Maggots back in medical favour

Phyllis Hulme's family and friends were aghast when she told them doctors planned to put maggots on her leg ulcer.

"I got some horrified looks. I think they thought: she's old, she doesn't know any better, she's gone a bit gaga," said the 81-year-old, who suffers from diabetes.

"But it's been marvellous. I used to feel like screaming sometimes, the pain was so bad, and the first night they were on the pain went."

It may sound gruesome, but it turns out that maggots are remarkably efficient at cleaning up infected wounds by eating dead tissue and killing off bacteria that could block the healing process.

Maggot medicine, in fact, has a long history. Napoleon's battle surgeon wrote of the healing powers of maggots 200 years ago, and they were put to work during the American Civil War and in the trenches in World War I.

With the arrival of modern antibiotics in the 1940s, however, maggots were consigned to the medical dustbin.

Now a new generation of physicians, keen to cut back on antibiotic use, is waking up to the creatures' charms. Some believe maggots are one of the most effective ways of treating wounds infected by the superbug methicillin-resistant Staphylococcus aureus (MRSA).

In a bid to prove the case for maggots conclusively, Dr Pauline Raynor of the University of York is recruiting 600 patients across Britain for the world's biggest ever maggot trial.

Her three-year study is being keenly watched by doctors and wound care specialists around the globe.

One third of patients - selected at random - will be treated with loose maggots, held in place by a dressing; one third with maggots contained in a gauze bag; and one third with hydrogel, a standard wound-cleaning therapy.

So far, most patients have been enthusiastic - once they are reassured that the sterilised greenfly larvae will not start burrowing into healthy flesh.

"These maggots are only interested in dead and unhealthy tissue. Rather than strip a leg, they will start eating each other instead," Raynor said. "Some patients obviously aren't very keen, but we've found the majority are willing to take part. It has not been a problem in terms of squeamishness."

The maggots are tiny when applied to the wound but can grow to half a centimetre after they have eaten their fill.

In the long run, maggots could save patients a lot of pain - and governments a lot of money - if wounds heal faster.

Britain alone spends some 600 million ($1.15 billion) a year treating leg ulcers, which affect 1 per cent of the population and can persist for years.

Conventional treatment may take months, while maggot therapy normally involves just two or three sessions, each of three days.

Dr Kosta Mumcuoglu of the Hebrew University Hadassah Medical School in Jerusalem, who has been practising maggot therapy since 1996, says international interest in the treatment is growing fast.

Last year, the US Food and Drug Administration approved maggots as a "medical device" and Britain has also made them available on prescription within the National Health Service.

- REUTERS