biotherapy with leeches and maggots
Maggots are applied to the wound either directly (open dressing) or in sterile membrane bags called "biobags." First, the maggots sort out the digestive enzymes which liquefy the dead or unhealthy tissue. Then they suck this liquid out of the wound and digest it in their intestines.
The biobags must be changed every three to four days, when the maggots are satiated with the unhealthy tissue. The astonishing thing about medically applied maggots is that they only dissolve unhealthy tissues. The healthy tissues are not decomposed by the enzymes. Furthermore, this mystical secret of digestion speeds up the healing process.
When maggots are inserted in a membrane bag the therapy is pretty much painless. Many patients don't feel the maggots at all; others feel a little bit of tickling. Full-grown maggots crawling on the skin or edges of a wound can cause tickling or painful sensations. Some patients report pain after the first day or two of maggot therapy. This is probably the result of the maggots - now bigger and heavier - crawling over exposed nerves in the wound bed, or multiple maggots squeezing into small crevices to reach the infected and necrotic debri. Pain usually can be predicted to occur in patients with significant wound pain before maggot therapy. In some cases, when the wound pain is not adequately relieved by simple pain medication, then maggot therapy must be discontinued early in order to terminate the pain immediately.
Medical grade maggots neither burrow under the skin nor attack healthy tissue. Furthermore, they cannot survive deep under the skin because they need air to breathe and there is no danger that they will stay within the wound and 'breed'.
Dr. Majunke at visite
Patients of maggot therapy mustn't necessarily be hospitalized. In fact,
quite lower medical costs make it far preferable to handle in an out-patient
setting. Only if the infection is life-threatening or additional larger
excisions must be made is it necessary to treat a patient in the hospital.
An advantage of the out-patient plan is that the patients can stay in their
own homes. Unfortunately, this usually leads to unsafe therapy conditions.
A Handbook of Maggot-Assisted Wound Healing
by Wim Fleischmann
Martin Grassberger and Ronald Sherman