Maggot therapy in the treatment of wounds of exposed knee prostheses

Wound Healing Dressings and Drug Delivery Systems: A Review

“…This is achieved by the secretion of proteolytic enzymes that liquefy necrotic tissue50 and allows them to absorb the dead tissue in a semi‐liquid form over the course of several days. In addition to removing necrotic tissue, maggots disinfect wounds by killing bacteria and also stimulate faster wound healing especially for chronic wounds 51–53. It has been suggested that maggots also stimulate the production of granulation tissue 54, 55…”

Clinical research on the bio‐debridement effect of maggot therapy for treatment of chronically infected lesions

“…Thomas et al . observed that maggots were effective in consuming necrotic tissue and exudation without damaging adjacent healthy tissue 23–25 . This is known as bio‐debridement or maggot debridement therapy: the maggots can be considered as street sweepers.…”

Not all maggots are created equal; not all maggots are therapeutic

“…Most potential hazards associated with maggot therapy are preventable, as long as adequate preparations are made and precautions taken. There are certainly risks with maggot therapy, as with all interventions; but many clinicians have demonstrated successful outcomes treating P. aeruginosa infections, 21 exposed tendons, 22 eschar, 14 open abdominal wounds, 14 pyoderma gangrenosum, 23 , 24 , 25 infected joints and joint prostheses, 22 , 26 , 27 thoracotomy wounds, 14 ischemic wounds, 28 , 29 , 30 , 31 , 32 and a whole host of other problematic wounds that no one would have dreamed of treating 20 years ago. That is not to say that MDT is always successful; it is not.…”