Grubby Surgeons

Once nuisances relegated to our trashcans, maggots are now being welcomed into leading US hospitals. Because evolutionary pressures have honed housefly larvae into lean, mean dead-flesh-eating machines, they are ideal candidates for removing necrotic tissue from poorly healing wounds. Initially popular in the 1930s and 40s, maggot therapy declined with advent of antibiotics. However, with the rise in multi-drug resistant bacteria, maggot therapy is making a comeback.

A mesh bag filled with hungry sterilized maggots is placed on a wound. The wriggling, rice-sized larvae liquefy the devitalized tissue using secreted proteolytic enzymes and then swallow it. Unlike surgical debridement, underlying new tissue is not harmed. The amount of bleeding is significantly less too. The process also releases an ammonia byproduct that disinfects the wound. It is both safe and economical. However, as one patient put it, "You have to get over the psychological and aesthetic considerations."' Plus, munching maggots have a tendency to tickle!

~Medagogue