A fly in the ointment

October 28, 2007 12:31 AM

MRSA eaten by maggots.
posted by orthogonality (35 comments total)

Ther's a picture of a maggot-infested wound on that "maggots" link that I doubt you'll want to look at if you're at work.
posted by puke & cry at 12:34 AM on October 28, 2007

Uhh...a warning about that last link being a pic of, y'know, maggots munching on someone's foot would've been nice.
posted by zardoz at 12:40 AM on October 28, 2007

Hooray for scientific progress, but ... [vomits with gusto]
posted by tepidmonkey at 12:42 AM on October 28, 2007

puke & cry: "Ther's a picture of a maggot-infested wound on that "maggots" link that I doubt you'll want to look at if you're at work."

You mean at a meal, don't you? How is this NSFW? I thought that only applied to sex and nudity.

Anyway, this is good if the additional trials bear this out in large numbers. Could be a fluke. The other MRSA thread was so depressing it's good there's some hope.

Here's my question, however, can you feel the maggots squirming in your wound? How do you keep them from falling off the wound and covering your home and the rest of your body? Are they bandaged into the wound? Wouldn't that kill them?
posted by who squared at 12:43 AM on October 28, 2007

C'mon, who squared, the maggots are doing you a favor. Don't be so pushy with them.
posted by Citizen Premier at 12:46 AM on October 28, 2007

And at a meal, who squared. Also, maggots only eat dead flesh. Maggots are your friends!
posted by puke & cry at 12:52 AM on October 28, 2007

who squared writes "How do you keep them from falling off the wound and covering your home and the rest of your body?"

Well, the maggots only eat dead flesh (and bacteria, like MRSA), so while having them in your home is unsightly, it's not a health risk (the medical maggots are sterilized). Eventually, they metamorphose into flies. Me, I'd just open a window -- I wouldn't kill anything that had helped me out.


puke & cry writes "Ther's a picture of a maggot-infested wound on that 'maggots' link that I doubt you'll want to look at if you're at work."

Your co-workers find depictions of medical procedures a form of sexual harassment? Kinky.
posted by orthogonality at 12:54 AM on October 28, 2007 [1 favorite]

So I guess it's just a matter of time before there's a CPT billing code for maggots squirming in your open wound.

Can we have the 20th Century back?

Please?
posted by felix betachat at 12:55 AM on October 28, 2007

Your co-workers find depictions of medical procedures a form of sexual harassment? Kinky.

Not sexual harassment, no. Just disgusting. That you would think it was sexual harassment speaks more about you than me, though.
posted by puke & cry at 12:56 AM on October 28, 2007

so we figured out what their dayjob is...
posted by paulinsanjuan at 1:20 AM on October 28, 2007

Maggot therapy has a very long history, and is currently undergoing a major resurgence:

While at Johns Hopkins University in 1929, Dr. Baer introduced maggots into 21 patients with intractable chronic osteomyelitis. He observed rapid debridement, reductions in the number of pathogenic organisms, reduced odor levels, alkalization of wound beds and ideal rates of healing. All 21 of his patients' open lesions were completely healed and they were released from the hospital after 2 months of maggot therapy. ...

Maggot therapy’s extensive use prior to World War II was curtailed when the discovery and growing use of penicillin caused it to be deemed outdated.

It seems that they are very good at removing dead tissue and leaving the living tissue alone -- they do this far more accurately than a surgeon can. They also secrete substances that kill bacteria, even antibiotic-resistant strains like MRSA.
posted by Artifice_Eternity at 1:25 AM on October 28, 2007

Oh, and:

Ther's a picture of a maggot-infested wound on that "maggots" link that I doubt you'll want to look at if you're at work.
posted by puke & cry at 12:34 AM on October 28 [+] [!]

Eponysterical?
posted by Artifice_Eternity at 1:27 AM on October 28, 2007 [1 favorite]

So I guess it's just a matter of time before there's a CPT billing code for maggots squirming in your open wound.

Not a matter of time at all. They've been using maggots to clean the margins of certain types of skin ulcer for years now. They work better than everything else, apparently.

Not just here in the UK either. Get your medical maggots here.
posted by PeterMcDermott at 1:29 AM on October 28, 2007

The maggots are securely held in under the dressing -

A piece of sterile net (LarvE® Net) large enough to cover the area of the wound is cut to size using sterile scissors. 2 or 3 Granuflex® hydrocolloid dressings are cut to size and shape to form a border or shallow chamber around the wound using the surrounding intact skin; plastic surgical adhesive tape is used to secure the LarvE® Net to the hydrocolloid thus forming an enclosure for the larvae over the wound.

I understand you can feel them moving slightly from time to time.

The success of maggots against MRSA has been under preliminary investigation for a while.

Here's the UK supplier of the maggots used in these experiments.
posted by Phanx at 1:35 AM on October 28, 2007

Or you could use their handy BioFOAM:

The larvae are confined within the pouch by heat sealing the fabric which has been chosen to be comfortable and conformable in use. The fabric is hydrophilic, and allows the free passage of wound exudates and larval secretions throughout the dressing.

Excellent.
posted by Phanx at 1:39 AM on October 28, 2007

Uhh...a warning about that last link being a pic of, y'know, maggots munching on someone's foot would've been nice.

