Maggot therapy - Curing wounds using Maggot therapy

Maggot Debridement Therapy (MDT) or simply Maggot therapy is an ancient way of treatment of perpetual non-healingg wounds. In this therapy the live maggots (fly larvae) are used for cleaning non-healing wounds. Maggots remove only dead, or necrotic, tissue in a wound. Maggots are toothless and don't nibble. They secrete enzymes that liquefy dead tissue and have an antibiotic effect in the wound.

Origin and history of Maggot Therapy

The origin of Maggot therapy is unknown, but it is in place since ages. Historically, maggots have been known for centuries to help heal wounds. Many surgeons noted that soldiers whose wounds became infested with maggots did better and had a much lower mortality rate than did soldiers with similar wounds not infested.

How MDT the Maggot Therapy Works?

• Its mysterious - mystery still surrounds the unique way that maggots 'nurse' wounds as they actively consume dead tissue and fluids.
• As they cleanse the wound site the maggots exude an antibacterial agent that has a wide spectrum of activity against many resistant pathogens.
• They also possess diverse proteolytic enzymes, which are capable of digesting bacteria.
• The mechanical feeding of the maggots and the reduction of necrotic tissue changes the wound's environment from an acid to a more alkaline pH, which assists in stimulating healthy granulated tissue.

Contraindications and adverse reactions to maggot therapy

When we look at the ancient material and literatue of Maggot therapy, there is no significant risks or adverse events related to the clinical use of sterile maggots although there some minor reactions which are as below:

• Ammonia toxicity
• Pyrexia
• Pain and discomfort - This can vary from mild picking sensation to pain that is so severe that it leads to premature termination of the treatment.
• Bleeding - It has been reported that a very small proportion of wounds dressed with maggots show evidence of bleeding.
• Infection

Management required for Maggot Therapy

• In view of the patient's poor state of health and anticipated difficulties with skin grafting or flap reconstruction of the insensate, deformed foot, it was decided to commence maggot therapy four days post injury.
• Initial treatment included leg elevation and application of topical silver sulphadiazine ( Flamazine ) to soften the eschar.