Table 1.

List of analyzed works.

Author	Type of Work	Participants	Conclusion
Opletova et al. (2012) [21]	Randomized controlled trial	105 patients with lower leg ulcers ABPI ≥ 0.8, divided into two groups.	MDT showed no significant benefit on day 15 compared to conventional treatment. Debridement with MDT was much faster and took place in the first week of treatment. Another type of dressing should be used after 2 or 3 applications of MDT. Pain scores were similar and low in both groups.
Parajilio et al. (2021) [25]	Original article	Qualitative study via information provided by the Biotherapeutics, Education, and Research Foundation (BTER) website. Structured telephone interviews were conducted with nine healthcare professionals who use MDT.	Specifically, the ‘yuck’ factor and the perception of MDT as an ‘ancient’ modality contributed to MDT stigma; in addition, a lack of outpatient insurance coverage deterred MDT use.
Dumville et al. (2009) [26]	Randomized controlled trial	267 patients with mixed lower leg ulcers ABPI ≥ 0.6, divided into two groups.	Larval therapy did not improve the healing time of the lower leg ulcers or reduce the number of bacteria compared to the hydrogel, but it significantly shortened the time required for wound cleansing. An increase in pain sensations during MDT was noted.
McCaughan et al. (2015) [27]	Randomized controlled trial	18 people (12 men, 6 women) aged from 29 to 93 years (median age 64) with at least one venous leg ulcer. Most were willing to try the “worms” (larvae) and were able to overcome the feeling of disgust because they wanted to heal their wounds.	Patients may hold unrealistic expectations that larval therapy will effect a longed-for cure for their leg ulcer(s), but an absence of healing may lead to feelings of disappointment or despair.
Morozow et al. 2019 [28]	Original article	A total of 576 people were enrolled: 414 (72%) women and 162 (28%) men. Patients’ perception of the sight of maggots and larval therapy were assessed.	Maggots are repulsive to many people, and this may influence the acceptance of larval therapy.
Spilsbury et al. (2008) [29]	Original article	The preferences of 35 patients regarding the acceptance of two forms of larval therapy (“in biobags” and “loose”) were assessed.	Eliciting patient preferences and increasing their involvement in treatment decisions are important elements for improving quality and achieving better health outcomes. These findings have implications for practitioners offering larval therapy as a treatment option and for the feasibility of clinical trials.
Turkmen et al. (2010) [30]	Original article	Larval therapy was implemented in 34 patients with chronic wounds; in 29 (85%), satisfactory wound cleansing was observed. In the remaining five patients, failures occurred due to insufficient dressing sealing in two patients (6%), death of larvae in two patients (6%), and method intolerance in one patient (3%).	Larval therapy should be considered as a therapeutic option for the management of certain challenging wounds.
Przybek-Mita et al. (2022) [31]	Original article	The study group consisted of 290 nurses specialized in chronic wounds undergoing training out of an entire group of 1136 individuals participating in training courses organized in Poland in 2020–2021.	The level of perceived stress may influence decisions related to the use of biological therapy. The higher the level of stress, the lower the readiness to undertake MDT.
Hopkins et al. (2022) [32]	Original article	The first stage of this mixed-methods study was a focus group organized to discuss MDT and the opinions of specialist nurses. An anonymous online survey was then launched via Nursing Times and distributed on social media to all nurses. Finally, in-depth interviews were conducted with specialist and general nurses.	Nurses specializing in wound care choose MDT more often than nurses without experience in this field. Attention was paid to the need for nurse training to solve problems with acceptance and willingness to use this method in practice.
Nigam et al. (2022) [33]	Original article	In a group of 412 respondents regarding the acceptance of larval therapy, only 36% of the respondents agreed to accept larval therapy as a first-line treatment in the case of a hypothetical painful wound.	Study participants expressed concerns and fears related to the use of larval therapy. Positive associations were reported between knowledge scores and potential acceptance of larvae therapy, suggesting that information dissemination and education may be an important factor influencing public perception and acceptance of the method.
Mudge et al. (2014) [34]	Randomized controlled trial	88 patients with venous and mixed ulcers ABPI ≥ 0.5 divided into two groups.	Larval therapy cleansed ulcerative wounds faster than hydrogel. Patients in the larvae group experienced more discomfort and pain during wound cleansing compared to the hydrogel group.
Mumcuoglu et al. (2012) [35]	Original article	Of the 435 patients who underwent MTD, 165 (38%) reported increased pain. In five patients, treatment had to be discontinued due to uncontrolled pain.	A large percentage of patients treated with MDT reported increasing pain with each day of therapy. It is necessary to introduce painkillers when cleaning with larvae.