You click on a link labeled "Maggots" and you are, in fact, presented with an image of maggots. Seems kind of logical to me. In fact, I can think of very few things in life so clearly labeled. You must be horribly confused when there are no men in the men's room.
posted by doctor_negative at 1:57 AM on October 28, 2007 [10 favorites]

For the record, maggots eat necrotic AND living tissue. Green bottle flies have more of an appetite for necrotic tissue, so don't go leaving your gangrenous feet to the common blow fly.
posted by strawberryviagra at 1:44 AM on October 28, 2007 [1 favorite]

Sure yucky pictures but damn that maggot therapy stuff is fascinating.
posted by gomichild at 2:55 AM on October 28, 2007

If confirmed in a randomized controlled trial, larval treatment would offer the first non-invasive and risk-free treatment of this increasing problem and a safe and cost-effective treatment in contrast to the expensive and potentially toxic antibiotic remedies.

Damn communist/librl maggots eating all the profit away for free ! Now I have to lobby my congressman again, for a new law dictating these maggots must be bred in very special supercontrolled alpha-omega centers, must find ONE single case in which they caused infection (one can conveniently spray some maggots with some disease..you know, a simple error in breeding eheh). These unexpensive, hard to control treatement are a menace to all that is noble and good !
posted by elpapacito at 3:17 AM on October 28, 2007 [1 favorite]

Last week on the blue. Similarly: In Communist China, fish eat you!
posted by rob511 at 3:21 AM on October 28, 2007

Given the choice between a festering wound that won't heal and maggots, I'll take the latter.
posted by malaprohibita at 5:28 AM on October 28, 2007

Brungilda, fetch the leeches (YouTube)
posted by briank at 5:43 AM on October 28, 2007

I am always impressed and moved when Age-Old Wisdom -- maggot therapy, leeches, acupuncture, yoga* -- is tried again and vindicated. (On the other hand, it's depressing that we have to relearn so many things.)
*Yes, yes, I know there are plenty of counter-examples.
posted by GrammarMoses at 5:47 AM on October 28, 2007

Don't get so excited, GrammarMoses. This doesn't exactly open the door to new age crystal healing or anything. The behaviour of leeches has been well understood for quite a long time. The only reason they aren't used more frequently is because of the less-gross, often just as effective alternatives. In cases where we don't have reasonable alternatives, it's obvious that we would continue with known-working methods.
posted by odinsdream at 6:08 AM on October 28, 2007

odinsdream: One would hope so. But sometimes good remedies are discarded by excited scientists who believe they've found something better. In case you didn't see these, here are a couple of interesting and relevant links from the recent MRSA thread.
posted by GrammarMoses at 6:25 AM on October 28, 2007

I can't wait to try and get this maggot therapy pre-approved by my insurance company...
posted by Thorzdad at 6:44 AM on October 28, 2007

Because it must be said:

Maggots, is there nothing they can't do?

Substitute leeches where appropriate.
posted by tommasz at 7:25 AM on October 28, 2007

It tickeles whene they eat the bad humours from me foote!
posted by Koko at 8:03 AM on October 28, 2007 [2 favorites]

I would guess they eat the necrotic tissue first because the bacteria are their direct competitors in the wound and, more crucially, they eat it because the smell the bacteria produce would tend to attract other flies to the wound, and that would also make for more competitors in the wound.

I'd also bet they secrete a killer anesthetic and itch suppressant to reduce the chances you'll scratch them out of the wound-- as well as an immunosuppressant.
posted by jamjam at 8:45 AM on October 28, 2007

The worms go in
The worms go out
The worms eat necrotic tissue and antibiotic-resistant flesh-eating bacteria
On your snout
posted by Astro Zombie at 9:57 AM on October 28, 2007 [2 favorites]

Damn communist/librl maggots eating all the profit away for free

There's nothing free about them. Those American maggots cost $80 a vial.
posted by PeterMcDermott at 11:43 AM on October 28, 2007

PeterMcDermott writes "They've been using maggots to clean the margins of certain types of skin ulcer for years now. They work better than everything else, apparently."

Used for treatment in some burn cases too.
posted by Mitheral at 12:16 PM on October 28, 2007

As someone who has never had a prescription of any kind, including an antibiotic, can someone please tell me whether that would make me more or less prone to antibiotic resistant staph. I get random cuts and scraps all the time. What would a staph infection even look like? All the pictures I can find make it look like acne.
posted by Pastabagel at 4:21 PM on October 28, 2007

As someone who has never had a prescription of any kind, including an antibiotic, can someone please tell me whether that would make me more or less prone to antibiotic resistant staph.

Neither, your drug history would be irrelevent. Antibiotic-resistant staph result from a bug mutation that survives the antibiotic treatment. This happens most often when people don't stay on a prescribed antibiotic treatment because they get "better" and they think it's OK to stop taking the antibiotic, which increases the chance that some of the nasty bugs survive the treatment.

(IANAD, please correct me if I got this wrong)
posted by Artful Codger at 4:53 PM on October 28, 2007

This is comforting.
posted by MotherTucker at 8:44 AM on October 29, 2007