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 Maggot Debridement: A Natural Alternative to Antibiotics and Surgery As the author acknowledges, the thought of using maggots for wound cleansing is still a loathsome concept for many people. The author argues that maggot debridement therapy (MDT) is an effective alternative treatment for such soft-tissue wounds as pressure ulcers, venous stasis ulcers, diabetic foot ulcers, and particularly nonhealing postoperative wounds recalcitrant to other forms of wound care. MDT's origins are ancient, but it has been approved for use in the United States for more than 60 years and its use is currently increasing.This paper provides a history of the use of MDT, which includes several clinical trials. Clinical benefits appear to be based on three distinct and often simultaneous effects: debridement, disinfection, and promotion of wound healing. "Maggots produce these effects by liquefaction and removal of necrotic tissue; killing of bacteria by ingestion, digestion, and antibacterial secretion; and stimulation of healthy granulation tissue. Changes in the wound environment may further encourage growth, resulting from the maggots' secretions of such substances as calcium carbonate, allantoin, and urea. More recently, maggot proteolytic enzymes have been characterized in detail. Disinfection has been presumed to occur as a result of digestion, possibly combined with the secretion of antimicrobial molecules." The author concludes: "A great unrealized benefit of MDT exists in the outpatient community, where the attributes of this effective, simple, inexpensive, and non-physician-dependent treatment should make MDT a better choice than many currently available treatment options." Sherman RA. maggot febridement in modern medicine. Infectious Medicine, 1998;15(9), pp651-56.
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Date Last Modified - Monday, 27-Jul-2009 09:12:59 PDT
