Maggots munch away in a medical miracle
Published: April 20, 2007
Most people will recoil in horror at the thought of maggots crawling over their bodies and munching away on wounded flesh.
Yet, if you faced a choice between having maggots rid your body of rotting flesh, or having your leg amputated, you might not be so squeamish.
Last year, nearly 50 000 people were treated with maggot debridement therapy, mainly in the United States.
Though it is not a common treatment in this country, at least 50 South Africans have benefited from MDT over the past three years, according to Dr Frans Cronje, director of the specialist wound care centre at Eugene Marais Hospital in Pretoria.
Debridement is a medical term for the cleaning of infected wounds by surgery or other methods.
But there is, in fact, nothing new about maggot therapy, as medical observations about the benefits of this treatment can be traced back to at least the 1500s.
Napoleon Bonaparte’s surgeon, Baron Dominic Larrey, also reported that maggot-infested wounds often healed faster than those without maggots.
In the 1920s, the American physician William Baer began to intentionally apply fly larvae to heal wounds and, within a decade, maggot therapy was being performed routinely in many parts of the world.
But with the development of new surgical techniques and antibiotics during World War 2, the use of maggot therapy declined rapidly.
Yet, with the more recent emergence of drug-resistant bacteria in the modern world, maggots may be making a comeback to treat certain non-healing wounds.
Writing in the Durban Natural Science Museum’s magazine Palmnut Post, Cronje notes that, with a rapidly-ageing population in many parts of the world, maggot therapy may be part of the solution to treating patients with poor blood circulation or antibiotic resistant bugs on their wounds.
Cronje notes that apart from eating necrotic (dead) flesh and bacteria, fly maggots also secrete a substance called allantoin, which speeds up the healing process.
A Durban wound specialist says maggot therapy is rarely used in that city, although he recalls a case several years ago, during his early medical career in Eshowe.
Battling to disinfect a wound on an elderly patient, the doctor was advised by a senior surgeon to wheel the patient outdoors into the sun for a few hours.
The younger doctor took the advice, though he was worried about the fact that the wound would become exposed to flies.
“Sure enough, the wound was crawling with maggots within a few days - but they did a fantastic job in cleaning up the wound,” he says.
Although myiasis (where flies lay their eggs on a wound naturally) can be beneficial, there is also a risk that the flies carry other dangerous pathogens, which make the wound worse.
Because they feed on infected wastes, blowflies can spread diseases such as dysentery and cholera, as well as diarrhoea.
This is why Cronje and his team at Eugene Marais Hospital have established an insect laboratory to provide a ready source of sterile (germ-free) maggots.
The laboratory breeds the larvae of the greenbottle blowfly (Lucilla cuprina).
Kirsten Williams, an entomologist at the Durban Natural Science Museum, is also involved indirectly in the project because this species of blowfly is closely related to another blowfly species, Lucilla sericata.
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