Maggot Debridement Therapy (MDT)

Editorial Team / Admin · Jun 23, 2015

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We moved your thread to the Nursing Student Assistance forum where you will receive replies.

GuEsT78 · Jun 23, 2015

I'd certainly feel squeamish, but I once heard a pediatric surgeon explain that maggots have exquisite taste in human flesh. They do something that it's hard for a surgeon to do, remove (yes eat) the dead flesh that needs to be removed while leaving living flesh intact.

This from a 2009 journal on diabetes:

The medical literature is rapidly growing with scientific evidence demonstrating the efficacy and safety of maggot therapy for a variety of problematic wounds. This article examines how these and other technologies are optimizing the study and application of maggot therapy for wound care.

Maggot Therapy Takes Us Back to the Future of Wound Care: New and Improved Maggot Therapy for the 21st Century

You can use the search bar on at the top of that page to locate other articles.

windsurfer8, BSN, RN · Jun 23, 2015

Do you know who is answering your question? It could be a 13 year old kid making stuff up on here. Any "data" you gather here is aboslutely worthless as you have NO IDEA who is answering. It could be a nurse...a psych nurse...a ICU nurse...wound care nurse...home health care...LPN. They could have been a nurse one day or 20 years. They may have not changed a dressing in their entire life. You are going to take data for a RESEARCH PAPER from a message board? Make sure you put on your paper where you gathered your information and see what kind of grade you get.

Here.I.Stand, BSN, RN · Jun 23, 2015

Have you checked CINAHL, PubMed, Google Scholar, etc? Answers to this thread would not be valid research. As windsurfer said, you can't know for sure who is answering, have no way to confirm our credentials. I could be a teenage Frank Abagnale type, here to learn the lingo so I can be more convincing at "work." For a more recent reference, remember that kid in FL who got caught pretending to be a PA?

How would you cite our responses--because improper citation=plagiarism. What would your instructor say about an AN message board citation on your reference page.

My suggestion--I want to help, I promise--is to go to those sites I listed above and do a search for scholarly research articles. You could try "Maggot debridement therapy," "patient response to mdt," "nurses and mdt," etc. and see where you get.

Tip--your school or even public library might have access to articles that your home search might say you have to pay for. Just ask the librarian to show you how to access them.

You could also try calling your area hospitals and ask to speak with their wound care RNs. That would be a verifiable interview. :up:

heron, ASN, RN · Jun 23, 2015

I went to school in the early seventies with a former Navy corpsman just out of the service. He talked about using maggots in naval hospitals to debride wounds. It would be interesting to get a look at their old manuals.

GuEsT78 · Jun 23, 2015

Do you know who is answering your question? It could be a 13 year old kid making stuff up on here.

How true! One of the most brilliant cartoons ever in New Yorker magazine, home of many brilliant cartoons, was one with a dog at a keyboard. The dog is telling another dog, "On the Internet nobody knows you're a dog."

https://en.wikipedia.org/wiki/On_the_Internet,_nobody_knows_you're_a_dog

Schools should do more to teach their students to doubt what they find on the Internet. For years, Wikipedia had an article about totally invented war. Even legitimate seeming, peer-reviewed science articles sometimes turn out to be bogus or badly done.

My post above was to a professional journal article hosted by the National Library of Medicine. There's a wealth of free information there that students should be taught to consult. A look for "maggot therapy" turned up almost 3,000 hits. Teachers shouldn't just unleash students with the thought, "Well, they'll be able to find what the need on Google." Yeah, along with all sorts of crazy stuff.

For those who'd like a starting place, here's the advanced search page for PubMed Central:

Advanced search - PMC - NCBI

Even if students can't follow the actual research, they can learn a lot of from the abstract.

There's even a free and a paid iPhone/iPad app for students on the go or nurses on the job.

PubMed On Tap

Notice this from the description: "PubMed On Tap is included in the Online LPN to RN guide to Terrific Apps Every Nurse Should be Using."

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Be careful about buying medical/nursing apps in general though. Some come up lacking. Despite rumblings from the FDA, there's no review process for them. Experts in a field don't need and thus don't buy or review them. Those who get them tend to be people who don't know enough to evaluate the app's accuracy.

I reviewed one on the iTunes Store in an area I understand well (childhood leukemia). It gave every appearance of being written by ill-paid pre-med students who were merely throwing something together from various medical manuals.

It left the impression that leukemia should be suspected in children who were white and had been exposed to radiation. White is so common, it means nothing. In 16 months on a Hem-Onc unit, I never cared for a child who'd gotten radiation in the past. In children, leukemia just happens. It should be suspected in any child who's got an infection that won't go away, that's feeling tired, that has unexplained bruising, or that's feeling joint pain. It infuriates me that an app intended for pediatricians wouldn't stress those warning signs.

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For the record, I am not a 13-year-old kid or a dog. I'm EMT-trained and a former nurse tech who worked on a Hem-Onc unit and with teens at a major children's hospital for over two years. I then did graduate work on medical ethics at the University of Washington's medical schoolâ€”studying law in a medical school I called it. Now I'm a writer on a host of topics, including those connected with with the quality of care in hospitals. I tend to look for new approaches to well-established problems.

And I've never seen maggots used as a treatment. That would be most interesting.

