Maggot therapy for foot and leg wounds.

Maggot debridement therapy has been used for more than 70 years to treat nonhealing soft tissue wounds. Blowfly larvae are used to debride, disinfect, and promote healing of chronic wounds. The use of maggot therapy is on the rise, owing to recognized limitations in our current medical and surgical wound care options. Anecdotal evidence of maggot therapy efficacy is plentiful, but large prospective comparative clinical trials are desperately needed. Until data from such studies become available, treatment criteria and safety data must be derived from retrospective studies, case series, and other published accounts. Based on these limited sources of data,treatment guidelines are proposed for the safe and effective use of maggots for treating problematic foot and leg wounds.