Table 4: Wound healing process and the alternative methods.

Elements of wound healingMethods

InflammationBactericidal and bacteriostatic effects on both aerobic and anaerobic bacteria through the action of the super oxide enzyme Antibacterial potential effect of alkaline pH of maggot secretion [77, 78]
Wound bacteria are killed as they pass through the maggot’s digestive tract
Presence of a potent bactericide present in maggot secretions
Cytokine regulation and enhanced phagocytosis [75]
Suppresses cytokine release and limits the amount of inflammation, interacting with macrophages to improve tissue healing
Enhances phagocytosis and chemotaxis [54]
Antimicrobial host defence enriched with growth factors and other active substances [83]

Granulated tissue formation—epithelializationIncreases epidermal cells and fibroblast proliferation and differentiation [29]The healing of wounds is an interactive process (regulators as growth factors, cytokines and chemokines) [42]
Synthesized and released locally proteins or polypeptides [42, 43]
Increases fibroblast proliferation through maggots excretions and secretions [75]
Influences on chemotaxis, mitogenesis, and differentiation
Promotes healing by stimulating fibroblast and keratinocyte proliferation
Promotes granulation tissue formation [55, 61] and epithelialisation

Matrix formations Increases fibroblast proliferation and collagen productionStimulates extracellular matrix and remodeling processes [45]Stimulates the deposition of extracellular matrix and collagen [56]

AngiogenesisThe oxygen gradient promotes the formation of new vessels required for wound healing [28, 35, 68]Growth factors, cytokines, and chemokines provide significant vasodilation and increased capillary permeability to the wound site, allowing the infusion of recruited polymorphonuclear leucocytes (PMNs) and macrophages [48, 84]Promotes new capillary growth [55, 56]

Animal models.