In the sixteenth century, common medical practices included the use of maggots and leeches as part of the healing process. People believed they could use leeches and maggots to remove harmful body tissue, which were perceived as the cause of illness. Medical technology has doubtlessly progressed by leaps and bounds in the four centuries since then, however, some of today’s doctors have returned to the forgone practices. Using maggots in a procedure called Maggot Debridement Therapy (MDT) has proved a useful protocol for managing certain kinds of wounds, particularly diabetic foot ulcers.
Chronic non-healing wounds, such as diabetic foot ulcers often face several impediments to the challenge of healing. A major hindrance is the presence of devitalized tissue in the wound bed, which interferes with the ability of the healthy tissue to grow and heal. Debridement, or the removal of dead tissue, is an integral part of wound healing. Many methods of debridement exist, including the surgical removal of tissue. MDT is useful because it removes only diseased tissue and leaves the healthy tissue intact. Furthermore, it is free from many of the side effects of other types of debridement.
Maggots are useful for debridement for a variety of reasons. For one thing, they consume bacterial microorganisms present in the wound. This effectively halts bacterial infection. They also secrete a substance that acts as an antibacterial agent against infection. Also, they produce enzymes that decompose dead tissue. Maggots eat the decomposed product, and leaving the tissue free to grow and heal.
Misconceptions about maggot therapy are many. People are accustomed to thinking of maggots as harmful, flesh eating worms; in truth that is not the case. Maggots only eat decomposed tissue. Furthermore, by secreting ammonia and calcium carbonate, maggots actively encourage wound healing.
Doctors use sterile maggots that are harvested in laboratories specifically for MDT. Doctors then place the maggots on the patient’s wound, and place a dressing over it. The dressing allows oxygen to reach the maggots, while covering the good skin around the wound, so that the liquid enzymes do not damage the healthy skin. Two to three days later, the dressing is removed and the physician removes the maggots, which have enlarged with their feeding—sometimes up to ten times their original size.
Doctors reserve MDT for patients that meet certain criteria. For one thing, they will not perform it on patients with profusely bleeding wounds. For another thing, they won’t use them on wounds that are too near in proximity to large blood vessels, internal organs, or body cavities. Finally, maggot therapy is not for the weak of heart. A patient has to be comfortable with the idea of using maggots in order to receive the therapy.
MDT is an interesting treatment available for debriding chronic, non-healing wounds. It has the positive use of removing devitalized tissue, while leaving healthy tissue intact. Furthermore, it requires no surgery or drugs, which may be important for certain patients. MDT is one option in the growing field of debridement methods that exist to expedite the wound healing process for chronic wound sufferers.
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