Biotherapy Medical and Maggot Debridement Therapy
how to use freemaggots

Clinical application of net boot method
(The standard duration of maggot application is 48–72 hours)

Pictures are provided by professor Miyamoto, Department of Regenerative Medicine,Nippon Medical School, Japan.
<The day before treatment>
Stop using any topical ointments or creams that might inhibit the growth of maggots. If the wound surface is covered with hard and dry necrotic tissue, it is best to soften the wound bed using wet gauze or a hydrocolloid/hydrogel dressing.
<Day 1>
1. Wound bed preparation

Ensure that no ointment, cream or dressing material remains on the wound.

maggots and gauze in tube
2. Taking out the maggots

(1) Take the maggots with gauze out of the tube.

(2) Maggots remaining in the tube can be flushed out with saline onto a piece of gauze.

flushing out remaining maggots
3. Setting the maggots on the wound

(1) Put the maggots with gauze on the wound.

maggots with gauze on the wound

(2) Cover the wound with several pieces of gauze and fix them lightly with tape.

maggots and the wound
4. Preventing the maggots from escaping

(1) Cover the whole foot with a net boot and use adhesive tape to fix it tightly at a level above the wound.

net boot

(2) Put a bandage over the net boot and wrap the whole foot.

<Days 2–3>

If there is a problem of exudation or odor, the outer bandage can be replaced.

<Day 4>
1. Removal of the outer dressing

Remove the outer bandage, net boot, and gauze.

remove the bandage,net boot and gauze
2. Removal of the maggots

Remove the maggots using tweezers and water. They are supposed not to burrow into living tissue, but care should be taken not to leave them on the wound.

remove the maggots