Maggots Prove Worth in Therapy

Discovery News 

For those of us who can hardly stand seeing grubby insects, it may be frightening to fathom intentionally letting them feast on our open wounds.

But for a small group of patients with diabetes, a round of maggots is just what the doctor ordered, according to one Reuters article.

Participants with limb infections and circulatory problems had 50 to 100 maggots patched to their wounds every two days for 10 days or so. Of 37 people with diabetes receiving maggot treatment, 21 had successful outcomes, the article states, which constituted getting rid of the infection or removing a certain portion of dead tissue from the wound site.

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Five patients' wounds were infected with the drug-resistant bacterial strain called MRSA, which has been difficult to treat in patients in recent years. In these cases, maggot therapy prevented more drastic actions to save the limbs, including amputation.

Patients for whom the treatment wasn't successful had more severe infections to begin with, including more inflammation and bone infections.

The results were presented at a conference and haven't been scrutinized by other scientists yet. Even then, maggot therapy isn't a cure-all -- doctors use grafting methods and gels to encourage new tissue growth. These juvenile insects mostly work to remove and clean dead tissue from the wound.

Still, maggot therapy remains a controversial area of medicine, mainly because studies have shown mixed results in the treatment's success in promoting new tissue growth over traditional methods. With time, however, the insects have shown promise for one aspect of the healing process: debridement, or the removal of dead or infected tissue to allow for healthy tissue to regenerate.

In this sense, maggots aren't better at reducing infections, but they certainly speed up the time it takes to debride a given wound, researchers say. The insects also pick through dead tissue better than a scalpel can, but there's debate as to whether they can damage healthy tissue if left in a wound too long.

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The take-home message: Maggots can help clean up dead tissue from an infection, but doctors know now that they may not be equipped to cure the infection itself, according to a government feature article on the topic. Usually, doctors reserve maggot therapy as a last option, since it's not necessarily a replacement for traditional treatment. Maggots have provided the most success to patients with ulcers, especially those that develop on the lower extremities.

The origins of these medical maggots date back to at least 1,000 years ago in Australia, Burma and Central America. After gaining popularity, the method lost momentum with the advent of penicillin during World War II in the 1940s. With time, scientists have fine-tuned which fly species produce the best crawlers for treatment (maggots are immature larval forms of flies).

Specific maggots and leeches earned approval as medical devices by the U.S. Food and Drug Administration in 2004. Most experts think the rise in popularity of maggot therapy in recent decades can best be attributed to people developing bacterial infections resistant to antibiotic drugs.