John AdoyiWhen most people think of maggots, they envision something wriggling, slimy, very disgusting and repulsive. Anything that a maggot is found on, is usually washed or thrown away in a typical Nigerian home. However, these tiny larvae are making a significant impact in the medical field, particularly in wound treatment. Once considered an outdated practice, the use of maggot in medicine has re-emerged as a valuable treatment for non-healing wounds, providing a natural and effective solution where modern medicine sometimes falls short. This kind of treatment is called Maggot Debridement Therapy (MDT).
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Join our WhatsApp ChannelHistorical Context:
The use of maggots in medicine dates back to centuries. Ancient civilisations observed the beneficial effects of maggots in wound healing, but it wasn’t until the early 20th century that maggot therapy was formally recognised. During First World War doctors noticed that soldiers with maggot-infested wounds often had cleaner and less infected injuries, leading to quicker recoveries. It was Doctor William Baer who wrote about the positive effects and outcomes of the maggots and pioneered it application in treating chronic injuries. As professor of orthopedic surgery at John Hopkins School of Medicine, US, he initiated the use of sterile maggots as a reputable method of wound therapy. His pioneering work meant the use of maggot therapy began to flourish in the 1930s and early 1940s, and was widely used in hospitals in the US and Canada until other antibiotics like penicillin were produced, reducing the usage of maggots. However, by 2004, the use of clinical maggots reemerged in the United Kingdom and in the United States and its efficacy has been growing ever since especially as harmful bacteria are becoming resistant to other available antibiotics.
How it works:
According to the UK’s Chelsea and Westminster Hospital, the maggots used are special clinical-grade, aseptically reared larvae of the common green bottle fly (Lucilia sericata). These maggots are usually the size of a grain of rice and usually grows between 10-12MM when applied to the wound. These maggots do not have teeth meaning they cannot bite and they do not multiply.
The Maggot therapy works through three primary actions:
Debridement: Maggots secrete enzymes that liquefy necrotic tissue, which they then ingest, cleaning the wound more thoroughly than many surgical methods.
Disinfection: The larvae release antimicrobial substances that kill bacteria, reducing the risk of infection.
Healing Stimulation: The movement of maggots and their secretions stimulate the formation of granulation tissue, which is crucial for wound healing.
Scientists have said that the maggots have the ability to produce 47 different antimicrobial peptides.
“These small, bacteria-killing molecules can be ramped up significantly in response to infection, demonstrating the maggots’ dynamic response to different types of wound conditions,” Yamni Nigam, Professor in Biomedical Science in Swansea University said.
Modern Applications and Acceptance
Despite the “yuck” factor, MDT has gained significant acceptance in the medical community. The US Food and Drug Administration (FDA) approved MDT in 2004 as a prescription treatment for non-healing necrotic skin and soft tissue wounds, such as diabetic foot ulcers and pressure sores.
In Nigeria, the Aminu Kano Teaching Hospital in Kano state, applied MDT to 30 patients including a woman that had already been booked for amputation due to foot ulcer. and it was remarkable, DR. Mustapha Ahmad Yusuf, a medical entomologist told Daily Trust in 2021.
“Many wounds can be treated in a shorter period when compared to the way or days patients would have been spending in hospital beds. This is one of the novelties of this method. We have wounds that would normally take more than a month before they could get cleaned for the plastic surgeon to graft, but this maggot therapy could do the job between five and 10 days,” he said.
MDT is also being offered to patients in Germany, China, Kenya and Australia.
MDT is not only effective but also cost-efficient, making it a valuable option for patients with chronic wounds, particularly in regions with limited access to advanced medical treatments. Research continues to explore ways to enhance the benefits of maggot therapy. For instance, scientists are experimenting with genetically modified maggots that can secrete human growth factors, potentially accelerating the healing process even further.
Changing Perceptions
While the idea of using maggots in medicine might initially evoke a visceral reaction, the clinical success and patient outcomes are hard to ignore. Though it has some side effects like patient feeling pains at the initial stage of application and the fact that some patients cannot stand the sight of maggots, maggots are shedding their “gross” reputation and gaining recognition as a powerful tool in modern wound care.
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So, next time you hear about maggots, think twice before cringing. These tiny creatures might just be the unsung heroes in the fight against chronic wounds, proving that sometimes, nature’s solutions can be the most effective.
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