TUESDAY, Dec. 20 (HealthDay News) -- The surgeons' scalpel may
have new (and wriggling) competition in cleaning troublesome
To the uninitiated the treatment may seem strange. But new
French research suggests that bagging up live, sterile fly larvae
in tightly meshed dressing packs and applying them to open sores
can be a quick, safe and effective way to clear away dead
Actually, "maggot debridement therapy" (MDT) has a long history
in medicine. And the new investigation suggests that this approach
-- traditionally reserved for more severe wounds -- can be a quick,
first-line therapy for less severe lesions.
"Twenty years ago, maggot therapy was performed mostly as a 'last resort' prior to amputation," for the treatment of non-healing wounds, explained Dr. Ronald A. Sherman, a "biotherapeutics" researcher at the University of California, Irvine, and the Los Angeles and Orange County health departments. He was not involved in the new study.
Sherman noted that past studies found that when used as a last
resort (after antibiotics and surgery failed), maggot therapy
eliminated the need for amputations in an estimated 40 to 60
percent of cases.
The treatment has gained ever-broader acceptance in recent
years, with studies touting its safety record and effectiveness in
less severe, non-emergency situations.
"(This) is one of those studies, and clearly supports those who include maggot therapy as part of their wound-care tool bag," Sherman said, by suggesting "that there is no reason to delay maggot therapy until the wound and underlying diseases have progressed."
The study, published online Dec. 19 in the
Archives of Dermatology, was led by Dr. Kristina Opletalova, from the department of dermatology at the University of Caen Basse-Normandie at the Centre Hospitalier Universitaire de Caen in Caen, France.
To gauge the potential of maggot therapy, between 2005 and 2008
the researchers focused on 105 patients treated at two hospitals in
All the patients had open wounds on their lower limbs that were
about 16 inches square or smaller in area, and less than
three-quarters of an inch deep. The wounds had not yet healed, and
were characterized by a mass of dead tissue ("slough") that had
separated from living tissue.
About half the patients were randomly selected to receive MDT
while the other half received conventional dressing treatment.
The team used
Lucilia sericata maggots (larvae of the common green bottle
fly), with each double-layered, spongy mesh cube filled with 80
sterile, live, maggots. The maggots were unable to move outside the
confines of the dressing's seal. However, the bag's fiber housing
allowed for air and fluid permeability, and the maggots were mobile
inside the bags, allowing maggot excretions and secretions to reach
the target wound.
Over a two-week period, patients had the maggot-filled bags
applied to each wound four times. The control group received
conventional treatment: wound scraping by means of a scalpel to
remove dead tissue, followed by standard dressing of the exposed
At the one-week treatment mark, the researchers found that MDT
patients had significantly less dead tissue in their wounds than
conventional treatment patients (roughly 55 percent versus 67
The benefits seemed to equalize by the two-week mark, however,
with slough measurements between the two groups nearly the
The authors concluded that MDT can promote much faster removal
of dead tissue during the first week of care for standard wounds.
They said that this could be especially valuable when time is of
the essence, as can be the case for patients awaiting skin
But the team also noted that though safe and painless, the
benefits of maggot therapy do not exceed those of standard care
over the longer term, nor does it shorten the overall time it takes
to close up a wound. They therefore advised that physicians only
turn to MDT during the first week of treatment.
Sherman, also director of the BioTherapeutics, Education &
Research Foundation in Irvine, Calif., called the study
"well-conceived" and "well-executed."
It "demonstrated that maggot therapy is safe and at least
equally effective to conventional surgical wound care," he noted.
"This is not a new finding, but their study is very important
because it adds to our limited database on maggot therapy."
But Sherman also noted that more aspects of maggot therapy
remain to be explored, such as the potential for so-called
"free-range maggot therapy" in which bag-less larvae are placed in
direct contact with the wound.
"While this is a powerful testament to the potency of the maggots' therapeutic secretions, we are still left wondering whether or not free-range maggots might have done any better," he said. But this, he noted, awaits further study.
The U.S. Food and Drug Administration approved maggot therapy in
2004 as a "device" used by prescription.
Learn more about maggot treatment at the
Care Information Network.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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