The successful use of maggots in necrotizing fasciitis of the neck: a case report.
BACKGROUND
The use of maggots to digest necrotic tissue as a form of wound debridement has a long history in medicine. Necrotizing fasciitis of the neck has a high mortality rate despite aggressive surgical and medical intervention. The use of maggots in this disease has been reported only once before.


METHODS
We report the case of a 73-year-old woman, who underwent neck dissection and had necrotizing fasciitis of the neck develop shortly after. After initial surgical wound debridement, we used maggots as a biosurgical method for further debridement. A net containing 100 maggots (Biobag; BioMonde, Germany) was used.


RESULTS
Daily wound dressing showed rapid improvement of the wound; 4 days after beginning treatment, the wound was free of necroses.


CONCLUSIONS
In this case, we could avoid repeated surgical wound debridement with the use of sterile maggots. The frequently rapid progression of necrotizing fasciitis could be well controlled.
Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mainz, Langenbeckstr. 1, 55131 Mainz, Germany. simonpreuss@web.de
Simon F
SF
Preuss
Mark J
MJ
Stenzel
Anwar
A
Esriti
D000368:Aged; D000818:Animals; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003646:Debridement / Q000379:methods*; D004175:Diptera / Q000201:enzymology / Q000502:physiology*; D004322:Drainage / Q000379:methods; D019115:Fasciitis, Necrotizing / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007814:Larva; D053685:Laser Therapy; D009333:Neck / Q000473:pathology*; D037981:Neck Dissection / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000150:complications; D014062:Tongue Neoplasms / Q000601:surgery