Maggot debridement therapy in the treatment of nonhealing chronic wounds

Abstract

Background: Maggot therapy utilizes freshly emerged, sterile larvae of the common greenbottle fly, Phaenicia (Lucilia) sericata which secrete digestive enzymes that selectively dissolve necrotic tissue, disinfect the wound, and thus stimulate wound healing. Introduction: The purpose of this paper was to review the literature in an attempt to determine the efficacy of maggot debridement therapy (MDT) of skin ulcers (e.g. diabetic foot ulcers, venous stasis, osteomyelitis), with specific focus on assessing the healing time and amputation rate. Methodology: Efficacy was measured by comparing MDT to traditional treatment (i.e., antibiotics and surgical debridement). Level of evidence included case-control, cohort retrospective, retrospective, prospective control, non-randomized in-vivo, and report studies. Results: Overall results of the thirteen articles that met the inclusion criteria indicate that MDT healing time was equal to or significantly shorter and amputation rate was less than traditional treatment. Limitations: Limitations to these studies include minimal amount of subjects involved in each study, the inability to conduct randomized control studies and insufficient number of articles found. Conclusion: Preliminary studies confirm that MDT successfully accelerates debridement of long-standing chronic wounds leading to enhanced healing time and reduced amputation rates, making it a particularly safe and affective method in wound care.