O uso de larvas de dípteros (Arthropoda: Insecta) para o tratamento de lesões tegumentares: uma abordagem multissistêmica

Abstract

Wound healing is a complex process involving multiple biochemical and cellular events. It is estimated that approximately 60 million people worldwide suffer from chronic and difficult-to-heal wounds that can threaten life, inhibit functions and compromise appearance, for this reason may represent a major public health problem. The treatment of wounds can also be neglected with regard to domestic animals. The search for new treatment alternatives is therefore an important issue. In the context of wound healing, larval therapy (LT), which consists of the application of sterile larvae of necrophagous flies (Insecta, Diptera) reared in the laboratory, on wounds, is an inexpensive treatment with few contraindications and very promising results. The process of wound healing from LT is performed through three main actions: debridement, disinfection (against a wide range of microorganisms) and tissue remodeling. This study aimed at evaluating different strategies for the application of larvae or their products to promote the repair and antimicrobial treatment of wounds, both in the medical and veterinary fields. The specific objectives can be summarized as follows: (i) collect and compile information on wound treatments; (ii) assessing the viability, in vitro, and the implications of using Cochliomyia macellaria (Fabricius) (Insecta, Diptera, Calliphoridae) when combined with topical agents (honey, hydrogel, papain gel 10% essential fatty acids, collagenase or silver sulfadiazine) as a strategy to identify additive or synergistic combinations for tissue repair; (iii) to evaluate in vitro the antibiofilm and antioxidant activity of exosecretions (ES) of C. macellaria, Chrysomya megacephala (Fabricius) and Lucilia cuprina (Wiedemann) (Insecta, Diptera, Calliphoridae) on the bacteria Staphylococcus aureus and Pseudomonas aeruginosa; (iv) to evaluate in vivo the action of a formulated topical product containing C. macellaria ES with regard to tissue repair, antimicrobial and immunomodulatory properties; (v) to present an efficient and acceptable alternative for the treatment of small domestic animal wounds. The results recorded here show that: (i) there are several treatments for wounds, it is up to the professional, from the theoretical and technical knowledge to list the appropriate; (ii) the combined use of hydrogel or 10% papain gel and TL may be promising to enhance tissue repair; (iii) the ES of all tested species of blowflies present antioxidant potential and antibiofilm; (iv) the topical product containing ES of C. macellaria has an efficient cicatrizant action and can contribute to the tissue repair; (v) LT is a promising and efficient alternative for the treatment of infected wounds of domestic animals. Therefore, both larvae and their products can be effective therapeutic strategies to treat wounds.