By Rachael Rettner
MyHealthNewsDaily

The idea of putting maggots into open flesh may sound repulsive, but such a therapy might be a quick way to clean wounds, a new study from France suggests.

Men in the study, all of whom had wounds that wouldn't heal, were randomly assigned to have dead and unhealthy tissue removed from their lacerations by either standard surgical therapy or maggots (that eat dead tissue).

After about a week, men who received the maggot therapy had less dead tissue in their wounds than men who underwent surgery, the researchers said.

However, after two weeks, the immature insects had lost their advantage: Both groups had about an equal amount of dead tissue in their wounds. And in the end, the maggots did not help the wounds heal faster.

Although the effects of maggot therapy were not dramatic, it may be useful in certain cases, such as in patients with diabetes, whose wounds need rapid control, the researchers said. But continuing the maggot therapy beyond one week is not of benefit, they said.

Medical use of maggots was approved in 2004 by the U.S. Food and Drug Administration. However, only a small minority of patients with unhealing wounds receive the treatment, said Dr. Robert Kirsner, a dermatologist at the University of Miami School of Medicine, who was not involved in the new study.

The study included about 100 men with wounds on their lower limbs. About half received maggot therapy and half received surgical treatment. For the maggot therapy, sterile maggots were placed in a small pouch that was placed on top of the wound. The therapy was applied twice a week for two weeks.

Neither the patients nor the doctor evaluating the wounds knew which therapy a patient received (patients wore a blindfold when their bandages were changed.)

After eight days, the percentage of dead tissue in the wounds of patients who received the maggot therapy was 54.5 percent, compared with 66.5 percent in patients who received surgery. But after 15 days and 30 days, the amount of dead tissue in the wounds was about the same for both groups.

The number of patients who reported feeling a crawling sensation in their wound, and the number reporting pain, was also about the same in both groups, according to the study, which was conducted by researchers at the University Hospital Center of Caen , in France.

Maggots secrete an enzyme that dissolves dead tissue but leaves healthy tissue alone, Kirsner said.

Although there are few risks to the treatment, "there is a gross factor to it," Kirsner said. "Patients have to be very psychologically strong," he said.

Another group of patients that may benefit from the therapy are those who cannot undergo surgery, for instance, if they cannot receive anesthesia, Kirsner said.

Future research should determine whether the effects of maggot therapy can be improved using more maggots, and whether an increase in the number of critters would be painful, the researchers said.

The study is published online in the journal Archives of Dermatology.

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Commentary:

An old ethical principle holds that we ought not speak ill of the dead. After all, they can’t defend themselves. That rule is getting kicked around quite a bit just a week after the death of Steve Jobs.

Tabloids and bloggers, citing cancer experts who never treated Jobs and have no access to his medical information, are speculating that Jobs “doomed” himself with alternative medicine.

After Jobs was diagnosed with a rare form of pancreatic cancer in 2003, he allegedly delayed surgery to remove the tumor -- the conventional treatment -- for nine months.

During that time, he also -- allegedly -- attempted treat his cancer with alternative medicine and diet, some news reports claim. 

That choice, the headlines proclaim, may have cost him his life by letting his cancer grow and spread.

 In a detailed post to Quora, an online forum popular among the Silicon Valley crowd, Harvard cancer doc Dr. Ramzi Amri wrote:

Let me cut to the chase: Mr. Jobs allegedly chose to undergo all sorts of alternative treatment options before opting for conventional medicine.

This was, of course, a freedom he had all the rights to take, but given the circumstances it seems sound to assume that Mr. Jobs' choice for alternative medicine could have led to an unnecessarily early death.

There are some major holes in this kind of speculation from Monday-morning medical analysts.

For one, reports that Jobs rejected mainstream medical advice after his diagnosis remain unconfirmed. Very few people know exactly what Jobs chose to do when he found out he had cancer. None of them are blogging. 

Plus, Jobs lived eight years after his diagnosis with a neuroendocrine tumor. As MyHealthNewsDaily explained today, the average life expectancy for someone with a metastatic neuroendocrine tumor is about two years, according to the Pancreatic Cancer Action Network. (It’s unclear when Jobs cancer turned metastatic.)

It’s fair to assume that a person of his means and intelligence could access any and all expertise that existed to decide how best to try and fight his disease. 

Beyond that, it just doesn’t do anybody any good to guess or gossip.