Maggot débridement therapy in outpatients

Arch Phys Med Rehabil. 2001 Sep;82(9):1226-9. doi: 10.1053/apmr.2001.24300.


Objective: To identify the benefits, risks, and problems associated with outpatient maggot therapy.

Design: Descriptive case series, with survey.

Setting: Urban and rural clinics and homes.

Participants: Seven caregivers with varying levels of formal health care training and 21 ambulatory patients (15 men, 6 women; average age, 63 yr) with nonhealing wounds.

Intervention: Maggot therapy.

Main outcome measure: Therapists' opinions concerning clinical outcomes and the disadvantages of therapy.

Results: More than 95% of the therapists and 90% of their patients were satisfied with their outpatient maggot débridement therapy. Of the 8 patients who were advised to undergo amputation or major surgical débridement as an alternative to maggot débridement, only 3 required surgical resection (amputation) after maggot therapy. Maggot therapy completely or significantly débrided 18 (86%) of the wounds; 11 healed without any additional surgical procedures. There was anxiety about maggots escaping, but actual escapes were rare. Pain, reported by several patients, was controlled with oral analgesics.

Conclusions: Outpatient maggot débridement is safe, effective, and acceptable to most patients, even when administered by nonphysicians. Maggot débridement is a valuable and rational treatment option for many ambulatory, home-bound, and extended care patients who have nonhealing wounds.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / methods*
  • Ambulatory Care / psychology
  • Ambulatory Care / standards
  • Ambulatory Care / statistics & numerical data
  • Animals
  • Attitude of Health Personnel
  • Attitude to Health
  • Bandages
  • Canada
  • Debridement / adverse effects
  • Debridement / methods*
  • Debridement / psychology
  • Debridement / standards
  • Debridement / statistics & numerical data
  • Female
  • Humans
  • Israel
  • Larva*
  • Male
  • Middle Aged
  • Patient Selection
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data
  • Risk Factors
  • Skin Ulcer / etiology
  • Skin Ulcer / physiopathology
  • Skin Ulcer / therapy*
  • Time Factors
  • Treatment Outcome
  • United States
  • Wound Healing
  • Wounds and Injuries / etiology
  • Wounds and Injuries / physiopathology
  • Wounds and Injuries / therapy*