Maggots debride necrotic skin! They do this by eating the rotten flesh so that new flesh can grow. The trick with maggot therapy is to keep the hungry maggots from damaging the new tissue. I once had a patient who had deep necrotic bed sores from staying in her wheelchair days and nights on end. She ate, urinated, defecated, etc. in this chair. One side of her body was paralyzed - courtesy of a stroke. She lived by herself and got bathed only when one of her grown kids or grandkids came to visit. Anyway, when she was brought into the ER, she had all these bed sores (some down to her bone) and they were all maggot-infested. The maggots literally kept her alive by eating away all the dead, organism-laden flesh! And yes, I helped de-maggot her. The process took almost a week.
Maggots could be used in an emergency situation. Historically, they have been used that way for centuries - long before the invention of antibiotics. I suppose one would have to use common sense with maggot management. That is, one would have to keep them off the healthy tissue by plucking them off or by shielding the healthy tissue in some way. Healthy tissue is pink, so one would not want them eating on that - only the blackened areas! However, in a situation where there is little dead tissue left and there are an abundance of maggots, they will start to eat the healthy tissue - not by choice, I don't think. I know that I have plucked many a maggot off healthy tissue on some of my inner city patients.
Offered by Lyn.