Decubitus ulcers

A clinical trial of MDT was developed for the treatment of pressure ulcers of the sacrum, ischium, and lower extremities in patients with spinal cord injuries. Sherman reported that the maggot therapy debrided the wounds faster than any of the other non-surgical treatments and speeded overall healing.

Eight wounds were treated conventionally for 3 to 4 weeks before initiating maggot debridement therapy. These were stage 2 to stage 4 ulcers and were necrotic wounds of 5 cm to 30cm in surface area. Ulcers treated with MDT were successfully debrided within 10 days compared to conventional treatments, which took 28 days.

The ulcers had been increasing in surface area by an average of 21.8% per week despite conventional treatment, but within 6 weeks or less after the initiation of MDT, the surface areas of the ulcers were decreasing on average 20% per week. Clearly, maggot therapy was the more successful treatment when compared to conventional strategies for ulcer care. Additionally, a study of elderly patients with various ulcers, including pressure ulcers, showed similar results.

The total length of treatment can vary depending upon a number of variables, such as the size and character of the wound. Sherman reported that complete debridement of most pressure ulcers required 2 to 6 cycles of maggot therapy. Thick eschar takes longer to dissolve than moist necrotic tissue; tough fibrous tissue takes longer yet. In some cases, surgical debridement of thick eschar may precede maggot debridement therapy.


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