The World’s Tiniest Surgeons: Maggots Are All Over Foot Ulcers


By: Linda von Wartburg

In days of yore, along about the time when bloodletting wasconsidered a legitimate cure, maggots were a popular tool in thesurgeon's black bag. In the Civil War, doctors employed busymaggots to clean rotten tissue from wounds that might otherwise haveled to amputation.

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

According to Professor Andrew Boulton of the University ofManchester in the UK, heavy use of antibiotics has led to theevolution of a drug-resistant "superbug" calledmethicillin-resistant staphylococcus aureus (MRSA). In a recentreport in Diabetes Care, Professor Boulton explained that althoughMRSA colonization is increasingly implicated in infected chronicfoot ulcers, maggots have a healthy appetite for those verybacteria.

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

Within seven to 45 days, the maggots apparently ate all the MRSA intwelve 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 lastlarval application." Furthermore, the duration of treatment was farshorter than the 28 weeks usually required for conventionaleradication of MRSA in diabetic foot ulcers.

The researchers believe that if their findings are confirmed in amore 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 ofmaggot therapy, see our article "Maggot Therapy Re-Emerging", May 1995.)

Source: Diabetes Care 2007




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