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Mar 20, 2009 04:45 PM | 9
If you have a stubborn leg ulcer, you may be tempted to seed your wound with maggots, a treatment reportedly used on and off between the 14th and 20th centuries. But you may want to reconsider: maggots don’t help the wounds heal any faster than soothing gels, and the insects cause more pain.
Research in today's British Medical Journal shows that while maggots "clean," or remove a wound's dead tissue, a lot faster than a salve called hydrogel (which keeps a wound moist and helps clean it), they don’t actually heal it any quicker. What's more, patients who had loose or bagged larvae placed on their wounds reported experiencing more pain than those who used the gel. The findings are based on a group of 267 British patients; wounds treated with the gel healed in 245 days; those treated with maggots healed in 236 days, a difference that wasn’t statistically significant. The larvae, however, ate up the dead tissue in 14 to 28 days, versus 72 days by the gel.
"In terms of leg ulcers, maggots do not help them to heal — that’s the take-home message to me," Nicky Cullum, the study's chief investigator and a professor of health sciences at York University in England, tells ScientificAmerican.com. "They don’t offer an advantage and they are associated with pain."
Britain's National Health Service (NHS) funded the research, and maggot suppliers provided the larvae.
Cullum, who expressed skepticism about maggots as a first-line treatment for leg ulcers in a 2006 letter to the BMJ, undertook the study after the therapy was promoted in the U.K. in the late 1990s. "We may have overestimated how important cleaning is to healing," Cullum says. "Maggots do clean the wound quite rapidly and everyone thought it would lead to quicker healing, but it didn’t. Cleaning may not be so important to healing and [possibly] what matters is good bandaging."
Between half a million and 600,000 people a year in the U.S. suffer from venous ulcers, according to the Cleveland Clinic, often late in life after suffering a clot or other vein disease. Circulation problems that prevent the heart from adequately re-supplying the extremities with oxygen cause blood to pool in the legs, depriving the skin of the nutrients it needs to stay healthy. Because of these circulation problems, the wounds can persist for years, which may explain why patients were willing to have their flesh eaten to try to get rid of them.
Some 50,000 maggot treatments were given last year, Bloomberg News notes. The treatment works because maggots secrete enzymes that break down dead tissue, but it's not clear what role that process has in healing.
"There was a lot of enthusiasm because they have these wounds for a long time and are desperate for an effective treatment," Cullum says.
Image © iStockphoto/Sergiy Goruppa
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9 Comments
Add CommentWhy is there a pic of beetle grubs in an article about maggots?
Reply | Report Abuse | Link to thisI wonder if the maggots did their work for 2 to 4 weeks, then the patient was switched to the gel if you'd get the best of both cures and they would heal better and faster?
Reply | Report Abuse | Link to thisIf the beneficial enzymes the maggots create could be isolated and created synthetically, couldnt that enzyme be added to the gel? That way the combined benefits could be recognized
Reply | Report Abuse | Link to thisHow about lampreys or other natural devourers of dead meat?
Reply | Report Abuse | Link to thisI like both the ideas about isolating the enzymes and combining fast maggot cleaning with gel treatment, but I suppose the problem is the reluctance of serious skin wounds to heal at all - as burns and scalds show. Perhaps the problem is the need to keep the wound protected from ambient infection bearers. Maggots probably leave the freshly exposed flesh exposed (heh) to these.
This seems a case of prevention being better than cure, and for that we need a society that cares deep down to individual level for everybody and not just the rich. Our own rich and useless maggots and their thugs (gusanos) need to be swept aside and securely binned so a collective, inclusive and good-life oriented rather than profit-driven polity can be set up instead. Science and its development is always political in the final analysis.
SCIAM is beginning to sound like the grocery store tabloids with pictures of GRUBS in an article about maggots, presumably because of the prominent mandibles (which the maggots do not have), clearly to engage the viewer's imagination, misleading association not withstanding, and then saying "patients were willing to have their flesh eaten", implying the maggots were eating living tissue. This is an arguably ambiguous phrase, admittedly, but ambiguous statements are the grist, the modus operandi of tabloids. Maggots do NOT eat living tissue, only the dead and/or rotting tissue, which have no nerves and no feeling.
Reply | Report Abuse | Link to thisCome on, SCIAM. NOTHING was said of maggots removing gangrenous tissue, one of the primary reasons maggots were tried. Give us a little credit, please. The author of this "article" may be a liberal, but remember your audience (your meal ticket) is Republican. The reason we don't read tabloids isn't that we don't buy groceries. The FACTS can be fascinating, IF it is well written. Spend more time on your homework and less on your hyperbole.
There is no mention of maggots eating live tissues. Only dead tissues are eaten.
Reply | Report Abuse | Link to thisI wonder if the medics tried different stages of clean up by maggots. I mean try 50%, 70%, 80%......etc., and use the gel afterwards. My experience, when wounds healed and dried up, the dead tissue buckled up and thicken so that premature partial or full scrape out is most likely to happen, leaving a small fresh wound in the center. I suspect if the dead tissue is thinned out by the maggots first, the dead tissue works in two ways. First, the thinned dead tissue would still provide a barrier for germs and harmfull substance to enter the wound. And second, the wound as it dried up will be less prone to unnecessary motion, and less likely to be scrape prematurely. I think it makes sense, don't you?
Your critiques of the article are well founded. The gratuitous political commentary is not. Even if the party affiliations of SCIAM readers have been polled, enabling you to characterize them as the publisher's "meal ticket", this does nothing to support your implication that Republicans are uniquely dedicated to the "facts."
Reply | Report Abuse | Link to thisConsidering the way in which it panders to Creationism,, global warming denial, and the pseudo-scientific tripe promoted by anti-abortionsists, the Republican Party is in no position to make such a claim.
ajhil,
Reply | Report Abuse | Link to thisYour comments well taken. Agreed on the panderings of the GOP, also!! And, I WAS off-base with the political comments. However, republicans ARE smarter than the watchamacallems!!
Get back to work.
A certain study found that a therapy can be use to cure a wound. It is a treatment to clean cuts and wounds. Modern medical science has brought maggot therapy, using maggots to wash cuts, from out of the pages of history to the modern hospital environment. Research done in France found that maggots can clean wounds quicker than surgery in patients with seeping cuts. Source of article: <a title="French study finds maggot therapy works as well as surgery" href="http://www.newsytype.com/14066-maggot-therapy/">French study finds maggot therapy works as well as surgery</a>
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