This is a 57-year-old woman with rheumatoid arthritis and a non-healing ulcer of the leg for a year, likely due to vasculitis. Traumatizing vasculitic ulcers with sharp debridement often makes them larger (besides being horribly painful) – so it’s generally a bad idea to debride them until you are sure the vasculitic process is controlled. Once hers was controlled with immunotherapy, I decided to use maggots to clean the wound so that I could apply a cellular product (“skin substitute”). Maybe later I will show you how well she did with Theraskin, applied immediately aftr the maggots had gotten this wound totally clean.
The great thing about these tiny surgeons is that they only remove the dead tissue, and they are happy to work all night.
Maggots before they are put into the wound:
And here they after 24 hours of hard work, removing all the necrotic tissue in this wound:
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
Carolyn I think Maggots have a place in wound care but have found that Medicare and insurances won’t pay for them. Have there been changes in the acceptance of payments by insurance carriers? Dr Holland