Maggots better than surgeons at wound cleaning -- for a week anyway

Maggots are increasingly used to clean wounds that are not healing or healing only very slowly. The maggots eat away the dead (necrotic) tissue while ignoring healthy tissue that is forming during the healing process. The alternative, which has been used for centuries, is to physically scrape out the dead tissue, which can be painful for the patient and may not remove all of the dead tissue. Some researchers also think the use of maggots has an antibacterial effect and promotes healing because of chemicals released by the insects. Although the use of maggots has many advocates, there have been few clinical trials of their efficacy and those trials that have been performed have mixed results. Nonetheless, the U.S. Food and Drug Administration approved use of the technique in2004.

Dr. Anne Dompmartin of the Centre Hospitalier Universitaire de Caen in France and her colleagues studied nonhealing wounds on the legs of 119 patients. Half the patients had their wounds debrided with a scalpel three times a week for two weeks. The remainder had maggots -- the larvae of the fly Lucilia sericata -- placed on the wound twice a week for two weeks. The maggots, 80 at a time, were sealed into a commercial plastic device that prevents them from escaping while allowing access to the wound.

The team reported in the Archives of Dermatology on Monday that wound healing at the end of eight days was significantly better in the group that was cleaned with the maggots. After 15 days, however, results from the two groups were indistinguishable. Pain was moderate in both groups. Both groups also reported a crawling sensation on their wound at day eight.

The next question to be answered, the steam concluded, is whether using more maggots might improve the process without increasing pain.


Twitter: @LATMaugh