Maggot Therapy in Wound Care

No doubt, the word maggot can trigger a vagal reflex causing some people to gag at the mere mention of the word. But nature's critters have proven beneficial to healing of chronic/stalled wounds. They are well used in the UK, but it's acceptance in the US has been not as favorable even though Medical Maggots are regulated by the FDA. Nonetheless, if your doctor recommends medical maggot therapy (also called maggot debridement therapy, larvae therapy, biodebridement) for your wounds, here are a few things you should know:

Why maggots? Maggots do a great job eating away dead tissues while preserving healthy tissues. Additionally, they excrete an enzyme that stimulates tissue granulation, helping the wound heal faster. They are usually indicated in a chronic, poor healing wound that has failed other treatments. 

Will it hurt? In some, patients have complained of tingling and discomfort around the area. Usually a pain medication is sufficient to resolve the discomfort. I use maggot therapy in diabetic patients with neuropathy so they have no sensation at all and it doesn't bother them. 

How long is the treatment? Depends on the size & nature of the wound. Dressing changes occur every few days and the wound is evaluated. Treatment ends once the wound bed is deemed to be healthy for a skin graft or if there is no improvement over several weeks, indicating a change in the course of treatment is necessary.

What if they escape? Yes, this can happen but they now come in an encased polymer bag (see picture below). 

How do other people tolerate it? Initially, people are squeamish, but once they see how it is applied and give it a chance for a few days, it's not really all that bad. I'm transparent with my patients and tell them we're using everything in our arsenal to get the wound to heal and encourage them to give it chance. My goal is to prevent amputation, so many people understand that I'm doing all that I can to save their limb. There is no joy for me seeing my patients continue to suffer with a chronic wound.  

 Maggot or larvae therapy applied to chronic nonhealing wound, secured with tape around the perimeter. Expect a lot of drainage from the wound, this is from the enzymes they secrete. 

Maggot or larvae therapy applied to chronic nonhealing wound, secured with tape around the perimeter. Expect a lot of drainage from the wound, this is from the enzymes they secrete.