It all seems as though the word bio didn’t just come to limelight, it had existed for more than a thousand years now compared to what everyone has been made to believe. Presently, we have biotechnology which deals with the biology that studies the use of microorganisms to execute industrial processes and this can be found in the deliberately engineered agricultural produce, we have also biogenetic which deals with the production of living organism from other existing and living organism. There are other bios like bioluminescence which deals with how luminescence or light is provided through a biological process like using the firefly, bionic deals with the application of biological sciences to the study and purpose of engineering electronic schemes. Here, we are more interested in biotherapy and how it works.
Did you just see a maggot spelt out in my title? I bet you did! Have you heard of maggot therapy or Maggot Debridement Therapy before? I still bet you haven’t!
Take a look at what some guys discussed back at Napoleon’s military camp
(Notice their tone of conversation)
Officer 1: This is one of the finest battles I have ever fought and I have a feeling we are still going to lose after all.
Officer 2: It is also my finest but I don’t understand why you are been negative.
Officer 1: I haven’t seen our soldiers as badly wounded as this in even our fiercest encounters. Whatever happens now is far from us.
Officer 2: Oh, you had to be negative because of our combat injury? That was thoughtful but late of you. The generalissimos already thought as much as you are but theirs was just early.
Officer 1: (Takes a deep sigh). I’m happy they all took that into consideration. Do they still have us in mind as pertaining effective treatment?
My platoon officer got shot in the leg, he is badly injured and in pains, he doubts his chances of fighting for his country again or worse, works again.
Officer 2: I must be sincere with you here. Yes, they do. General Napoleon just called for a doctor from a rich medical country. He is a renowned wound healing therapist. The general believes he could cast a spell of belief and unity in the squad by using a therapy called the Maggot Debridement Therapy.
Officer 1: Maggot! Well, do you sincerely see that happening because we’re short of soldiers?
Officer 2: Yes because we have a firsthand info about his method of healing and the method doesn’t take long. We should be fine.
Officer 1 sighed until their voices both faded.
This event talks about an officer in Napoleon’s army who became pessimistic about how things would become in a few days to come. He had fought in major wars and each one has seen him encounter the worst even though victory came. He had started to encounter some of the usual occurrences that he spoke up and he didn’t want to experience what he had in the past. The major concern for him was soldiers been shot and there was no recovery process in place. The second officer boldly told him of a doctor whom they had hired and his method of process for healing. The readers would have expected the first officer to ask what officer 2 meant by maggot therapy but he didn’t. Now, will you ask me?
Note: The above story is fictional.
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A little foreword
More than thousands of years ago, warriors and soldiers were known for their courage, loyalty, and agility. They fought every of their battle from the heart. They took pride in their countries. Contrary to all of these positives was two things; it was either they got wounded which eventually did lead to death or they, died from the onset. This isn’t good for the army, their number kept decreasing. An American doctor, by the name William Baer somehow discovered how wounds (deep) covered with a dense swamp of maggot had a major and quick healing delivery. This news fled all around and it became established in no time.
What are maggots and do they contain any superpower to treat wounds?
Let me take you through a brief of biology. The cycle of fly goes this way, once an adult delivers, it offspring come in form of an egg which lasts from 8 – 24 hours, then transform to Larva which usually takes 4-7 days, then to pupa that has a span of 10-20 days and finally transforms to the adult. Pretty fast a cycle. Right from this cycle is where the larva is taken and used for maggot therapy.
Maggots are the underdeveloped or developing (larva) phase of a housefly found in decaying substances. When flies whether housefly or any other undergoes development, there are stages they must pass through from egg to adult and the larva is one of the stages.
In the science world, we say biotherapy is the use of living things or substances from them to treat diseases in human. Sounds cool, right? In biotherapy, not just maggot is used, another method uses leech but the larvae of fly have been found to be effective. When it comes down to using maggot as a wound healing therapy, not just any maggot is used. Some maggots are known to be disease carriers, some eats plant while the one best suited for medical usage is Lucilia sericata which is commonly known as bottle or blowfly.
At this juncture, I think it is safe to say our chosen maggots for this medicinal purpose have superpowers. They don’t bite; they only feed on the gangrenous part of the flesh or necrotic tissue (Necrotic tissue is a cell injury that causes dead tissue). The work of the maggot is to pass out enzymes that break down complicated or composite protein of the wound into an elementary part to make it digestible.
The science behind maggot therapy and how it works
Maggot therapy had gained ground for a massive number of years until there was a revival of antibiotic drugs in the 1940s. By this, they were forced out of the line since people or patients preferred the antibiotic drugs over the maggot therapy. They felt maggot therapy was irritating, unprofessional and probably traditional. An example of the widely used antibiotic drug is penicillin. Maggot therapy is simply the remedial application of maggots to wounds.
