Maggot debridement therapy in modern army medicine: perceptions and prevalence

Maggot debridement therapy (MDT), despite its long history and safety profile, finds limited use in the military health care system. Although new methods are continually being investigated to debride wounds more quickly and effectively, MDT remains largely a therapy of last resort. We evaluated the frequency of MDT in the Army sector of the MHS and the decision-making process surrounding its use. A 22 question survey of Army physicians was prepared and distributed through select Medical Corps Consultants in specialties likely to practice debridement. 83% of respondents were familiar with MDT, and of those familiar, 63% were aware of FDA approval for the product and 10% had used the product themselves. The three most frequently cited reasons for not using the therapy were no need (52%), no access (23%), and insufficient experience (19%). Informing the 37% of physicians who are not aware of FDA approval is an obvious target for program improvement. However, as many do not find a need for MDT, targeted improvements to MDT access and education for those physicians who encounter indications for MDT would permit them to apply MDT where there is an unmet need.