Maggots make medical comeback

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Aug. 3, 2004. 01:00 AM

 

Maggots make medical comeback

 

FDA okays them in wound cleaning

 

Patients accepting

despite yuck factor

 

LAURAN NEERGAARD

ASSOCIATED PRESS

WASHINGTON

 

Think of these wriggly little creatures not as, well, gross, but as

miniature surgeons: Maggots are making a medical comeback, cleaning out

wounds that just won't heal.

Wound-care clinics around the country are giving maggots a try on some

of their sickest patients after high-tech treatments fail.

 

It's a therapy quietly championed since the early 1990s by a California

physician who's earned the nickname Dr. Maggot. But Dr. Ronald Sherman's

maggots are getting more attention since, in January, they became the

first live animals to win Food and Drug Administration approval ? as a

medical device to clean out wounds.

 

A medical device? They " mechanically " remove the dead tissue that

impedes healing, the FDA determined. The process is called chewing.

 

But maggots do more than that, says Sherman, who raises the tiny,

wormlike fly larvae in a laboratory at the University of California,

Irvine. His research shows that in the mere two to three days they live

in a wound, maggots also produce substances that kill bacteria and

stimulate growth of healthy tissue.

 

Still, " it takes work to convince people " that " maggots do work very

well, " said Dr. Robert Kirsner, who directs the University of Miami

Cedars Wound Center.

 

Actually, maggots' medicinal qualities have long been known. Civil War

surgeons noted that soldiers whose wounds harboured maggots seemed to

fare better. In the 1930s, a Johns Hopkins University surgeon's research

sparked routine maggot therapy, until antibiotics came along a decade

later.

 

Patients say maggot therapy is not that hard to accept. Pamela Mitchell

of Akron, Ohio, begged to try maggots when surgeons wanted to amputate

her left foot after an infection in a diabetic ulcer penetrated the

bone. It took 10 cycles of larvae, but she healed completely.

Despite the yuck factor, " if you're faced with amputation or the

maggots, I think most people would try the maggots,'' Mitchell said.