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Maggot therapy for wound débridement found effective only in first week

Maggot wound débridement therapy is significantly faster than conventional treatment but only during the first week, according to a recent study.

Researchers in France conducted a randomized, multicenter, controlled, prospective phase 3 trial at two hospital referral centers. Study patients — a random sampling of 119 individuals with an ankle brachial index of 0.8 or greater — each had a nonhealing, sloughy wound 40 cm² or smaller and less than 2 cm deep. Patients received either maggot débridement therapy (MDT) or conventional treatment. Conventional dressings were applied before patients were discharged after two weeks.

The mean slough percentage was not significantly different between groups (51 received MDT and 54 received conventional treatment) at days 1, 15 and 30. But at day 8, the difference in the slough percentage was significant between the MDT and control groups (MDT, 54.5%; control, 66.5%; P=.04).

“Maggot therapy is easy, efficient and not operator dependent,” researcher Anne Dompmartin MD, PhD, of Centre Hospitalier Universitaire de Caen, Caen, France, told Healio.com. “And wound care takes less time than nurse débridement.”

The researchers said further studies are needed to determine if débridement could be improved by using more maggots in the dressing and whether those dressings would be more painful to patients. They also noted that because there is no benefit in continuing the treatment after 1 week, another type of dressing should be used after two or three applications of MDT.

“Contrary to in vitro studies, [MDT] has no effect on wound closure,” Dompmartin told Healio.com. “The patients accepted this treatment very well and were not disgusted at all.”

The FDA approved medical maggots in 2004 as a device prescribed by physicians.