[Maggots of Lucilia sericata in treatment of intractable wounds]

Although beneficial effects of wound infestation with maggots had been known for many centuries, it was not until dr Zacharias recognized medical importance of maggots during the American Civil War. He intentionally introduced maggots into the wound for its debridement. Baer successfully used maggots in treatment of osteomyelitis in 4 children in the 1930'. After many successes in the 1930' maggots therapy had become limited to intractable wounds after introducing sulphonamides and mass-production of Flemming's penicillin. Present use of maggots came in the 1980' when better methods of sterilization both eggs and maggot were developed and clinical efficiency of antibiotics used for wound treatment decreased dramatically. Today maggots' therapy became less treatment of last resort but of first choice in leg ulcers, carbuncules, pressure ulcers and infected traumatic wounds. Its beneficial effect was noted in diabetic foot and in destroying malignant tissue as well. Easiness in application, safety, near no side effects and often exceptional efficiency in wound debridement makes maggots therapy the first line therapeutic tool in both hospital and out-patient surgery. Clinical experience has demonstrated that maggot therapy may reduce costs of treatment considerably by shortening hospital stay and decrease usage of antibiotics.