[3 case examples of intravital maggot infestations]

The authors report on three cases of myiasis which rarely occurs in the civilized world. Poor social conditions, old age, alcoholism, diabetes and vascular occlusive disease were predisposing co-factors. All three victims showed large necrotizing skin ulcerations, but in no case a generalized infection had developed. Therefore the probable benefit from the maggot infestation concerning these ulcerating skin lesions is discussed. For centuries clinicians have observed that maggots provide debridement of necrotic wounds particularly in Military Medicine. With the advent of antibiotics their therapeutic use declined. Recently "biosurgery" (syn. maggot or larval therapy) again became a promising tool for therapy of infected, necrotizing skin-ulcerations. Besides wound debridement marked anti-microbial activity and secretion of proteolytic enzymes could be detected. Maggot debridement is an valuable and cost-effective treatment option for patients with nonhealing wounds.