In days of yore, along about the time when bloodletting was considered a legitimate cure, maggots were a popular tool in the surgeon's black bag. In the Civil War, doctors employed busy maggots to clean rotten tissue from wounds that might otherwise have led to amputation.

Now the little buggers are back in vogue to treat stubborn infections in diabetic foot ulcers.

According to Professor Andrew Boulton of the University of Manchester in the UK, heavy use of antibiotics has led to the evolution of a drug-resistant "superbug" called methicillin-resistant staphylococcus aureus (MRSA). In a recent report in Diabetes Care, Professor Boulton explained that although MRSA colonization is increasingly implicated in infected chronic foot ulcers, maggots have a healthy appetite for those very bacteria.

Professor Boulton and his team gathered a group of thirteen diabetic patients with MRSA-infested foot ulcers of about three months' standing. Then they laid on ten green bottle fly larvae per square centimeter of ulcer, re-applying the maggot treatment an average of three times, for four days at a time.

Within seven to 45 days, the maggots apparently ate all the MRSA in twelve of the thirteen foot ulcers. There was a reduction in "sloughy necrotic tissue and an increase of granulation tissue [freshly healing, capillary-filled tissue] on removal of the last larval application." Furthermore, the duration of treatment was far shorter than the 28 weeks usually required for conventional eradication of MRSA in diabetic foot ulcers.

The researchers believe that if their findings are confirmed in a more formal trial, maggots will be established as a safe, non-invasive, and altogether superior treatment for foot ulcers. Plus, the little fellows work cheap. (For an in-depth discussion of maggot therapy, see our article "Maggot Therapy Re-Emerging", May 1995.)

Source: Diabetes Care 2007