Objective: To identify the benefits, risks, and problems associated with ou
tpatient 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 tr
aining and 21 ambulatory patients (15 men, 6 women; average age, 63yr) 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 sat
isfied with their outpatient maggot debridement therapy. Of the 8 patients
who were advised to undergo amputation or major surgical debridement as an
alternative to maggot debridement, only 3 required surgical resection (ampu
tation) after maggot therapy. Maggot therapy completely or significantly de
brided 18 (86%) of the wounds; 11 healed without any additional surgical pr
ocedures. There was anxiety about maggots escaping, but actual escapes were
rare. Pain, reported by several patients, was controlled with oral analges
ics.
Conclusions: Outpatient maggot debridement is safe, effective, and acceptab
le to most patients, even when administered by nonphysicians. Maggot debrid
ement is a valuable and rational treatment option for many ambulatory, home
-bound, and extended care patients who have nonhealing wounds.