Esme12, ASN, BSN, RN · Jun 23, 2015

Welcome to AN! The largest online nursing community!

What the members say is true you never know who is online however we do help students....bear in mind we are not quotable/approved resource.

Maggot therapy has been used for generations....Maggots only eat decaying tissue leaving the healthy tissue

Maggot therapy is the controlled, therapeutic use of live blow fly larvae ("maggots") to treat skin and soft tissue wounds.
The history of maggot therapy, and the mechanisms by which it works, will be discussed below. But first, some disclosures:
In the United States, Medical Maggotsâ„¢ are regulated by the Food and Drug Administration as a prescription only medical device.
The Medical Maggotsâ„¢ brand of medicinal maggots are cleared by the FDA for marketing under the following indications: "for debriding chronic wounds such as pressure ulcers, venous stasis ulcers, neuropathic foot ulcers and non-healing traumatic or post surgical wounds."

Medical Maggotsâ„¢ (maggot therapy, maggot debridement therapy, MDT, biotherapy, biosurgery, biodebridement, larval therapy) | Monarch Labs - Advanced Wound BioSurgery

Esme12, ASN, BSN, RN · Jun 23, 2015

In maggot debridement therapy, germ-free ("disinfected") larvae of therapeutic fly species ("medical grade maggots") are used to treat and manage wounds in a procedure known as "maggot therapy." The maggots are applied to the wound for 2 or 3 days within special dressings to keep the maggots from migrating. Since medicinal maggots can not dissolve or feed on healthy tissue, their natural instinct is to crawl elsewhere as soon as the wounds are clean, or the larvae are satiated.
The scientific literature identifies three primary actions of medical grade maggots on wounds:
They debride (clean) the wound by dissolving dead and infected tissue with their proteolytic, digestive enzymes;
They disinfect the wound (kill bacteria) by secreting antimicrobial molecules, by ingesting and killing microbes within their gut, and by dissolving biofilm;
They stimulate the growth of healthy tissue.
The following topics about maggot therapy are detailed below:
History of maggot therapy
Current status of maggot therapy
Biology of flies and maggots

I have some stories where maggot therapy was useful.....I was a newish grad and we had a patient come in and was admitted (they admitted everything back then) with a foul smell from his case. Clearly he had bee itching inside his cast with a sharp tool. When the MD cut a hole ( a window) and revealed a pocket full of maggots......I thought I was going to pass out!!!!! :eek:

The MD left the maggots and the patient had the best healing of his wound.

A more remarkable story was a patient we had in ICU with severe inhalation burns. We could not oxygenate her for anything. One evening the nurse caring for her came out of her room with a startled look on her face and I had a suspicion......there was a fly in the patients mouth. We tried unsuccessfully to catch the fly and it ran down her air way......low and behold a few days later we were suctioning maggots out of her ETT tube!!! The surgeon said don't worry and cance3led her trach scheduled for the next day. Low and behold within 3 days her ABG's improved dramatically and that were able to decrease her settings....

Eventually she was extubated and went home. I was amazed. The surgeon said that the maggots only eat dead tissue and then die and is absorbed as protein.....who knew?

National Guideline Clearinghouse | Pressure ulcers: prevention and management of pressure ulcers.

nurseprnRN, BSN, RN · Jun 23, 2015

Not to undercut the very strong and entirely appropriate marching orders about finding real, verifiable sources IN THE NURSING LITERATURE.... but I just have to share a story. You can't quote it in your paper, though. :)

When I was a student I did a surgical rotation on an ortho floor in a VA hospital. We had a lot of old guys from WWII with osteomyelitis left over from their old war wounds. My guy was also an alcoholic who would occasionally fall asleep outdoors. The bandage would slip off his shin, exposing his draining tibial osteomyelitis. Flies would come, lay eggs, maggots resulted ... and his wound was never cleaner. He was mostly admitted in the winter when it was too chilly to be sleeping outside and there were fewer flies around. This had been going on for the better part of thirty years at that point.

joseyjo · Jun 23, 2015

Sorry, I guess I wasn't quite clear in my original post. I'm not wanting you guys to do my research for me, and I'm definitely doing my own research! In addition to research of scholarly journals, periodicals, books, websites,government documentation, etc, my research paper requires me to have two personal interviews. With this untraditional of a treatment I'm having a hard time finding people to interview. I was hoping that maybe someone on here had experience and I could interview them about their experience maggot therapy. Thank you to everyone who shared your stories. If any of you has personal experience with this therapy, and would be willing to let me interview you for my paper I would appreciate it!

JustBeachyNurse, LPN · Jun 23, 2015

Sorry, I guess I wasn't quite clear in my original post. I'm not wanting you guys to do my research for me, and I'm definitely doing my own research! In addition to research of scholarly journals, periodicals, books, websites,government documentation, etc, my research paper requires me to have two personal interviews. With this untraditional of a treatment I'm having a hard time finding people to interview. I was hoping that maybe someone on here had experience and I could interview them about their experience maggot therapy. Thank you to everyone who shared your stories. If any of you has personal experience with this therapy, and would be willing to let me interview you for my paper I would appreciate it!

Try calling a local wound care center or VA hospital you may find the interviewee you seek and make professional contacts good for the future!