strange medicine : Maggot therapy

Maggot therapy (also known as maggot debridement therapy (MDT) or biosurgery) is a type of biotherapy involving the intentional introduction of

 live, disinfected maggots (fly larvae) 

into the non-healing skin and soft tissue wound(s) 

of a human or animal 

for the purpose of cleaning out the necrotic tissue within a wound (debridement) and disinfection.

Maggots have been used since antiquity. There are reports of the successful use of maggots for wound healing by Maya Indians andAboriginal tribes in Australia. During warfare, many military physicians observed that soldiers whose wounds had become colonized with maggots experienced significantly less morbidity and mortality than soldiers whose wounds had not become colonized. 

During World War I, Dr. William S. Baer observed that one soldier was left for several days on the battlefield with compound fractures of the femur and large flesh wounds of the abdomen and scrotum. When the soldier arrived at the hospital, he had no signs of fever despite the serious nature of his injuries. When his clothes were removed, it was seen that "thousands and thousands of maggots filled the entire wounded area." To Dr. Baer's surprise, when these maggots were removed "there was practically no bare bone to be seen and the internal structure of the wounded bone as well as the surrounding parts was entirely covered with most beautiful pink tissue that one could imagine." 

Later at Johns Hopkins University in 1929, Dr. Baer introduced maggots into 21 patients with intractable chronic osteomyelitis. He observed rapid debridement, reductions in the number of pathogenic organisms, reduced odor levels, alkalinization of wound beds, and ideal rates of healing. All 21 patients' open lesions were completely healed and they were released from the hospital after two months of maggot therapy.

After the publication of Dr. Baer's results in 1931, maggot therapy for wound care became very common, particularly in the United States.More than 300 American hospitals employed maggot therapy during the 1940s. 

The extensive use of maggot therapy prior to World War II was curtailed when the discovery and growing use of penicillin caused it to be deemed outdated. But with the advent of antibiotic-resistant bacteria, Dr. Ronald Sherman sought to re-introduce maggot therapy into modern medical care.The therapeutic maggot used by Sherman is a strain of the green bottle fly (Phaenicia sericata) and was marketed under the brand name Medical Maggots.

In January 2004, the U.S. Food and Drug Administration (FDA) granted permission to produce and market maggots for use in humans or animals as a prescription-only medical device for the following indications: "For debriding non-healing necrotic skin and soft tissue wounds, including pressure ulcers, venous stasis ulcers, neuropathic foot ulcers, and non-healing traumatic or post-surgical wounds."