Correspondence to: Michelle L. Maggot debridement therapy MDT is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients. None of the patients refused MDT due to aversion of this treatment modality and the majority of patients had minimal discomfort. In 17 of 23 patients with multiple co-morbidities, the treatment of their complex diabetic wounds by MDT resulted in improvement or cure.
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Correspondence to: Michelle L. Maggot debridement therapy MDT is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients.
None of the patients refused MDT due to aversion of this treatment modality and the majority of patients had minimal discomfort. In 17 of 23 patients with multiple co-morbidities, the treatment of their complex diabetic wounds by MDT resulted in improvement or cure. Maggot debridement therapy is an effective treatment of diabetic wounds. Introduction Patients with diabetes have difficulty healing wounds. This is especially true in the elderly whose numbers are increasing, resulting in rising cost for the delivery of health care.
The annual cost to manage these wounds exceeds 20 billion dollars, 1 with a loss of over two million work days. Maggot Debridement Therapy MDT has been infrequently used in the last 60 years due to improved dressings, new surgical techniques, and the surge of new antibiotics to treat non-healing wounds when they become infected. However, uncontrolled diabetics were excluded from the study. Methods Patients with diabetic wounds were evaluated for MDT and written consent for treatment was obtained.
Each vial contained — maggots that were viable long enough for two MDT treatments. Approximately 40—50 maggots were carefully inserted into the wound bed with a sterile Q-tip and gauze moistened with saline was applied on top of the maggots.
A bulky dressing was applied over the wound.
Maggot Debridement Therapy in the Treatment of Complex Diabetic Wounds
Disinfection of the wound  Stimulation of healing  Debridement[ edit ] In maggot therapy, large numbers of small maggots consume necrotic tissue far more precisely than is possible in a normal surgical operation, and can debride a wound in a day or two. They derive nutrients through a process known as "extracorporeal digestion" by secreting a broad spectrum of proteolytic enzymes  that liquefy necrotic tissue, and absorb the semi-liquid result within a few days. Secretions from maggots believed to have broad-spectrum antimicrobial activity include allantoin , urea , phenylacetic acid , phenylacetaldehyde , calcium carbonate , proteolytic enzymes, and many others. The infestation by maggots of live animals is called myiasis. Some maggots will feed only on dead tissue, some only on live tissue, and some on live or dead tissue. The flies used most often for the purpose of maggot therapy are blow flies of the Calliphoridae : the blow fly species used most commonly is Lucilia sericata , the common green bottle fly.
Maggot debridement therapy
Patient with 20 year history of an ulcer on his ankle Maggot debridement therapy is a safe and very effective method for treating poorly healing wounds. Here is an example of an ulcer on the ankle of a 59 year old man. He came into my practice after consulting many other doctors who had prescribed antibiotics or who diagnosed it as a venous stasis ulcer. The patient first developed a wound on the medial malleolus of his right ankle when he was a young child riding in the basket of a bicycle. The medial malleolus is the protruding part on the inside of the ankle which is part of the tibial bone.
In maggot debridement therapy also known as maggot therapy, larva therapy, larval therapy, biodebridement or biosurgery , disinfected fly larvae are applied to the wound for 2 or 3 days within special dressings to keep them from migrating. The literature identifies three primary actions of medical grade maggots on wounds: 1. They clean the wounds by dissolving dead and infected tissue "debridement" ; 2. They disinfect the wound kill bacteria ; 3.