Maggots as Good as Gel in Leg Ulcer Treatments

But while larval therapy works well, study says there's no rush to abandon standard care

Posted: March 20, 2009

 

FRIDAY, March 20 (HealthDay News) -- The use of maggots to treat leg ulcers is similar to standard hydrogel therapy in terms of health benefits and costs, according to British researchers.

Debridement (removal of dead tissue from the ulcer surface) helps promote healing and is a common part of treatment for leg ulcers, chronic wounds most often caused by diseased veins. While a hydrogel is commonly used for debridement, it's been suggested the maggots (larval therapy) debride wounds more quickly, stimulate healing and reduce infection.

In the first randomized controlled trial of larval therapy, researchers studied 267 patients with at least one leg ulcer with dead tissue. The patients were randomly selected to receive either loose larvae, bagged larvae or hydrogel and were monitored for up to one year.

Compared to hydrogel, larval therapy significantly reduced the time to debridement, but there was little difference in time to ulcer healing, health-related quality of life or levels of bacteria.

While larval therapy is more effective at debriding than hydrogel, there's no evidence that larval therapy should be recommended for routine use on leg ulcers with dead tissue with the goal of speeding healing or reducing levels of bacteria, the researchers said.

In a separate analysis, the researchers concluded that larval therapy and hydrogel have similar cost-effectiveness.

The findings were published online March 20 in BMJ.

More information

The U.S. National Library of Medicine has more on skin ulcers. Think Harder offers guidance on finding a doctor who will prescribe maggot therapy.

Actual artilce and the bias

Actually the article by US News is more correct that the misinformation you are going by. I will not go into all the in incorrect info but print just a few of the misinformation in the BMJ artilce.

In short, the study proves that maggot therapy was 5 times faster in >debridement than control therapy. It also proves that when maggot >therapy is stopped immediately after debridement and treatment >returns to conventional therapy (instead of continuing maggot >therapy for maintenance debridement or stimulation of wound >healing), then the healing rate slows down back to normal, and >healing is not significantly faster than control (healing was only >one week earlier with maggot therapy, which was not statistically >significant). All prior reports and studies have demonstrated that >the healing rate is accelerated with maggot therapy, and slows dows >within a couple weeks of stopping therapy.

>

>This was not a study of maggot induced wound healing, but rather >maggot debridement, followed through to wound healing. It should be >touted as a great success for maggot therapy; but instead is being >reported by some as a failure . . . as though being as good as the >number one treatment is a failure. A true study of maggot therapy >for wound healing would have continued maggot therapy beyond >debridement, truly comparing hydrogel to maggot therapy, not >hydrogel to hydrogel for 32 weeks after maggot debridement.

>

>Not only did they follow maggot debridement with 32 weeks of >hydrogel just like the control therapy (no wonder the time to >healing was the same), but what's more, they STOPPED compression >therapy during maggot therapy. This is very bad study design, >because everyone agrees that compression therapy is the most >important component in the treatment of venous stasis ulcers. So the >maggot treated arm actually had to compete with compression therapy >. . . a very unfair comparison. And this was not even noted in the >abstract nor the press release. It was not MDT vs hydrogel but >rather MDT vs hydrogel AND compression therapy. Very biased study; >very biased assessment, very biased press release; and it was the >press release that all of these articles are about, since the study >was not released until after the articles were written.

>

>>

Pamela of FL @ Mar 27, 2009 12:55:26 PM

US News poor editing of this article

I have to agree with offsuit of XX. US News did poor editing of this article and left out pertinent facts of this study, such as some patients complaining about pain from the maggots so that the maggots had to be removed.

My advice to everyone here is to obtain any news of scientific progress from peer-reviewed journals, and not the mass media. In peer reviewed scientific journals there are lower chances of relevant information being left out due to editor incompetence. In this case the US News reporting on this topic is biased and not representative of the facts.

dbc of TX @ Mar 21, 2009 00:55:59 AM

Maggots as First Aid

Forty-five years ago in Navy survival training I was taught to let flies lay their eggs in open wounds before binding them up, if medical help was not available. I think the resistance to using maggots in medicine is a cultural bias that views insects as pests to be exterminated at all costs. Nature has so much to teach us but in our arrogance we refuse to heed its lessons.

Wiley Knight of HI @ Mar 20, 2009 18:44:07 PM

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