Diabetes Wound Care (Maggot Debridement Therapy)

In maggot debridement therapy, sterile maggots are used to clean up a wound as the maggots are able to break down dead tissue and speed up the healing process.

For people with diabetes, foot ulcers are a common risk — and one that often leads to infection, hospitalisation, or in worst case scenarios, amputation. 

Regular foot care and timely wound treatment can reduce the risk of serious ulcer-related complications. For many diabetics, conventional wound treatment with special bandages and regular wound cleaning can help these wounds heal over time.

Maggot Debridement Therapy: Another Method for Cleaning Wounds

A more unconventional approach to wound treatment uses maggots to clean and heal wounds, and is proving successful.

In maggot debridement therapy, sterile maggots are used to clean up a wound as the maggots are able to break down dead tissue and speed up the healing process.

Nicolas McIndoe, Head and Principal Podiatrist, Podiatry, Ng Teng Fong General Hospital explained: “Maggot debridement therapy uses maggots grown in a sterile environment to clean up a wound. These maggots secrete enzymes that break down dead tissue and clean up open wounds to facilitate the healing process.”

More Effective Than Conventional Methods

Compared to conventional surgery, maggots do a more "accurate" job because they do not affect healthy tissues at all.

Studies on maggot therapy for wound debridement have also shown that compared to the conventional method of using a scalpel or scissors, maggot therapy can clean wounds up to 18 times faster.

Other studies also found that the secretions from the maggots help reduce chronic inflammation and speed up the healing process.

Most Useful When Dead Cells Have Accumulated

Maggot therapy, he said, is most useful in wounds that are sloughy and necrotic. Sloughy wounds have yellowish tissues and necrotic wounds have dead, hardened black or grey tissues.

The accumulation of these dead cells prevents wounds from healing. Only when these cells are removed, can healthy new cells take their place.

Maggot Debridement Therapy: How It Is Done

In maggot debridement, about 200 live baby maggots are used per application and a special bandage keeps the maggots in place while also absorbing excess moisture.

Each application lasts two to three days. While there is no pain, patients may experience a crawling sensation, McIndoe explained.

Reactions from Patients to Maggot Wound Debridement

While many react initially with a squeamish face, nervous laughter or a blank stare, most people are curious about the procedure and are open to learning more about it and how it can help, he shared, adding: “Some patients require multiple applications and once they have seen the effects of the therapy, are more open to continuing until the wound is clean. We have found that most wounds show good improvement after maggot therapy and together with a multidisciplinary, holistic approach, it is a successful complementary therapy for some wounds.”

In fact, he has observed that patients are quite open-minded towards maggot therapy. “I’ve heard a few patients joke that they’re ‘raising’ them and calling them their pets.”

Original article titled "Sole Saviours" was first published in ONEHealth Magazine, Issue 6, 2015.

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