Maggot debridement therapy in chronic wound care

Dominic CW Chan, Daniel HF Fong, June YY Leung, NG Patil, Gilberto KK Leung
Centre for Education and Training, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong

OBJECTIVE. To review the current evidence on the mechanism of actions and clinical applications of maggot debridement therapy.

DATA SOURCES. Literature search of PubMed and Medline was performed up to January 2007.

STUDY SELECTION. Original and major review articles related to maggot debridement therapy were reviewed. Key words used in the literature search were 'maggot debridement therapy', 'wound healing', and 'chronic wound management'.

DATA EXTRACTION. All relevant English and Chinese articles.

DATA SYNTHESIS. The mechanism of such maggot therapy was shown to be due to the debridement, disinfection, and wound healing enhancement actions of maggot excretions/secretions. The efficacy of maggot debridement therapy in chronic wound management has been demonstrated in chronic venous ulcers, pressure ulcers, and diabetic ulcers. There is also a new delivery system for the excretions/secretions, which has been shown to be as effective as using live maggots.

CONCLUSIONS. Maggot debridement therapy has been shown to be a safe and effective means of chronic wound management. However, there are a number of limitations when considering its local applicability. Future development of the delivery system may help to overcome some of these limitations and improve its acceptability.

Hong Kong Med J 2007;13:382-6

Key words: Debridement; Diptera; Larva; Wound healing; Wounds and injuries