Wound Care: Maggot Debridement Therapy

Maggot debridement therapy (MDT) has long been used to treat various wounds or ulcers. Although the mechanisms underlying MDT are not completely understood, laboratory studies have clarified the various effects of larval secretions/excretions. The most noticeable change in maggot-treated wounds is debridement. Other characteristics include microbial death (disinfection) and accelerated wound healing (growth stimulation). Recently, it has been reported that the amino acid-like compounds present in maggot excretions/secretions may mediate wound healing by stimulating angiogenesis. In the clinical setting, MDT for critical limb ischemia has been reported to lead to an increase in skin perfusion pressure, which serves as an index of peripheral circulation in the skin and subcutaneous tissue. Laboratory and clinical findings to date suggest that ischemic ulcer is a good candidate for MDT.