Maggot therapy for wound debridement: a randomized multicenter trial.

ABSTRACT

OBJECTIVE: To study the efficacy of bagged larvae on wound debridement compared with conventional treatment. DESIGN: Randomized, multicenter, controlled, prospective phase 3 trial with blinded assessment of outcome measures by a single observer. SETTING: Two hospital referral centers in Caen and Lyon, France. PATIENTS Random sampling of 119 patients with a nonhealing, sloughy wound 40 cm(2) or smaller, less than 2 cm deep, and an ankle brachial index of 0.8 or higher. INTERVENTION During a 2-week hospital stay, patients received either maggot debridement therapy (MDT) or conventional treatment. At discharge, conventional dressings were applied and a follow-up visit occurred at day 30. MAIN OUTCOME MEASURE: Percentage of slough in wounds at day 15. RESULTS: There was a significant difference between groups at day 8 (54.5% in the MDT group and 66.5% in the control group) (P = .04). The mean percentage of slough at day 15 was 55.4% in the MDT group and 53.8% in the control group (P = .78). CONCLUSIONS: Although MDT shows no significant benefit at day 15 compared with conventional treatment, debridement by MDT is significantly faster and occurs during the first week of treatment. Because there is no benefit in continuing the treatment after 1 week, another type of dressing should be used after 2 or 3 applications of MDT. TRIAL REGISTRATION clinicaltrials.gov Identifier NCT01211236.