Maggot remedy for diabetes patients

Visitors of diabetes patients at Wellington Hospital could be forgiven for shrieking at the new surgery team working there.

Diabetes specialist podiatrist Angela Bayley certainly got a surprise when she redressed the infected foot of a diabetes patient and chubby maggots crawled out of the wound.

"I had gone back two days later and was quite shocked to see these 25 maggots. I woke up every hour that night with them in my head."

But she has now got used to the sight.

She is hoping the tiny surgeons will offer new hope to patients suffering from diabetic foot, which often results in amputation of toes, the foot or the whole leg as infection rages out of control.

Ms Bayley has been working for a year to bring maggot treatment to Wellington Hospital and has just had her first case.

She believes she is the only person in New Zealand to offer the treatment for diabetic foot, and probably the only person using them in medicine.

A hospital in Scotland has also just reintroduced the larvae to treat patients.

Maggots are used to treat patients with badly infected wounds that do not respond to normal treatment. They also offer an alternative treatment for patients resistant to antibiotics.

The maggots are bred in sterile conditions at the Environmental and Scientific Research Institute laboratory at Wallaceville and couriered to the hospital as needed.

They are released into the wound when they are about 48 hours old.

They replace the scalpel by consuming the damaged, hardened flesh in the wound, leaving good flesh exposed and speeding the healing process, Ms Bayley says.

"It's very hard for me to see in there without causing damage. They can wriggle in to the nooks and crannies in a way I can't."

Maggots have been used in wound treatment for centuries but were largely abandoned with the introduction of antibiotics, Ms Bayley says.

In the 1980s and 1990s Britain, the Ukraine and France resurrected the treatment.

The maggots work by digesting the harmful bacteria in the wound.

"They have very little hooks. They are not chewing or munching or nibbling. It's like they are dissolving the tissue and sucking or drinking it in.

"They excrete ammonia and urea that disinfects the wound. It's a wonderful solution."

When they go into the wound, the maggots are just 3mm in length and about 1mm wide - barely visible to the naked eye. After 48 hours they are fat and writhing - hence the shock on removing the dressing.

One of the most difficult aspects of the project was convincing patients that putting baby flies on their skin was a good idea, Ms Bayley says.

"The reaction is usually the one you would anticipate.

"They are such a cheap and effective treatment. They are the world's smallest surgeons. They work for 72 hours without stopping and you don't have to pay them."

- NZPA