Czech doctors apply maggots to help heal wounds
Would you believe that flies can actually help heal wounds? Although it sounds like a paradox, soldiers injured in battles recovered more quickly if their wounds became infested with maggots. The beneficial properties of larvae have been known for centuries in many civilisations. With the introduction of antibiotics and new surgical methods, this age-old treatment was abandoned in the last century.
"We applied maggot therapy a year and a half ago. It was in a 41-year-old patient who had a large muscle destruction after prolonged ischemia and we faced the decision whether to amputate his leg in the thigh or risk arterial reconstruction. We proceeded to arterial reconstruction but the ischemia was so severe that we had to cut a lot of necrosed muscle from his calf for several weeks and the necrectomy looked like a never-ending story. So we were looking how to help this patient."
Doctor Novotny says that at that moment he recalled seeing a patient ten years before with one leg wrapped in dirty newspaper. Underneath the improvised dressing was a well healed ulcer and a few maggots were crawling in it. That memory gave Doctor Novotny an idea...
"We started to search on the internet and found a lot of literature on maggot therapy. We contacted a research unit in Wales which deals with this type of therapy and they sent us two pots, which means about 300 maggots, in a week and we put them in the wound of this patient."
This is the procedure: Sterile maggots are applied to the wound, a fine net is placed over them, so that they stay in the wound, and finally the wound is protected by a dressing. The maggots should stay in the wound for three days. When they have 'done the job', they are rinsed away from the wound.
So after three days, when Doctor Karel Novotny and his team took off the covers, they saw a beautiful clean wound. They discharged the patient the next day.
"We used Lucilia sericata which is found in our climate zone normally. Lucilia, or the greenbottle fly feeds only on dead tissue. It produces special enzymes which dissolve dead tissue and then its sucks it."
The greenbottle fly maggots spare living tissue. Eating the dead tissue is not the only way in which they help heal wounds. Doctor Karel Novotny.
"It is said that there are four ways in which the maggots work. It is the enzymes we mentioned, then they also eat the pathologic bacteria which can be in the wounds. Next they produce several specific substances which help healing, like allantoin, urea, etc. And the fourth way is that they support granulation by irritating the wound with their movement."
That means they stimulate the growth of new tissue by their crawling.
It may sound disgusting, but it works. Treatment with fly maggots is gentle, cheap and fast. In many cases maggots have helped to save a limb which otherwise would have had to be amputated.
Find out more at www.geum.org/diakazuistiky/abstrakt1.htm
