[The treatment of suppurative chronic wounds with maggot debridement therapy]

Maggot debridement therapy (MDT) is the intentional treatment of suppurative skin infections with the larvae of the fly, Lucilia sericata. Today, this treatment modality is being used in over 30 countries and during the last 20 years, more than 60,000 patients have been treated in 2,000 medical institutions. Sterile maggots, produced in university laboratories and by private industry, are usually applied to the wound either by using a cage-like dressing or a tea bag-like cage. During the therapy, the wound is debrided and disinfected. New layers of healthy tissue are formed and the tissue oxygenization improved. In the majority, the offensive odor emanating from the necrotic tissue decreased significantly. One of the side-effects is increased pain during the treatment. The use of non-sterile maggots could lead to septicemia. MDT was first introduced in Israel in 1996 and in 2002 in Turkey. Today, this method is being used in 16 hospitals in Israel and in Istanbul and Ankara in Turkey. In Israel, over 500 patients with approximately 750 wounds were treated; 87.3% of the wounds were located on the legs and 22.7% in the sacral region. One third of the patients were candidates for either an amputation or an important surgical intervention. Approximately 25-30% of cases with superficial, painful wounds complained of increased pain and they were treated with analgesics. A thorough debridement of the wound was achieved in about 80% of the cases. Studies conducted worldwide have shown that MDT is an effective, simple, quick and cost-effective treatment modality for the chronic wounds, unresponsive to surgical and other conventional methods.