Discussion
Management of DFU is so challenging that a monotherapy strategy for treatment may not be very useful. Some treatments are more common including: necrotic tissue debridement, infection control of the area with systemic antibiotics, reducing the pressure on the area, and revascularization (1).
Maggot therapy is believed to be an effective treatment as a debridement therapy in chronic wounds such as DFU. So, in Germany maggot therapy is offered to patients as a useful treatment (2, 3). But in this case not only maggot therapy was not useful but also worsened the ulcer and obligated a debridement therapy.
Contraindications of maggot therapy are listed below:
  1. Very dry wound,
  2. Open wounds into the abdominal cavity,
  3. Pyoderma gangrenosum in patients with immunosuppressive therapy and septic arthritis
  4. Wounds heavily contaminated with pseudomonas aeruginosa (4).