For those of you that get grossed out with a mental picture of fly larva feeding on dead tissue, I understand your queasiness on this topic. Ignorance of this subject could condemn a patient to an early death. Precious bug information could give a patient just the right care needed to save their life.
A lot of patients have wounds that just won’t heal. A majority of these individuals have been diagnosed as having diabetes. When you get a burn, cut or scrape, usually the body heals the intrusion on its own. In a diabetic, it’s more difficult with tissue repair because of all the excess sugar in the blood. Infection ensues quickly in a diabetic patient. This can lead to amputation of the diseased area and sometimes loss of that precious spark itself, life.
Blast to my past as a student intern working at Brooklyn Hospital in NY. There, one morning I got the experience of a lifetime. I was assisting a physician on rounds that had a debridement assignment. He was going to scrape and clean a severely infected leg wound on a diabetic patient. It was a scene out of a horror movie with the patient screaming in agony and some very unpleasant odors emitting from the wound. I have a secret. I kept my eyes closed most of the time otherwise, I would have passed out. After we left the room, the physician tells me that all he did was buy the patient some time. In the near future, not only would she lose her leg, but probably her life. I couldn’t eat that day. In fact, the horrifying incident remains to this day, locked up in my memory.
Lets discuss the benefits of an alternate to debridement, “medical maggots”. Maggots had been approved by the FDA in 2004 as a “medical device” to clean and heal wounds. These larva originally lost their popularity in the 1940’s with the advent of antibiotics. Now with increased bacterial resistance to medications, the buggy method is back in vogue working to clean up the patient’s open external surface. Treatment will work in up to 80% of individuals with advanced necrotic wounds. The earlier the use, the more effective the therapy. Research shows that healing occurs faster with the bugs than regular surgical debridement.
These larva are bred in labs and are completely sanitized. Bugs are left on the wound for 2-3 days with special dressings and bandages to keep them in place. Maggots are a specialized strain that only feeds on dead and infected tissue. They also kill any harmful organisms living on the skin. Harmful, because some are anaerobic bacteria that accelerate tissue destruction and lead to gangrene. The larva also increase the healing potential of the skin by beneficially modifying our immune system.
These maggots have been used for centuries for medical care. In those days, they weren’t bred in an antiseptic lab environment. Medicinal maggots are hatched from eggs laid by the adult female green blow fly.
These insects will not burrow into the wound and always remain on the surface. After removing dead and dying tissue, the maggots want to leave the wound area. They are contained by and removed within the bandages. Maggots will not reproduce in the wound.
Cleaner And Leaner Than Your Grandfathers Maggot
They don’t bite because they don’t have teeth. The larva have mouth openings called hooks. Rough body surfaces on the bugs cause the needed friction to help clean the wound. Maggots are very tiny and not usually felt doing their work in the wound. Patients that have exposed nerves in the open area may experience some pain. This usually lasts a maximum of one day. It may be treated with pain medication.
Medical maggot therapy is used for any kind of wounds including pressure ulcers (bedsores), leg ulcers and other vascular wounds. The cost is usually covered by insurance providers. Worst case, if it’s not covered, therapy is not expensive. To save a limb or a life at what cost? This procedure is priceless. Maggots are currently being used as a secondary/tertiary therapy rather than a last resort because of its success rate. Amazing how immature children of a fly could go up against conventional wound care in 2013 and come out ahead. Medicine is an art and the maggots create a faster, prettier woundscape picture than man.