Maggot therapy in Pretoria, South Africa: an update

Abstract

Maggots are known to clean wounds by removal of slough and dead tissue. This was put to therapeutic use in the last century between the great wars, where it was in use in at least 300 hospitals in the United States being prescribed by at least 1 000 physicians. Antibiotic use replaced it for a while, but resistance caused a renewed interest in maggot debridement therapy. Maggot treatment works on three levels by debriding dead and necrotic tissue with a process of 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 high risk candidates for general anaesthesia, and also when a shortage of beds in the hospital prevents admission for inpatient treatment. Since a private company became interested in rearing maggots, the treatment is now also available to a wider group of patients who may need debridement.