Maggot debridement therapy: a case study.

A 59-year-old woman arrived at Vancouver General Hospital after a motor vehicle accident in which she sustained massive degloving injuries to both lower extremities. Due to her faith (she is a Jehovah's Witness), traditional interventions such as surgical debridement and revision were not possible and consent to receive blood products was not provided. WOC nursing was consulted at the request of the family to utilize maggot debridement therapy (MDT) to treat her necrotic lower extremities. Initially, the use of the Lucilia sericata larvae (maggots) was viewed as a last effort to save the patient from septicemia while awaiting surgery. However, after MDT was applied once a week for a period of 6 weeks, both legs were rendered free of necrotic tissue. The patient is now free of infection and awaiting surgery for placement of skin grafts over healthy granulation tissue achieved after MDT.