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American Journal of Hospice and Palliative Medicine®
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Maggot Debridement Therapy in the Palliative Setting

Pascal Steenvoorde, MD, MSc

Department of Surgery of the Rijnland Hospital Leiderdorp, Netherlands, psteenvoorde{at}zonnet.nl, Rijnland Wound Clinic of the Rijnland Hospital Leiderdorp, Netherlands

Louk P. van Doorn, MA

Rijnland Wound Clinic of the Rijnland Hospital Leiderdorp, Netherlands

Cathrien E. Jacobi, PhD

Department of Medical Decision Making Leiden University Medical Center, Leiden, Netherlands

Jacques Oskam, MD, PhD

Department of Surgery of the Rijnland Hospital Leiderdorp, Netherlands, Rijnland Wound Clinic of the Rijnland Hospital Leiderdorp, Netherlands

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.

Key Words: maggot therapy • leg ulcer • palliative setting • outcome

American Journal of Hospice and Palliative Medicine®, Vol. 24, No. 4, 308-310 (2007)
DOI: 10.1177/1049909107302300
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