Abai, MR

6th International Congress of DipterologyMaggots to the Rescue: Using maggot therapy for woundsin hospice patientsTippett, A.W.Wound Consultant; Medical Director, Hospice of Southwest Ohio, Cincinnati, OhioIntroduction: Wounds are a problem that affect over 1/3 of hospicepatients (Tippett, AW. Wounds at the End of Life. Wounds, April 2005),and often these wounds are severe, with various causes: ischemic, pressure,diabetes, trauma and surgical. Many times debridement of the wounds isindicated, due to infection, sepsis, pain, necrosis, or gangrene, but patientsusually are not candidates for surgical debridement, including amputationof limb. Often other debridement forms such as wet to dry, or enzymatic,are not appropriate due to issues of pain, cost, or time constraints (e.g.infection with sepsis needs urgent debridement). Sometimes debridementis not seen as consistent with palliative care. This paper presents aselection of case studies of the use of Phaenicia sericata larval therapy(maggots) for wound debridement in hospice patients.Methods: A selection of case studies from wound treatment of hospicepatients over a three year period to illustrate wound types, problems, andoutcomes are presented. The cases were selected to be representative ofthe types of wounds encountered that could benefit from maggot therapy.Results: In all cases goals of therapy were achieved. Results included:resolution of sepsis, prevention of amputation, elimination of infection,reduced pain and odor, and in some cases, wound healing. Therapy waswell tolerated in all cases.Conclusions: Maggot therapy is a very viable option for treating complexwounds in hospice patients when debridement is indicated. Maggottherapy is rapid, inexpensive, nearly painless, simple, quite gentle, andconsistent with goals of palliative care. Standard protocols are publishedand easy to follow (Sherman, R. Maggot Laboratory. www.ucihs.uci.edu/com/pathology/sherman/). Families and patients are very involved, andgrateful for such innovative therapy, with newfound respect for one ofnature’s often maligned creatures.266