04-14-2009, KentB: Maggot Debridement Therapy and Treating Foot Ulcers in Diabetics

Foot ulcers pose a serious chronic problem for people suffering from diabetes and diabetic foot.  These open sores on the foot are very difficult to heal, and they often reappear again and again in the same areas of the foot.  Diabetics who have been treated for chronic foot ulcers build up resistance to antibiotic treatments.  They risk massive infection and even amputation.  While the best treatment is always preventative (diabetics should be constantly on the look out for small abrasions, ingrown toenails, calluses, blisters and corns that could lead to foot ulcers), an old treatment for dealing with tough infections is making a comeback.  Maggot debridement therapy – yes, I mean maggots as in fly larvae – provides a viable alternative to traditional antibiotics. 

The treatment is applied as follows: 

The maggots are placed in a sealed shell-like bandage that lies over the wound.  The dressing allows air to flow in and out (so that the maggots can breathe!) and the wound itself acts as a kind of “ground floor”.  Most treatments are applied for a period of two days because as the maggots eat they grow and attempt to leave the wound.  People with severe infections will require several two-day treatments. 

Maggot debridement therapy has a few advantages over the more traditional surgical approach.  First of all, maggots work continuously during the two-day period to rid the wound of the dead infected tissue.  A physician has a one-time shot to clean out the wound, and often additional dead or diseased tissue forms between visits.  Surgeons are also not as precise as maggots when it comes to removing only dead or diseased tissue.  The human eye has its limitations and often manual debridement with a scalpel results in additional bleeding or increased size of the wound.  The larvae, on the other hand, have no limitations when it comes to leaving the healthy, viable tissue alone.  Maggots also are useful for people who have frequent infections, like diabetics, and who have built up a resistance to antibiotics.  Not only are maggots a promising and long-term alternative to antibiotics, scientists also believe that the material they secrete into the wound possesses antimicrobial properties.  Maggots clean the wound of dead tissue and disinfect the area all in one process.

While the best method is to avoid foot ulcers to begin with, the return of maggot debridement therapy is an exciting development for diabetics who suffer from the chronic infections of diabetic foot. 

Jane Barron (janebarron@live.com) is a freelance writer based in New York.  She wrote this article for posting on OddShoeFinder.com, a free site that allows users to buy and sell single shoes and mismatched pairs of shoes.