Identifying flies used for maggot debridement therapy

Abstract

To the Editor: The use of maggots to clean necrotic wounds, known as maggot debridement therapy (MDT), has long been known to the scientific world. Its use has been recorded since the 1500s when soldiers’ wounds were often infested with maggots. Napoleon’s surgeon, Baron Dominic Larrey, reported that wounds that were infested with maggots appeared to heal faster than those without maggots.1 William Baer is considered to be the founder of modern MDT. While treating soldiers in World War I, he noted the good condition of wounds that had been infested with maggots, and was the first doctor on record to experiment with the use of maggots in treating infections.1 MDT even featured in the recent version of the film ‘Spartacus’. Various species of flies have been used for MDT,1 the most commonly used being Lucilia sericata, a greenbottle blowfly (Figs 1 and 2). This fly is closely related to another greenbottle, L. cuprina, but L. cuprina feeds on live as well as necrotic tissue, which is undesirable in MDT. L. cuprina is commonly named the ‘sheep blowfly’ because it is responsible for fly-strike in sheep, a form of massive, usually rectal myiasis that can kill sheep. A recent article2 suggested that L. cuprina was being used successfully for MDT at the Eugene Marais Hospital Wound Care Centre (EMHWCC). As this would be inconsistent with international experience in MDT and at odds with the usual biology of L. cuprina, it was decided to check the identity of these flies