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Background: Dating back to the mid‐1500s, maggot debridement therapy (MDT) has been a viable treatment modality for chronic wounds. In early 2004, the sterile larvae of Lucilia sericata received FDA approval for medical marketing for neuropathic, venous, and pressure ulcers, traumatic or surgical wounds, and nonhealing wounds that have not responded to standard care. However, it currently remains an under‐utilized therapy. The proven efficacy of MDT begs the question if this treatment modality should be considered as a first‐line option for all or a subset of chronic lower extremity ulcers. Objective: This article aims to address the history, production, and evidence of MDT and discuss future considerations for maggot therapy in the healthcare field. Methods: A literature search using the PubMed database was conducted using keywords, such as wound debridement, maggot therapy, diabetic ulcers, venous ulcers, among others. Results: MDT reduced short‐term morbidity in non‐ambulatory patients with neuroischemic diabetic ulcers and comorbidity with peripheral vascular disease. Larval therapy was associated with statistically significant bioburden reductions against both Staphylococcus aureus and Pseudomonas aeruginosa. Faster time to debridement was achieved when chronic venous or mixed venous and arterial ulcers were treated with maggot therapy versus hydrogels. Conclusions: The literature supports the use of MDT in decreasing the significant costs of treating chronic lower extremity ulcers, with emphasis on those of diabetic origin. Additional studies with global standards for reporting outcomes are necessary to substantiate our results. [ABSTRACT FROM AUTHOR]

This article discusses a case report of a 34-year-old female with chronic pyoderma gangrenosum (PG) and multi-drug-resistant pseudomonas infection. The patient had tried various topical and systemic treatments, including antibiotics, without success. Maggot debridement therapy (MDT) was then used to remove nonviable tissue and address microbial colonization. MDT resulted in a significant improvement in the wound, and subsequent negative pressure wound therapy (NPWT) further enhanced healing. The authors suggest that MDT can be considered as a safe and effective option for debridement in non-healing PG wounds with bacterial colonization or necrotic tissue. [Extracted from the article]

Maggot mortality among these solutions ranged between 33% and 46%, with Dakin's solution treatment associated with the highest mortality rate, suggesting the need for supplemental treatments to obtain complete clearance of wound myiasis.[5] The evidence to support a single most effective treatment strategy for wound myiasis is inconclusive. There remains a need for additional studies to establish the comparative efficacy of treatment modalities and to develop standard guidelines for the management of wound myiasis. Dear Editor, Wound myiasis, or maggot infestation, is a rare but serious complication of complex wounds and is most commonly seen in tropical and subtropical regions. [Extracted from the article]

AbstractBackground Fly maggots have been known for centuries to help debride and heal wounds. Maggot therapy was first introduced in the USA in 1931 and was routinely used there until the mid-1940s in over 300 hospitals. With the advent of antimicrobiols, maggot therapy became rare until the early 1990s, when it was re-introduced in the USA, UK, and Israel. The objective of this study was to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds and ulcers in long-term hospitalized patients in Israel. Methods Twenty-five patients, suffering mostly from chronic leg ulcers and pressure sores in the lower sacral area, were treated in an open study using maggots of the green bottle fly, Phaenicia sericata. The wounds had been present for 1–90 months before maggot therapy was applied. Thirty-five wounds were located on the foot or calf of the patients, one on the thumb, while the pressure sores were on the lower back. Sterile maggots (50–1000) were administered to the wound two to five times weekly and replaced every 1–2 days. Hospitalized patients were treated in five departments of the Hadassah Hospital, two geriatric hospitals, and one outpatient clinic in Jerusalem. The underlying diseases or the causes of the development of wounds were venous stasis (12), paraplegia (5), hemiplegia (2), Birger’s disease (1), lymphostasis (1), thalassemia (1), polycythemia (1), dementia (1), and basal cell carcinoma (1). Subjects were examined daily or every second day until complete debridement of the wound was noted. Results Complete debridement was achieved in 38 wounds (88.4%); in three wounds (7%), the debridement was significant, in one (2.3%) partial, and one wound (2.3%) remained unchanged. In five patients who were referred for amputation of the leg, the extremities was salvaged after maggot therapy. Conclusions Maggot therapy is a relatively rapid and effective treatment, particularly in large necrotic wounds requiring debridement and resistant to conventional treatment and conservative surgical intervention. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on maggot debridement therapy (MDT) in the healing of wounds.