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maggot

Some patients are refusing this treatment because it's so gross, but in future, it will become increasingly important

Gross, but effective

The idea of placing larvae, i.e. maggots, into an open wound as a way of healing it is both disgusting and terrifying for most people, but even within the last century chronic infections have been successfully treated with this method. However, the discovery and subsequent widespread use of antibiotics  quickly replaced it as the treatment of choice for obvious reasons.

Twitter/ Shane Matthew Neave

But considering the growing number of patients who are resistant to antibiotics, we could very well see a comeback of larval therapy.

What is larval therapy?

Larvae—often of the green bottle fly—are placed into an open wound to eat any dead tissues. The larval secretions kill germs and thus clean the wound, including antibiotic-resistant bacteria like  Staphylococcus. Furthermore, new bacterial growth is prevented and healthy skin cells aren't damaged.

Here's how it is done:

There are two types of treatment. In the first, maggots are simply placed in the wound. About 10 larvae are placed for every square centimeter of wound. A so-called hydrogel is placed around the edge of the open skin to prevent the maggots from traveling beyond it.

Flickr/ Cory Doctorow

A breathable net is placed over the larvae, which is then covered by gauze and a bandage.

YouTube/ Healthpoint

The other variant is the so-called "bio bag" method. Here, a porous synthetic membrane is placed on the wound and covered with gauze. This is often a less disgusting option for patients.

In both cases, the dressings have to be changed every three days so the larvae can be cleaned. The entire process is repeated until there are noticeable improvements in the healing of the wound.



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