- The Washington Times - Thursday, March 19, 2009

LONDON (AP) - In a study testing treatments for leg ulcers, British doctors found that a surprising, yet perhaps revolting, option works just as well as standard treatment: maggots.

If that sounds like a step backward, it’s probably because Europeans first began using maggots to treat wounds about 700 years ago.

Researchers at the University of York studied 267 patients with leg ulcers in the United Kingdom from 2004 to 2007. Patients were either treated with a gel commonly used for ulcers or with maggots.

The maggots were bred in sterile conditions and were about the size of a grain of rice. The insects were either packed into a teabag-sized packet or corralled into the wound with bandages.

Patients who got the maggots healed just as quickly as those who got the gel, but suffered a little more pain in the process. The research, along with another study that said maggots were as cost-effective as the gel, was published Friday in the BMJ, formerly known as the British Medical Journal.

“Maggots definitely work, but this is not the standard of care in any developed country,” said Dr. Harold Brem, a wound expert at New York University Langone Medical Center. Brem was not connected to either BMJ study.

“If you are out in a remote place and don’t have access to a surgeon or good medical care, then maybe maggots are an option,” Brem said.

British doctors found the maggots ate up dead tissue quicker than the gel, though that didn’t speed up the healing. There were similar rates of side effects in both treatments, affecting about 14 percent of patients.

But those who used maggots reported more pain.

Nicky Cullum, one of the paper’s authors and a professor at the University of York, said the pain might have been due to the enzymes secreted by the maggots. That could have struck the patients’ nerve endings.

The pain would not have been from the maggots actually eating the dead tissue. “They’re not chomping down with big teeth or anything,” Cullum said. “They’re just hoovering up goo.”

Cullum didn’t expect maggots to become standard treatment for leg ulcers, but said the study proved their worth as an alternative option.

Brem wasn’t surprised that some doctors and patients had turned to maggots for help. “These are desperate patients who may lose their legs,” he said. “Some of them will agree to anything they think might help.”

Then again, using maggots in this way has been prevalent in Europe and the U.S. before.

They reportedly were used during the 14th century to treat wounds, and military doctors also turned to them in the 18th century.

Maggots were commonly used in this way as late as the 1930s, but fell out of favor when antibiotics and surgery became widely available after World War II.


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