[Biosurgery - maggots, are they really the better surgeons?]

Between 1 October 1996 and 31 December 1998 123 patients (74 men, 43 women) suffering from acute (n = 17) and chronic (n = 21) infections and chronic wounds (n = 85) were treated with sterile maggots (Lucilia sericata). In most patients the indication for the use of maggots was a failure to respond to standard therapy. Healing occurred in all patients with acute infections, and chronic infections showed excellent short-term results. In chronic wounds disturbances of healing in diabetics responded best to maggot therapy, the etiologically inhomogeneous group of leg ulcers asked for a polypragmatic approach, and the worst results were seen in chronic arterial occlusive disease (stage 4). Our limited experience with "biosurgery", biased selection of patients, and lack of late results reduce the significance of our data; nevertheless, sterile maggots seem to be an astonishingly workable tool for solving problems in surgical wound treatment.