Maggot Debridement Therapy for an infected gunshot wound refractory to extensive sharp surgical debridement

A 36 year old male with an infected gunshot wound was at risk of an amputation.  Limited surgical debridement had been performed but further surgery was contraindicated due to proximity of the anterial tibial artery and tendon.  It was decided to use maggot debridement therapy to rid the wound of infectious, necrotic tissue.  Larval debridement was performed for 48 hours per week times two weeks.  The wound was successfully debrided.  One day following the second treatment the wound was found to be clean of infected and nonviable tissue and the white blood count was  within normal limits for the first time since admission following the injury.  Studies have shown that there is increased psychological stress, morbidity and mortality following amputation of a traumatic wound.  One week after the completion of maggot debridement therapy the wound was successfully closed and the patient was subsequently discharged from the hospital.