Maggot therapy just the cure for wounds

NST :Maggots, those revolting little creatures, have found their way into modern medicine in Malaysia.
The Institute for Medical Research has been studying maggot debridement therapy (MDT) for the past three years, and is encouraged by what it has found.
Maggots eat dead tissue in a wound and encourage healing.
"A surgeon will try and remove the dead tissue but sometimes the tissue is so tiny that we need a maggot ‘surgeon’," said Dr Lee Han Lim, head of the IMR’s medical entomology unit.
"The maggots are able to find minute dead tissue and feed on it, cleaning the wound. Depending on the patient, new tissue can grow within a week," he added.
The institute uses the larvae of the local tropical fly species known as Lucilia cuprina (also called langau) in its treatment.
Four-day-old maggots are inserted into a patient’s wound every four days, replacing the previous batch which would have grown too big.
"There’s no pain. Patients say the sensation of maggots crawling around in their wounds is ticklish," said Dr Lee.
According to him, the first patient to undergo MDT was a 63-year-old diabetic at the Lumut Navy Hospital who suffered an intractable ulcer in his foot.
"The ulcer was so bad that he was scheduled for an amputation, but he tried MDT as a last resort and his leg was saved."
MDT is also very cost-effective. The diabetic patient underwent five treatments (five maggot replacements) and the total cost was RM120.
Maggots were first used to treat the wounds of soldiers in the 1500s and later during World War I.
According to the European Tissue Repair Society, the number of doctors or centres worldwide which use MDT has increased from less than a dozen in 1995, to close to 1,000 today.
On the local front, 15 patients have successfully undergone MDT. The therapy failed on two patients whose wounds were far too serious.
Another patient who has benefited from MDT is Dr Lim Ju Boo, a retired senior research officer at IMR. "One day, while mopping, I felt a pain in my leg and saw an ulcer," he said.
For three months, Dr Lim consulted doctors in the orthopaedic department at Kuala Lumpur Hospital, even spending a month at the skin ward. The antibiotics prescribed had no effect.
"Nothing worked. Then I recalled hearing Dr Lee talk on maggot therapy and I asked him for help," said Dr Lim. The first two days after the maggots were inserted into the ulcer, he felt no sensation as there was a large amount of slough.
But the two millimetre-long maggots were working away, eating through the dead tissue and slough. They were replaced every day and on the fourth day, after three applications, there was new tissue growth.
"Those chaps in the hospital were not able to do for me in three months what the maggots did in four days," said Dr Lim.