title: Maggot debridement therapy: free-range or contained? An in-vivo study.
abstract: OBJECTIVE
  To determine which method of maggot debridement therapy--free-range or contained--is more effective for wound healing.
  
  
  METHODS
  In vivo study of 64 patients with 69 chronic wounds that showed signs of gangrenous or necrotic tissue. Patients were treated with either free-range or contained maggot debridement therapy according to maggot availability, dressing difficulty, and physician preference.
  
  
  RESULTS
  Significantly better outcomes were achieved with the free-range technique versus the contained technique (P = .028). With the free-range technique, the mean number of maggot applications and the total number of maggots per treatment were significantly lower than with the contained application technique (P = .028 and P < .001, respectively).
  
  
  CONCLUSIONS
  This clinical in vivo study supports in vitro studies in which containment of maggots was found to reduce the effectiveness of maggot debridement therapy.
authors.affiliation: Department of Surgery, Rijnland Hospital, Leiderdorp, The Netherlands.
authors.forename: Pascal
authors.initials: P
authors.lastname: Steenvoorde
authors.forename: Cathrien E
authors.initials: CE
authors.lastname: Jacobi
authors.forename: Jacques
authors.initials: J
authors.lastname: Oskam
mesh_terms: D000368:Aged; D000818:Animals; D002908:Chronic Disease; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D007814:Larva; D008297:Male; D009336:Necrosis / Q000628:therapy; D014945:Wound Healing; D014947:Wounds and Injuries / Q000473:pathology / Q000628:therapy*