Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, July 11, 1995 TAG: 9507110032
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: RANDI HUTTER EPSTEIN ASSOCIATED PRESS
DATELINE: OXFORD, ENGLAND LENGTH: Medium
Enough maggots, Rogers estimated, to help heal the wounds of 10 patients - figuring 10 maggots per square centimeter of open sore.
Rogers, an Oxford University entomologist, is a pioneer in the fledgling field of maggot therapy.
The notion is that maggots devour dead tissue and bacteria lurking in the wound but avoid healthy skin and muscle. In an age of increasing antibiotic resistance, the maggots may do a better job than medicine, proponents say.
``It's got global appeal. It's ludicrously cost-effective and low-tech,'' said Dr. John Church, an orthopedic surgeon. He, along with Rogers and fellow entomologist Paul Embden, aim to launch maggot therapy here. It is already up and running in one U.S. hospital.
``We just have to get past what I call the Yuck Factor,'' said Church. ``It's this immediate reaction of disgust.''
The Oxford team has a fertile family of flies, capable of producing hundreds of thousands of offspring every few weeks.
``We can produce phenomenal quantities, the biggest problem is overproduction,'' said Embden, swatting flies buzzing around the scientists and a visitor.
Now they just need the go-ahead from nurses, squeamish about changing bug-ridden bandages, and hospital managers, antsy about condoning infested wards.
Church said he has treated one patient successfully, but he would not reveal details of the case.
For at least three centuries, observant doctors had noted that patients with maggot-infested wounds healed faster than those without fly eggs, said Church. But only recently have a few clinicians sought to bring nature's remedy to hospital wards.
Dr. Ronald Sherman, entomologist-turned-doctor at the University of California, Irvine, completed one of the first studies comparing maggots to medicine. He has been breeding maggots and treating patients at the Veterans Affairs Medical Center in Long Beach for about five years.
The findings, based on 10 patients and published in the April issue of The Journal of Spinal Cord Medicine, indicated that the bugs could heal wounds that defied medicine. Patients got maggots after medicine failed. The maggots, said Sherman, shrunk the wounds by about 20 percent to 25 percent a week. All the patients healed completely within about a month, said Sherman.
Maggots thrive off dead meat and bacteria, and can ``get into the nooks and crannies that antibiotics can't reach,'' Church explained.
Within about five days, maggots mature into pupa, a hardened cocoon-like stage in which the full-grown fly develops. Bandages must be changed before the flies fly away, said Church.
Most patients require at least three batches of maggots.
Both Sherman's and Church's teams breed green-bottle flies, a common housefly formally known as Lucilia sericata. They suspect that other species are just as effective but caution that it is also possible other types of maggots could invade healthy tissue.
In other words: Don't try this without medical assistance.
Besides treating patients, the scientists seek to unravel the mysteries of maggots' inherent anti-bacterial traits. Such findings may yield clues to help design more effective antibiotics.
Sherman has a hunch the mechanism may be too complex to replicate. Then, again, if you have the real thing, why settle for an imitation?
``As an entomologist,'' said Sherman, ``I don't see why anybody wouldn't be just as happy with the maggot. But I'm sure if we could come up with a different delivery system without live critters, it would be more acceptable to most people.''
by CNB