A new dressing design for use with maggot therapy

Maggot therapy has been used since the 1930s for treating soft-tissue wounds. Despite decades of experience with this therapy, selecting appropriate dressing materials continues to be a problem. Before initiating our maggot therapy service, we needed to develop a dressing that would (1) prevent the maggots from escaping, (2) permit oxygen to reach the maggots, (3) facilitate drainage, (4) allow inspection of the wound, (5) require minimal maintenance, and (6) be of low cost. The optimal dressing design proved to be a two-layered cagelike dressing, the bottom layer of which comprised a hydrocolloid pad, applied to the surrounding healthy skin and covered by a fine chiffon or nylon mesh. Liquefied necrotic tissue drained through the mesh and was absorbed in a top layer of gauze, which was replaced periodically. Thus it was possible to contain the maggots within the wound by means of readily available materials.