Using maggot therapy in the debridement of chronic wounds in Malta : pre- and post-intervention analyses

Abstract

The study evaluated the effectiveness of maggot therapy in the debridement of chronic wounds. The objective was to measure the reduction of slough or necrosis from leg wounds as well as evaluate the patient's incidents of pain and other adverse effects as a result of maggot therapy. Additionally, the efficacy of maggot therapy in promoting wound healing was also monitored. A prospective exploratory research design was conducted in Malta at Mater Dei Hospital and in the community setting. This was carried out on seven participants with eight chronic wounds being cared for by the Tissue Viability Unit (TVU) of Malta between September 2009 and January 2010. These participants consented to be involved in the study, where treatment with maggots was to be paid for by the participants themselves. Application of maggots was done either through the use of free range maggots or else through the use of Containment- Bag Maggot Dressing System (Biobag). The research tool for this study was adapted from a pre-tested tool by 'Zoobiotic Limited (Ltd.).' As part of this research tool, a numerical wound measurement guide was used to measure wound dimensions. Besides, a Likert Scale was utilised to measure pain while structured interviews were employed to inquire into the patient's general experience. Each subject was reviewed on the day the maggots were applied, on the day the maggots were removed and three weeks after. The study showed effectiveness in the application of maggot therapy on chronic wounds. Although a small sample was used for this study, indications of where maggot therapy is most beneficial were identified. Hence, it was concluded that maggot therapy was clearly designated in debriding chronic wounds and eliminating infections. Moreover, this study established that maggot therapy is highly effective and due to the lack of research on this medical field, demonstrated that further research is required to prove the cost effectiveness of such therapy.