17 replies to this topic

[bigsmiles]

Ok, now I’m not sure if my friend is pulling my leg here but he told me that the District Nurse’s this morning said they are going to be using maggot therapy to treat yet another pressure sore that seems to have found its way to his lovely bottom again! as they so often do. He says there is dead skin tissue around the wound which wont heel unless they dress with the maggots, there like in a small bag and covered with the dressing for about two days (yuk ) then the maggots munch away, yuk double yuk!…anyway I thought that maybe he was just having a bit of fun with me and we couldn’t stop laughing about maggots in his pants for hours but he tells me he’s deadly serious. Anyone else heard of this before?

[elisabeth]

Christ Almighty hasn't the medical world progressed since then? I have heard of maggots being used to treat gangrene, but that's in the old days. I can't believe the district nurses are suggesting this, well, actually, I can. I guess many don't want to admit that doctors might know more than them in cases like this. Not all district nurses are like this, but I know many who are. If the pressure sore is that bad it probably needs hospitalisation and debriding by a plastic surgeon. I don't want to think what effect maggots might have if he has osteomyelitis under the pressure sore.

My God, this is just crazy. Is it cheaper for the government to do this rather than hospitalising your friend or something? This seems greater than just a strange decision by a district nurse

Edited by elisabeth, 13 April 2007 - 04:22 PM.

[Chilepepper]

Here you go Bigsmiles.

http://www.ucihs.uci...man/home_pg.htm

[KimAndSophie]

Ewwww.... They would seriously have to knock me out first if they were going to try that on me and not even tell me what they were about to do! I need to go take a shower now!

[bigsmiles]

Hi Elizabeth, its strange you mention this osteomyelitis, is this an infection in the bones of some kind? Only he’s had three hip operations in about twelve months to try and put a stop to leaking fluid which has been ongoing for god knows how long now and he’s been on vac therapy for what seems like forever.
He’s had his ball joint removed and the leaking just continues and surgery to clean the area, now he's waiting further surgery to put the ball joint back to hopefully stop the bone from just moving all over the place! It just goes on and on….which they keep saying its an infection of some kind. Anyway back to the topic , if this is what they really intend doing then god knows what problems he might end up with….sounds horrible. I don’t understand why they want to do this as he’s had worse pressure sores in the past, even had surgery - skin grafts. Can’ t believe this is for real , well yes I can years ago years ago maybe but haven’t we come along way since then….I don’t like the thought of this at all.

Thanks Chile pepper will get a cuppa and have a good read!

[wheeels]

This has been going on for years and has nothing to do with what age of medicine we are in. The benefit of using maggots is that they only eat dead flesh not healthy flesh so they can do something that no Dr or nurse can do.

My understanding is they come from a lab so hey are clean.

May sound gross but effective.

[Joed]

I know it sounds repulsive, and I'm fairly sure I could never withstand the treatment myself, but maggot debridement therapy (MDT) is becoming increasingly more 'common' and accepted by the medical world today as an effective treatment.

The larvae are exchanged every two to three days with fresh ones....I'm not sure of the reason for that, but I suppose they get....full? Or maybe their metamorphesis (sp) is that rapid and they begin to change into an adult blowfly in that space of time. (?)

There was a documentary about this last year along with leech therapy, which is also enjoying a resurgence in use.

Gee, I just hope they don't bring tripaning (drilling holes in the skull) back.

[Bulky]

I watched an episode of "Beyond Tomorrow" on cable-TV that talked about lab-raised maggots and wound therapy. They discussed how some battlefield causalities healed quicker "in the trenches" of WWI (might have been II) than in field hospitals. Yes maggot theory might be gross, but is assisted bowel routine conceptually palatable in comparison?

[elisabeth]

I'm sure the maggots are clean and everything and are raised in a laboratory, but I still have extreme reservations for various reasons.

Primarily, if someone has a pressure sore that bad they should probably seek hospital treatment. Sure, the dead flesh might go away but there is still the wound left to deal with. A wound that needs debriding to that extent probably needs more care than a district nurse popping round every couple of days to exchange the full maggots for new ones can provide.

Secondly, I wouldn't have thought it would be wise to use maggot therapy in a nonclinical setting. I would have thought that treatment like this needs round-the-clock observation.

Thirdly, nurses are unable to test for any sort of infection of the bone (yup, osteomyelitis). So what happens if the wound is debrided with maggots at home and the wound later heals only to break down again because of an underlying infection in the bone and its all back to square one? Undiagnosed osteomyelitis is probably one of the most common reasons for the recurrence of pressure sores, or so I've been told by various people in the medical field anyway.

Fourthly, if the wound is so far gone that it needs intense debriding it probably also needs further tests to find out the extent and depth of the wound. Pressure sores are a little bit like the roots of a tree to a certain extent, they don't just grow downwards they also grow outwards sometimes and the only thing that can really assess that are hospital tests.