A little chat about penicillin: Penicillin as commonly known is derived from penicillium fungi and is an antibiotic which treats bacterial infections. They are either taken by injection or orally. The discovery of penicillin dates back to almost 100 years ago. Alexander Fleming was as usual reporting back at his laboratory where he noticed the bacteria he kept in a petri dish were not covered (Mistakes have recorded a great deal of success in our lifetime). This, he closely noticed led to a hindrance to the growth of the bacteria and from there Fleming thought about how this could positively apply to the medical world.
How does the penicillin work? In bacteria cell walls, there exists a protein called peptidoglycans. The peptidoglycans strengthen the cell walls therefore making it difficult or impossible for external particles to flow into the bacteria. The penicillin works by bursting the walls of the bacteria which is caused indirectly by acting on the peptidoglycans. Once the penicillin makes its way past the bacteria’s wall, it inhibits it from growing.
It is understood that antibiotics and some other surgical procedure took the stage after World War II and maggot therapy was used once in a while. Right now, there is a sudden emergence in the use of Maggot Debridement Therapy than ever before.
How it works
Larvae are raised and cared for by their farmers for the sole purpose of the therapy. When the larva is gotten in bags, doctors clean and soften wound that it is to be used on. Since maggots excrete alkaline enzymes and have ammonia, the surrounding skin can be shielded by using a cream barrier that prevents irritation. There are two major applications of maggot on a wound which are spraying maggots before dressing it up and putting the maggots in a confined bag that holds them in a sealed area. After cleaning is done, doctors mostly apply them (maggots) loosely which they leave for 2 to 4 days depending on the severity of the wound to get an efficient result.
The dressing can be changed once or twice depending on whether the wound smells. Note that maggots do not smell.
In simpler terms or a layman’s, a typical clinic ensure they obtain the patient’s consent and are sure the patient wants to carry on with the procedure before gently washing the wound with a saline solution i.e a solution of sodium chloride and distilled water and cover the wound with cream barrier or protectant to protect it. To have an effective dressing, a substance that forms a gel with water (hydrocolloid) which serves as a wall and also a foundation is cut to surround the wound which forms the backbone of the dressing. After this is done, the larva is placed in the wound depending on how much the therapist feels would be needed. Once the maggots are in, you can block the top of the dressing to ensure they don’t leave the wound. The top of the dressing is usually done with a net so as to allow oxygen come in for the maggots. Note that the net shouldn’t have a hole larger than 1mm since the maggots are in that region or less.
Professionally, fixed-weave polyester is used as it won’t stretch. Remember hydrocolloid is used as the foundation; latex-free glue is applied by clinicians on the hydrocolloid so the dressing can stay on it. And above the net is a tape holding the edge of the flesh to the net. Premade maggot dressing is used instead of the above step if a therapist thinks he needs to bypass the procedure.
Undressing the wound is pretty easy, as said earlier; the dressing could last for 2-4 days and after the maggots are done, the tape is firstly removed and the net is torn to recover the maggots. The maggots are therefore packed into a biohazard bag for safety and any remaining maggot is drained to make the wound maggot-free. When all these are done, the patient is good to go.
Where has maggot therapy found the most usage?
Maggot debridement therapy is not as simple as the use of penicillin and experts should be sought in case it is to be carried out. MDT is seen as the last resort for wound healing; it is usually done because it is relatively cheap compared to other traditional methods.
Maggot therapy which is as well called maggot debridement therapy (MDT) involves using maggots on an external body (flesh) excluding the eyes. It is used for all kind of wounds from diabetic foot ulcers to burn injuries to fungating breast wounds.
Why MDT a safe procedure
Are you afraid of how Maggot Debridement Therapy can turn out? Don’t be. A clinic that deals with wound healing must ensure a safe practice and a couple of things like
- Ensuring the right species of the maggot is picked. As I highlighted the other time, there are a number of maggots with different aims, one is to transmit disease, another is to eat plants and the one we are interested in, Lucilia Sericata is safe for human flesh.
- Cleaning off microbes in the maggots
- Growing of bacteria-free flies in the lab
- Quality control measures must be taken to certify that the company of maggot meets the safety standard and is safe to use.
When a potential patient knows about all these beforehand, he can carry on with the therapy.
Conclusion
If a wound healing is one concern you have, even a severe wound that won’t heal on time is a candidate for maggot therapy. A better criterion for been used is when it is applied to soft tissue on the outside (usually the flesh) of a human. You may be concerned that how does the clinician get rid of the pack of maggots; it’s simple, maggot leave once they have done their part on the necrotic tissue of the wound and are collected by the therapist. On the patient’s part, the most felt pain could either be patient discomfort or anxiety. So, while going through the therapy, the therapist must take a good note of the instructions on the dressing and the patient must also feel at rest.
Analgesics must be within reach in case a patient starts to feel pain. Pain usually occurs when larva grows so large the patient starts to feel it crawl in the wound.
Special dressing in this healing method is to ensure that they wouldn’t leave the wound site or wander away which is very important.
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