Maggot therapy takes us back to the future of wound care: new and improved maggot therapy for the 21st century

Abstract

In the 21st century, eighty years after William Baer presented his groundbreaking work treating bone and soft tissue infections with live maggots, thousands of therapists around the globe have rediscovered the benefits of maggot therapy. The renaissance in maggot therapy is due in large part to recent technological advancements that have solved or minimized many of the treatment's earlier drawbacks: the need for reliable access to this perishable medical device, simplified application, and low-cost production. Modern dressing materials have simplified the procedure and minimized the risk of escaping maggots. The establishment of dozens of laboratories throughout the world, along with access to overnight courier services in many regions, has made medicinal maggots readily available to millions of people in need. Studies show that fears of patient nonacceptance are unfounded. The medical literature is rapidly growing with scientific evidence demonstrating the efficacy and safety of maggot therapy for a variety of problematic wounds. This article examines how these and other technologies are optimizing the study and application of maggot therapy for wound care.

Figure 1.

Le Flap™ (Monarch Labs, LLC, Irvine, CA), a single-piece, dual-layered, hinged maggot confinement dressing, keeps the maggots in place but provides complete access to the wound bed below. After cutting a wound-size hole in the hydrocolloid layer and placing maggots onto the wound, the adherent top netting is gently folded over the hydrocolloid frame. Photo furnished by Monarch Labs, LLC (Irvine, CA).

Figure 2.

Medicinal maggots being applied to a diabetic foot wound. Maggots are held in place by a nylon stocking, which is here being glued to a strip of hydrocolloid, just proximal to the plantar wound. Excess stocking is trimmed, and a frame of tape is placed to further secure the cage-like dressing. Photo furnished by BTER Foundation.

Figure 3.

One example of the maggot containment dressing is the Biobag™ (BioMonde Laboratories, Barsbüttel, Germany). The polyester net pouch completely surrounds and contains the maggots. Available in various sizes. Photo furnished by BTER Foundation.