It has been known for centuries that wound myiasis of soldiers injured in battle improved survival and wound healing. Therapeutic myiasis, "maggot debridement therapy" (MDT), is still used around the world. However, veterinary use is uncommon, and there is little evidence supporting MDT. The Maggot Therapy Laboratory of the University of California, Irvine, provided disinfected maggots for clinical use by physicians and veterinarians. This paper reports on the experience of 8 veterinarians. A total of 20 patients (2 dogs, 4 cats, 1 rabbit, and 13 horses) were included. The most common reason for using MDT was to assist wound healing when conventional methods had failed. One problem with the therapy was the time and effort involved in applying the dressing so it could not be removed by the animal. However, experience reduced this concern and all the veterinarians surveyed said they would use MDT again. Better outcomes are seen in nonseptic animals, so MDT should be considered earlier rather than as a last resort.

COMMENTARY: In their acknowledgment, the authors commend the veterinarians that were willing to try MDT. Several of the animals were saved from euthanasia by the use of maggots. Clinical studies are warranted for this method of therapy to determine the optimal indications and contraindications to MDT. One of the biggest objections surely will be the "gross out" factor of many veterinarians and pet owners.

Treating wounds in small animals with maggot debridement therapy: A survey of practitioners. Sherman RA, Stevens H, Ng D, Iverson E. Vet J 173: 138-143, 2007.