The Future use of Maggots in Medicine

Would you have ever thought wound-care clinics around the country would be using maggots on some patients after high-tech treatments fail? Can you imagine using these wriggly little creatures for treating wounds? Maggots are making a medical comeback, cleaning out wounds that just won’t heal. This is a therapy that has been in use since the early 1990s by a California physician who’s earned the nickname Dr. Maggot. But Dr. Ronald Sherman’s maggots are getting more attention since, in January, they became the first live animals to win Food and Drug Administration approval, as a medical device to clean out wounds. Dr. Sherman says, “maggots do more than that,” in his research, it shows that in the mere two to three days they live in a wound, maggots also produce substances that kill bacteria and stimulate growth of healthy tissue.

Dr. Robert Kirsner, who directs the University of Miami Cedars Wound Center, said, “it takes work to convince people” – including hospital administrators – that “maggots do work very well. It will probably be easier to use maggots now since the FDA approval, and we’ll talk about it more and think about it more.” Kirsner estimates he uses maggots in about one in 50 patients where conventional therapy alone isn’t enough.

These worm-like critters, have received much attention this past year, because in June, FDA also gave its seal of approval to leeches, those bloodsuckers that help plastic surgeons save severed body parts by removing pooled blood and restoring circulation. There’s a little more yuck factor with maggots because most people have seen them on TV crime dramas, where infestations of bodies help determine time of death.

Civil War surgeons first noted that soldiers whose wounds harbored maggots seemed to fare better. In the 1930s, a John Hopkins University surgeon’s research sparked routine maggot therapy, until antibiotics came along a decade later.

Today, Diabetic foot ulcers alone strike about 600,000 people annually and lead to thousands of amputations. Despite precise surgical techniques to cut out dying tissue, artificial skin and other high-tech treatments, hard-to-heal wounds remain a huge problem. Dr. David G. Armstrong, a Chicago specialist who first tried maggot therapy in frustration about seven years ago and says he’s now used it on several hundred patients.

Drop maggots into the wound and cover with a special mesh to keep them in place. Two to three days later, after the maggots have eaten their fill, lift them off and dispose. Wound size determines how many maggots, and how many cycles of therapy, are needed. It costs a few hundred dollars, says Dr. Armstrong, of the Rosalind Franklin University of Medicine and Science. Patients say it’s not that hard to accept the use of maggots. Pamela Mitchell of Akron, Ohio, begged to try maggots when surgeons wanted to amputate her left foot, where infection in an inch deep, 2-inch-wide diabetic ulcer had penetrated the bone. After 10 cycles of larvae, she healed completely.

Michell said, “on day 2, when the maggots were fat, I could feel them moving, because they were ready to come out,” she recalled. But, “If you’re faced with amputation or the maggots, I think most people would try the maggots.”

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