The utilisation of maggot debridement therapy in Pretoria, South Africa

Abstract

Maggots are known to clean wounds by removing slough and dead tissue. This was put to therapeutic use in the last century, between the world wars, when it was in use in at least 300 hospitals in the United States and being prescribed by at least 1 000 doctors. Antibiotic use replaced it for a while, but the emergence of antibiotic resistance has led to a renewed interest in maggot debridement therapy. Maggot treatment works on three levels: debriding dead and necrotic tissue by extracorporeal digestion, disinfection by the secreted enzymes and the stimulation of wound healing. We have access to a maggot laboratory at the Steve Biko Academic Hospital in Pretoria, where maggot therapy is frequently used to debride and clean wounds. The results are at least comparable to other modalities of wound debridement, and can be used on patients who are highrisk candidates for general anaesthesia, and also when a shortage of beds in the hospital prevents admission for inpatient treatment.