||Maggot Debridement Therapy (MDT), debridement means cleansing of a wound; especially the removal of dead, or "necrotic" tissue, is a form of "biological debridement."
Other names for maggot therapy include: larval therapy, larva therapy, and biosurgery.
Historically, maggots have been known for centuries to help heal wounds. Many military 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. William Baer, at Johns Hopkins University in Baltimore, Maryland, was the first physician (an orthopedic surgeon, actually) in the U.S. to actively promote maggot therapy; his results were published posthumously by his colleagues in 1931. MDT was successfully and routinely performed by thousands of physicians until the mid-1940�s, when its use was supplanted by the new antibiotics and surgical techniques that came out of World War II. Maggot therapy was occasionally used during the 1970s and 1980s, when antibiotics, surgery, and other modalities of modern medicine failed. In 1989, physicians at the Veterans Affairs Medical Center in Long Beach, CA, and at the University of California, Irvine, reasoned that if maggot therapy was effective enough to treat patients who otherwise would have lost limbs, despite modern surgical and antibiotic treatment, then we should be using maggot therapy BEFORE the wounds progress that far, and not only as a last resort.
Veterinarians are now using maggot therapy, too. Several recent studies have shown the benefits of MDT for treating serious wounds in small animals (like dogs and cats) and larger animals (like horses). MDT has been used most extensively for equine hoof and leg infections, but also for cleaning necrotic tumor in animals so as to clean the wound and eliminate the copious amounts of foul-smelling drainage.
Maggot therapy has three major actions:
1. Debridement, or cleaning, of the wound, by removing dead (necrotic) tissue;
2. Disinfection of the wound, by killing bacteria;
3. Promotion of wound healing.
MDT is administered as a dressing, using live fly larvae. Five to eight disinfected ("sterile") maggots, about 2mm in length, are placed on the wound in a sterile fashion; the wound is covered with a little gauze; and then covered by a dressing to keep the maggots from leaving the area. The dressing is usually removed one to three days later, depending upon how fast the maggots mature. When mature, the maggots will no longer digest (liquify) the dead, infected tissue. The dressing is then removed, and the wound can be rinsed. This "cycle" of MDT may need to be repeated, once or twice a week, until the wound is completely cleaned. Sometimes one application is sufficient; rarely, therapy may need to continue for several weeks, depending upon the size of the wound and the amount of necrotic tissue.
All maggots are not the same. Some maggots invade healthy tissue; others can digest only dead tissue. The maggots which have been used therapeutically, and described in the medical literature as being very safe and effective, include: Phaenicia sericata, Phormia regina, and Lucilia illustris.