“Surgeons” With a Wiggle and an Appetite

As repulsive as the thought may be to some, a capable and hygienic “surgeon” is making a resurgence—the lowly maggot. A report in The Journal of the American Medical Association (JAMA) states that doctors in the United Kingdom conducted a pilot study on 12 patients with leg ulcers. Six were treated with conventional hydrogel therapy, and six, with the application of maggots. *

“All six patients undergoing larval [maggot] therapy were left with clean wounds after only 3 days,” says JAMA. Of those treated conventionally, “only two had clean wounds after 1 month of treatment; the other four required further medical attention.” The British medical journal The Lancet says that maggot therapy “can dramatically reduce treatment times compared with conventional therapies” and that it “costs little more than half as much as hydrogel.”

When employing maggot therapy—say on a wound that has turned necrotic—doctors introduce young, sterile larvae into the wound, says JAMA. (Of course, doctors use only those species of larvae that do not attack healthy tissue.) The wound is then covered with a fine nylon mesh and an absorbent pad to hold liquefied dead tissue. When the maggots are satiated, they are removed and discarded, and new ones are added until the wound is completely clean. Thereafter, blood flow to the remaining healthy tissue promotes the growth of new flesh.

“We have never had a patient decline the maggots,” said vascular surgeon Michael Walker. “It is staff, not patients, who are the squeamish ones.” Besides the United Kingdom, the United States and Canada also use larval therapy at some medical centers. In fact, a surgeon quoted in The Lancet said that “there are a lot more patients in the USA requesting maggot therapy than can find practitioners willing to apply it.”

Maggot therapy was discovered by accident. “Battlefield physicians,” says Science World, “saw that soldiers’ wounds infested with maggots tended to heal better than non-infested wounds. Soon maggot therapy was born.” And now it is used in hundreds of hospitals in the United States and Europe.

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A number of maggots shown on a finger (actual size)

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Picture copyright SMTL, http://www.smtl.co.uk/

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Before

After

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Photos by R. Sherman, University of California, Irvine