Strange as it may sound, maggots have recently been in vogue in medical circles. In increasing numbers, doctors have been placing live maggots on patients’ wounds to clean out decaying tissue; because the maggots eat only dead tissue and leave healthy tissue untouched, they’ve been seen as an efficient way to clean the wound. But now researchers have announced the results of the first large clinical trial comparing maggots to traditional therapies, and found that maggots don’t have a clear advantage.
Maggots did clear away the dead tissue faster, but that’s where their superiority ended. “Maggots, although they sped the cleaning, didn’t speed the healing of the wound,” [lead researcher Nicky] Cullum said in an interview. “Both treatments had a similar cost, but the maggots led to more pain.” The researchers found no evidence that maggot therapy should be recommended for routine use on leg ulcers [Bloomberg].
People with poor circulation in their legs often develop difficult-to-treat leg ulcers. Standard treatments for these ulcers employs various kinds of hydrogels — wet dressings that pull dead tissue from the ulcers. With hydrogels, but not with maggot therapy, a compression dressing can be used to cover the wound and ease patients’ pain [WebMD].
In the study, published in the British Medical Journal, 270 patients with leg ulcers were treated either with larvae of the green blowfly or hydrogel and followed for up to a year. Cullum says the test subjects were game for the experiment: “Surprisingly, people were disappointed when they were allocated to hydrogel” [Bloomberg]. Researchers found that both sets of patients healed at the same rate, but those treated with maggots reported twice as much pain.
The researchers didn’t write off the wriggly therapy entirely. They say that maggots may yet have advantages in some specialized areas, such as preparing patients for skin grafts, where faster wound cleaning means patients can be moved into surgery more swiftly. But establishing this will require further clinical studies [Reuters].
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Image: NIH, showing medical maggots in their packaging