Maggot medicine gains popularity

Maggots at work in the lab

By Georgina Kenyon

Maggots are fast becoming the treatment by choice for healing wounds in British hospitals. And for good reason too.

They are currently one of the most effective means of treating wounds that are infected by the superbug methicillin-resistant Staphylococcus aureus (MRSA), which can cause life-threatening illness in hospital patients.

And the antibiotic methicillin is just one of many drugs which are being overpowered by multi-drug-resistant forms of bacteria.

This means maggots are good news for patients and hospital doctors who once lived in fear of multi-drug-resistant forms of bacteria for which there was previously precious little treatment.

Ulcer treatment

Doctors at the West Cumberland Hospital in Whitehaven and the Princess Wales Hospital in Bridgend have been experimenting with maggots for healing infected ulcers over the past few years.

You cannot say maggots are high tech and shiny, but they sure are effective

Dr Stephen Thomas

Dr Stephen Thomas, director of Biosurgery at Princess of Wales Hospital, said: "We have now developed Larve Bags, something like a tea bag for applying the maggots.

"This makes them much more user friendly for our patients.

"But they do take longer to work than if they are free ranging in the wound and the tea bag version is not always applicable - especially if you need a wound healed quickly."

Dr Thomas and his colleagues have published papers in medical journals on the success of maggot therapy.

All six patients suffering from venous ulcers and treated with maggots were healed more quickly and effectively than the group who were treated with the standard hydrogel dressing.

No feeling

Most patients do not report any feeling of the maggots on their skin

Anne Walker

Anne Walker, a leg ulcer specialist who uses maggots for maggot debridement therapy at West Cumberland Hospital, said: "Most patients do not report any feeling of the maggots on their skin.

"But they do report a 100 per cent success rate.

"The maggots are very effective for diabetic foot ulcers too.

"I have used the maggots on patients about 150 times. Surgery is usually not an option for these patients, they just need their wound healed and cleaned.

"Because normal dressings take weeks or even months to help a wound to heal and the maggots only a few days, most patients are happy to try the maggots."

She added: "When a wound is painful and smells, patients want fast treatment."

Maggots are great

According to Alan Hughes, 60, a patient of Dr Walker: "Maggots are great. They do the job."

Mr Hughes was admitted to West Cumberland Hospital two years ago for bed rest after a fall that caused ulcers in both his legs.

"But the ulcers on one leg would not heal. My GP and the hospital doctors had tried everything."

Then Dr Walker arrived by his bedside and she suggested maggot therapy.

Two hundred maggots were then applied to Mr Hughes leg and left for three days.

It's just like a maggot sandwich

Alan Hughes

They were applied to Mr Hughes leg, trapped between two sheets of gauze taped together with surgical tape and then taped closely onto the ulcer.

The maggots then chomped through the gauze while being held in place.

Mr Hughes said: "It's just like a maggot sandwich."

And it worked.

"I would not hesitate to recommend maggots. They cleaned up my wounds completely," said Mr Hughes.

"At the end of the treatment you could feel a tickling sensation but nothing to disturb you."

Not cheap

Maggots, however, do not come cheap, with 200 maggots costing £100.

This is in comparison to a typical surgical dressing for an ulcer costing about £10.

Maggots are available on the NHS and are the size of a salt granule when applied initially to a wound but grow to about a quarter of an inch when full of dead skin.

Dr Thomas said many patients will ask for maggots to treat their wounds if they have caught an infection which has isolated them from other patients.

"This is often the case if a patient has caught MRSA which is very infectious.

"One man had developed MRSA infection following open heart surgery and was put in an isolation unit to prevent other patients catching the infection.

"He really wanted maggot treatment so he could be back with other people on the ward."

How they work

Maggots are thought to work by secreting proteolytic enzymes to break down dead tissue into a soup-like substance which they then injest.

Hospital maggots are specially bred for wound treatment. They are sterile and are usually of the green blowfly variety as this species only injests dead tissue.

And it is Britain that is leading the way in maggot therapy.

Dr Thomas said: "The US tends to like more high-tech therapies. You cannot say maggots are high tech and shiny.

"But they sure are effective."

A bigger follow-up UK trial on the efficacy of maggot therapy is currently waiting Medical Research Council funding approval. If approved, West Cumberland Hospital will be one of the trial sites.