A review of the use of maggots in wound therapy.

Chronic wounds have been defined as those that do not follow the orderly manner of healing, and thus do not achieve closure. Such wounds are notoriously difficult to treat and the number of treatments around attest to the fact that management of chronic wounds is not possible with one agent and definitely never achieves the most satisfactory results in a period short enough to satisfy the patient. Maggots had been used sparingly initially and are gradually finding their way into a more acceptable system of wound management. A review of some of the most relevant literature regarding maggot therapy makes it clear that some factors beg a final conclusion such as patient and physician factors regarding maggot therapy, care of larvae, the indications, benefits and precautions of maggot debridement therapy (MDT). MDT has been given the fashionable name of myasis or "bio-surgery." Maggots used in MDT are not the same as that of the house fly (Musculus sp.) but are now specially bred larvae of the Lucilia sericata species. These larvae have the property of not damaging healthy dermis and subcutaneous tissue but can destroy healthy epithelium; thus, epithelium protection is mandatory in MDT. Several of these factors will be discussed in the review of some of the most important literature available on maggots and their use to the wound specialty.