Exploring the Effects of Lucilia sericata Larvae on Biofilm-forming Bacteria in Wounds

Objective: Biofilm-induced chronic wound infections are among the most significant causes of treatment failures. Healing chronic wounds with biofilm is a major issue worldwide due to high costs and adverse effects on patients. In this study, we aimed to investigate the impacts of Lucilia sericata larvae on biofilm-forming bacteria in chronic wounds. 
Method: We recruited 30 patients applying to Istanbul University-Cerrahpasa, Traditional and Complementary Medicine Research and Application Center, Wound Healing Unit, between December 2019 and March 2021. We obtained swab cultures before and immediately after applying Larval Debridement Therapy (LDT). After identifying isolated bacteria, we examined all agents by susceptibility and biofilm formation. 
Results: While isolating only a single bacterial genus/species in 19 patients, we could detect more than one bacterial genus/species in 11 of them. Moreover, we observed biofilm formation in bacteria isolated from 21 patients, but it was not the case in bacteria grown in 9 patients. Following LDT, we discovered that the biofilm layer on wounds was removed in a short time (two to three sessions). 
Conclusion: Although many methods are adopted in healing chronic wounds with biofilm formation, they often remain ineffective. The therapy with L. sericata larvae, a simple and effective method, may promote rapid healing of biofilm-forming wounds.