
Last Modified: 18 Oct 2017 09:00
URI: http://eprints.nottingham.ac.uk/id/eprint/47335

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