by Kimberly Allen, RN
The use of maggots to treat wounds may sound medieval but it has been used for thousands of years and continues to be used in medicine today. The modern use of maggots to treat wounds really started in WWI when military surgeons noticed that soldiers with wounds that had become infested with maggots were healing faster and better than those with wounds that were not infested with maggots. It was then used regularly and successfully by physicians throughout the 1930’s, but then came modern technology with antibiotics and improved surgical techniques. Maggot therapy then was only used when all else failed. However, now with the increasing resistance to antibiotic therapy as well as the increased number of people with diabetes that are developing stasis ulcers it has made a comeback.
Though advances in medical technology has significantly improved wound care, non healing wounds continues to be a significant problem. The cost of managing these types of wounds is over $20 Billion annually and that doesn’t include the cost of 2 million lost work days. What makes it even worse is that the incidence of non-healing is increasing. Just diabetic foot ulcers have become so common that they are responsible for 1 1/2 million foot ulcers as well as at least 70,000 amputations every year. This increase in non-healing wounds has doctors looking for alternatives to improve wound care consequently they have been doing controlled studies on the use of maggot therapy since 1990 and found it to be safe and effective as well as cost effective. In the 1930’s one of the objections to maggot therapy was its cost, which was $5 in 1933. Today, the cost of medical maggots remains the same as it was in 1933 with adjustments for inflation it is now about $80 in the US. Other concerns were getting viable germ free maggots, as well as the difficulty making dressings that kept the maggots in place. However, with the improvement in dressing materials it has become much easier to dress the wounds keeping the maggots in the wound bed. Also, there are significantly improved methods for disinfecting and raising germ free maggots as well as overnight courier services making it much easier to get the highly perishable maggots pretty much anywhere in 24 hours.
So how does maggot therapy work? Once the wound has been cleaned the live maggots are then put in the wound and covered with a dressing to keep them in place. The maggots then eat the dead tissue as well as destroy any bacteria leaving behind clean living tissue. In addition to that they promote healing and cell regeneration. The maggots are left in place for 48 to 72 hours then removed and replaced with fresh hungry ones. It takes approximately 10 treatments depending on how severe the wound is to get rid of all the dead tissue allowing the body to take over and heal the wound. Patients receiving maggot therapy also receive antibiotic therapy while receiving maggot therapy.
Though the idea of maggot therapy sounds creepy and it may give you a serious case of the heebie-jeebies it is safe as well as effective. Some patients do complain of pain or discomfort during the first few treatments. The pain is caused by the maggots getting fat from eating the dead tissue which then increases the pressure on the wound. It’s important to mention that not just any maggot will work, despite what you may have seen on TV. There are specific flies/maggots that are used for treatment and they are raised in a disease free environment and then shipped in sterile containers from laboratories that raise maggots specifically for wound care and can only be obtained with a prescription. They should also be applied by a medical professional to prevent complications like too many maggots in the area because if there are too many even though maggots do not normally eat healthy tissue they will if there’s too many.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.