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Maggot débridement therapy in outpatients

Archives of Physical Medicine and Rehabilitation
DOI: 10.1053/apmr.2001.24300
  • Debridement
  • Maggots
  • Outpatient
  • Rehabilitation
  • Medicine


Abstract Sherman RA, Sherman J, Gilead L, Lipo M, Mumcuoglu KY. Maggot débridement therapy in outpatients. Arch Phys Med Rehabil 2001;82:1226-9. Objective: To identify the benefits, risks, and problems associated with outpatient 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 training 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 satisfied with their outpatient maggot débridement therapy. Of the 8 patients who were advised to undergo amputation or major surgical débridement as an alternative to maggot débridement, only 3 required surgical resection (amputation) after maggot therapy. Maggot therapy completely or significantly débrided 18 (86%) of the wounds; 11 healed without any additional surgical procedures. There was anxiety about maggots escaping, but actual escapes were rare. Pain, reported by several patients, was controlled with oral analgesics. Conclusions: Outpatient maggot débridement is safe, effective, and acceptable to most patients, even when administered by nonphysicians. Maggot débridement is a valuable and rational treatment option for many ambulatory, home-bound, and extended care patients who have nonhealing wounds. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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