The use of maggots in wound debridement.

Since antiquity, clinicians have observed that maggots can provide debridement of necrotic wounds, but the therapeutic use has declined since the advent of aseptic wound management and antibiotics. In certain difficult wounds, the use of maggots for debridement may have a role. If so, the larvae must be prepared prospectively to control the bacterial population of the insect's intestinal tract and integument. The mechanism of wound debridement by maggots includes the secretion of proteolytic enzymes and antibacterial substances. A case of infestation of a necrotic wound in a patient with cancer of the head and neck is presented including the entomological identification and description of the maggots.