Trust me, hospital sucks. I should know, as I'm in hospital now with a pressure sore. I don't think I am being overly cautious, I'm just worried for a fellow SCI because most of the readmits on the spinal ward I am in at the moment are people with pressure sores, and the majority of them tried to treat them at home for so long without success that they were admitted to hospital riddled with osteomyelitis which can lead to amputation, some have been in for upwards of two years and all have a plethora of associated health issues due to leaving their sore for so long. So ultimately, I would recommend a doctor's consultation to be on the safe side.

And Bulky, I would much prefer to have a carer shove their finger up my butt than having maggots squirming around a wound anyday. An-y-day!!!

Edited by elisabeth, 14 April 2007 - 04:27 PM.

[Joed]

elisabeth, on Apr 14 2007, 03:26 PM, said:

Primarily, if someone has a pressure sore that bad they should probably seek hospital treatment.

In the program I watched, I believe that the patient was receiving her MDT in hospital.

Otherwise, I agree with all your good points concerning comprehensive treatment and having this done under the proper supervision/protocol.

[Bulky]

Ok, further to my last post, I should qualify that the maggot therapy was done in a clinical setting. Not "here's a bag of take home maggots." Whatever it takes I say and if maggot theory was going to help me at some stage in my quad-life, then so be it!

[elisabeth]

Joed, I guess I'm just overly cautious about pressure care because I have a pretty nasty pressure sore which has been bothering me for the last couple of years, treatment at home didn't work, and treatment last time I was in hospital didn't work. They are taking different steps now to fix the problem (different medical team) so hopefully after this lot of treatment ends I can resume my life again which includes two different jobs I am insanely passionate about and feel so lucky to have as well as return to Uni. I really could not care less about being in a wheelchair anymore and it's just this darned pressure sore holding me back and the thought of other people going through what I have been through so far with my wound would just be horrible.

But hey, if it's clean and it does the job so be it I guess, I just don't think I could handle it myself when I could just have a plastic surgeon debride the wound instead. I've got a pretty weak stomach:p

[moonstar]

HI BIGSMILES,
MY HUSBAND HAD MAGGOT THERAPY ON HIS HEELS IN JANUARY, I HAD THE SAME REACTION AS YOU WHEN IT WAS FIRST TALKED ABOUT, IT REALLY WORKED THOUGH. A SPECIALIST NURSE CAME WITH THE DISTRICT NURSE AND OVERSAW THE FIRST TREATMENT, THE MAGGOTS WHERE DELIVERED TO US FROM A STERILE LABORITORY, THEY WHERE CONTAINED IN LITTLE NETS THAT LOOKED LIKE TEABAGS, THEY WHERE PUT ON THE WOUNDS AND DRESSED WITH SPECIAL DRESSINGS, THE NURSE CAME EVERY DAY TO CHECK AND REDRESS THEM, THEY TAKE THEM OFF ON DAY FOUR SO THEY DONT TURN INTO FLIES, IN OUR CASE THEY DID A SECOND TREATMENT AFTER WHICH THEY APPLY A GEL TO THE AREA TO HEAL IT, IT TOOK A COUPLE OF MONTHS TO HEAL BUT IT WAS BETTER THAN BEING DRAGGED BACK TO HOSPITAL. THE REASON THEY USE MAGGOTS IS THEY ONLY EAT DEAD FLESH AND AS THEY WORK THEY EXCRETE A NATURAL ANTIBIOTIC THAT STARTS THE HEALING PROCESS STRAIGHT AWAY, IT IS NOT AS BAD AS IT SOUNDS AND REALLY WORKS, I MUST SAY THOUGH I DONT THINK I WOULD LIKE THE THOUGHT OF HAVING IT DONE xmoonstarx

[bigsmiles]

Thankyou for that Moonstar, will be sure to pass on that the maggots have been tried…tested and a success. The maggot therapy started just today so be sure to keep you all posted on how it goes. I’m glad you mentioned that they are taken off before they turn into flies…I did wonder. I remember my step father who was a keen fisherman once putting a box of maggots in the fridge (mum was going nuts!) and of course the lid wasn’t on firmly. The next day it was flies everywhere (horrible) and it took ages before we finally got rid of them

[elisabeth]

Interesting article in Daily Mail about NHS and maggot therapy.

I'm slowly changing my mind.

[bigsmiles]

That made an interesting read thanks Elisabeth….bring back the maggots! From what I’m told there has been a definite improvement and after a while you tend to not think about them. As long as they work and help with the healing process then that’s all that matters. I’m warming to the idea now, wouldn’t like the thought of it myself though

[moonstar]

HI BIGSMILES,
JUST WONDERING HOW THE TREATMENT IS GOING? IS IT WORKING?
xmoonstarx

[bigsmiles]

Hi Moonstar

Wound has almost completely healed but sadly he has managed to find himself with yet another pressure sore on his bum which is not looking very nice. Thinks he may of caught it transferring with the banana board. He never seems to go for very long before he has yet another
So is now stuck in bed at the request of D/N and is only up for only around two hours a day…which is not making him too happy. Just got to wait for the vacs therapy to arrive and hope this helps.

Thanks for the thought xx