Maggot debridement therapy in the palliative setting.
Success rates of Maggot Debridement Therapy (MDT) differ, but range from 70% to 80%. In this article it is argued that wound closure is not always feasible and is not always the aim of the treatment. A patient is described in whom the intent of MDT was not wound closure, but infection removal, reduction of odor, and eventually prevention of a below knee amputation. This succeeded: the pain was diminished, the odor reduced, and the wound showed signs of healing. Still the patient died. In maggot literature, as with other wound treatments, outcome is recorded as closed or as failed. In our opinion, MDT has other indications besides wound closure.
Steenvoorde
Pascal
P
Department of Surgery, Rijnland Hospital Leiderdorp, Netherlands. psteenvoorde@zonnet.nl
van Doorn
Louk P
LP
Jacobi
Cathrien E
CE
Oskam
Jacques
J
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000818:Animals; D003646:Debridement / Q000379:methods*; D017809:Fatal Outcome; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D017053:Infection Control; D007814:Larva; D007871:Leg Ulcer / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D009426:Netherlands / Q000453:epidemiology; D009812:Odorants; D010166:Palliative Care / Q000379:methods*; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing; D014946:Wound Infection / Q000517:prevention & control