Supporting patient care, education, and research
in Biotherapy & symbiotic medicine
Maggot Debridement Therapy ("MDT")
Maggot Debridement Therapy (MDT) is the medical use of live maggots (fly larvae) for cleaning non-healing wounds.
In maggot debridement therapy
(also known as maggot therapy, larva therapy, larval therapy, biodebridement or biosurgery),
disinfected fly larvae are applied to the wound within special dressings.
Medical grade maggots have three primary actions: they clean the wound by removing dead and infected tissue ("debridement"),
they disinfect the wound (kill bacteria),
and they speed the rate of healing.
This page describes the following issues:
History of Maggot Therapy
Historically, maggots have been known for centuries to help heal wounds. Many military surgeons noted that soldiers whose wounds became infested with maggots did better --- and had a much lower mortality rate --- than did soldiers with similar wounds not infested.
There is strong evidence to suggest that wounds were intentionally infested with fly larvae by one or two confederate military surgeons during the American Civil War. But it was William Baer, at Johns Hopkins University in Baltimore, Maryland during the late 1920's, who first treated, studied, and published a sizable series of patients into whose wounds he applied maggots. Baer is also one of the first to recommend using specific species of blow flies, specially reared and disinfected for that purposed. Baer presented his findings at conferences; his results in 98 children with osteomyelitis were published posthumously by his colleagues in 1931.
MDT was successfully and routinely performed by thousands of physicians until the mid-1940's, when its use was supplanted by the new antibiotics and surgical techniques that came out of World War II. Maggot therapy was occasionally used during the 1970's and 1980's, but only when antibiotics, surgery, and modern wound care failed to control the advancing wound.
The first modern clinical studies of maggot therapy were initiated in 1989, at the Veterans Affairs Medical Center in Long Beach, CA, and at the University of California, Irvine, to answer the following questions:
The results of those early studies, and the many studies and reports that have followed, indicate that MDT is still useful today.
By 1995, a handful of doctors in 4 countries were using MDT. In 1996, the International Biotherapy Society was founded in Wales. Today, over 3,000 therapists are using maggot therapy in 20 countries. Approximately 30,000 treatments were applied in the year 2003.
In January, 2004, the U.S. Food and Drug Administration (FDA) issued 510(k) #33391, thereby allowing the production and distribution of "Medical Maggots" as a medical device. In February, 2004, the British National Health Service (NHS) permitted its doctors to prescribe maggot therapy. Patients no longer have to be referred to one of a few regional wound-specialty hospitals to get maggot treatments.
Maggot Therapy is saving Lives and Limbs
|Not all species of flies are safe and effective a medicinal maggots. There are thousands of species of flies, each with its own habits and life cycle. The flies used most often for this purpose called "blow flies" (Calliphoridae); and the species used most commonly is Phaenicia sericata, the green blow fly.||
Diagram of a typical blow fly life cycle.
Diagram of a typical blow fly life cycle.
Medicinal maggots have three actions: 1) they debride
(clean) wounds by dissolving the dead (necrotic), infected tissue;
2) they disinfect the wound, by killing bacteria;
and 3) they stimulate wound healing.
The current status of MDT practice is estimated to involve over 3,000 doctors, clinics, and hospitals in over 20 countries. In 2003, approximately 30,000 treatments were administered to an estimated 6-10,000 patients.
The application of maggot dressings is simple: maggots are contained in a cage-like dressing over the wound for 2-4 days. The maggots may be allowed to move freely within that cage, with the wound floor acting as the bottom of the cage; or the maggots may be contained within a sealed pouch, placed on top of the wound.
The BTER Foundation, in collaboration with community leaders, has just drafted a MDT Policies & Procedures template. for hospitals and clinics to use when writing policies for their facility. The template is available for free download.
For more details about the specific application procedures, readers are referred to the manufacturer's directions. A list of manufacturers can be found elsewhere on this site.
The BioTherapeutics, Education and Research (BTER) Foundation has produced a
workshop to train health care providers in the Principles
and Practice of Maggot Therapy.
The workshops are held in cities accross the Country, as invitations and co-sponsors
Participants learn the indications, contraindications, and techniques
of maggot therapy during this 6-hour didactic and practical ("hands-on")
The 7th International Conference on Biotherapy is coming up. To find out more, contact the International Biotherapy Society
We are in the process of assembling a searchable database of therapists who are available for contact. In the meantime, refer to the UC Irvine Maggot Therapy Project's listing of maggot therapists.
Anyone interested in assisting in this project is encouraged to contact the Foundation. Estimated time of completion: June, 2005.
Please contact the Foundation if you would like to be included on this list, and you use or would like to begin using maggot therapy, and are willing to be contacted by prospective patients or others.
Licensed health care providers can obtain medical grade maggots from the following sources:
17875 Sky Park Circle, Suite K
Irvine, CA 92614
Phone: +49 (0)40 6710 57-0
Units 2-4 Dunraven Business Park
Tel: 0845 2301810
Fax: 01656 668047
Japan Maggot Company
Hideya Mitsui, MD
Assistant Professor of surgery
Department of vascular Surgery
Okayama University Medical School
2-5-1 Schikata Okayama city,
Merilyn Geary, Laboratory Director
Department of Medical Entomology
Westmead NSW 2145
Phone: +61 (2) 9845 7548
Fax: +61 (2) 9893 8659
Dr. Tarek I. Tantawi
Department of Zoology
Faculty of Science
Moharrem Bey, Alexandria
Dr. Kosta Mumcuoglu
Department of Parasitology
Hebrew University - Hadassah Medical School
PO BOX 12271, 91120
Phone: + 972-2-675-8093
Fax: + 972-2-675-7425
When maggots infest humans or other vertebrates, it is called myiasis. Naturally-occurring myiasis can be beneficial to the host, but sometimes it is harmful. The type of maggot and the circumstances surrounding the infestation are factors that can determine whether the infestation will be mutually benefitial parasitic.
Maggots frequently furnish important legal information, and are used to help solve crimes, because their age, or stage of development, can indicate the time of death (or, more specifically, the "post mortem interval"); the presence of maggots or other insects on a body (live or dead) can also provide information about the location and/or circumstances of a crime. The study of maggots and other insects in this role is called Forensic Entomology.
A reference list appears below. For a list of internet resources and links, check out our
"Links" web page.