Concept
Maggot therapy (also known as larval therapy) is a type of biotherapy involving the introduction of live, disinfected maggots (fly larvae) into non-healing skin and soft-tissue wounds of a human or other animal for the purpose of cleaning out the necrotic (dead) tissue within a wound (debridement), and disinfection. There is evidence that maggot therapy may help with wound healing. Maggot therapy improves healing in chronic ulcers. In diabetic foot ulcers there is tentative evidence of benefit. A Cochrane review of methods for the debridement of venous leg ulcers found maggot therapy to be broadly as effective as most other methods, but the study also noted that the quality of data was poor. In 2004, the United States Food and Drug Administration (FDA) cleared maggots from common green bottle fly for use as a "medical device" in the US for the purpose of treatment of: Non-healing necrotic skin and soft tissue wounds Pressure ulcers Venous stasis ulcers Neuropathic foot ulcers Non-healing traumatic or post-surgical wounds The wound must be of a type that can benefit from the application of maggot therapy. A moist, exudating wound with sufficient oxygen supply is a prerequisite. Not all wound-types are suitable: wounds which are dry, or open wounds of body cavities do not provide a good environment for maggots to feed. In some cases it may be possible to make a dry wound suitable for larval therapy by moistening it with saline soaks. Patients and doctors may find maggots distasteful, although studies have shown that this does not cause patients to refuse the offer of maggot therapy. Maggots can be enclosed in opaque polymer bags to hide them from sight. Dressings must be designed to prevent any maggots from escaping, while allowing air to get to the maggots. Dressings are also designed to minimize the uncomfortable tickling sensation that the maggots often cause.
