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Maggot therapy (also known as maggot debridement therapy (MDT), larval therapy, larva therapy, larvae therapy, biodebridement or biosurgery) is a type of biotherapy involving the intentional introduction by a health care practitioner of live, disinfected maggots (fly larvae) raised in special facilities into the non-healing skin and soft tissue wound(s) of a human or animal for the purposes of selectively cleaning out only the necrotic tissue within a wound (debridement), disinfection, and promotion of wound healing. Maggots are contained in a cage-like dressing over the wound for two days. The maggots may be allowed to move freely within that cage, with the wound floor acting as the bottom of the cage; or the maggots may be contained within a sealed pouch, placed on top of the wound. The dressing must be kept air permeable because maggots require oxygen to live. When maggots are satiated, they become substantially larger and seek to leave the site of a wound. Multiple two-day courses of maggot therapy may be administered depending on the severity of the non-healing wound. Maggots can never reproduce in the wound since they are still in the larval stage and too immature to do so. The wound must be of a type which can actually benefit from the application of maggot therapy. A moist, exudating wound with sufficient oxygen supply is a prerequisite. Not all wound-types are suitable: wounds which are dry, or open wounds of body cavities do not provide a good environment for maggots to feed. In some cases it may be possible to make a dry wound suitable for larval therapy by moistening it with saline soaks, applied for 48 hours. Maggots have a short shelf life which prevents long term storage before use. Patients and doctors may find maggots distasteful, although studies have shown that this does not cause patients to refuse the offer of maggot therapy. Maggots can be enclosed in opaque polymer bags to hide them from sight. Dressings must be designed to prevent any maggots from escaping, while allowing air to get to the maggots. Dressings are also designed to minimize the uncomfortable tickling sensation that the maggots often cause. [READ THE REST OF THIS ARTICLE]
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