Wound debridement: Lessons learned of when and how to remove "wild" maggots

Background: Wounds, particularly chronic wounds, are a common presentation to the Emergency Department (ED), and in severe cases can contain maggots. Maggot debridement therapy is a popular technique for wound debridement, but is limited to the use of sterilized larvae due to concerns of contamination and invasion of "wild" maggots into healthy tissue. Wild maggots in chronic wounds, therefore, should be removed, yet there is no reported literature that describes a technique for their removal. Objective: This article presents a step-by-step approach for the safe removal of "wild" larvae in a wound using Yankauer suction. Case Report: We present a case of a homeless man presenting to the ED with a foot wound found to have "wild" maggots that required removal. Conclusion: The technique described in this article is a simple, safe, and efficient way for the Emergency Physician to remove "wild" larvae from wounds.