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Anyone used greenbottle fly larvae on necrotic tissue before?

A couple of patients at my hospital have been treated with greenbottle fly larvae to cure problematic necrotic wounds. Anybody seen this done before? What results did you see, and would you recommend this treatment?

As gross as it may sound, using fly larvae (aka maggots) are perfect for the removal of necrotic tissue 'cause they'll only eat dead tissue. Now, I imagine this saves the person who would have to go in and delicately remove only the necrotic tissue in a large/deep wound; I bet some healthy tissue would also be inadvertently removed. I haven't seen this in any of the small hospitals I've been in, but I have heard of fly larvae being used... now, I don't know if those cases were specifically with a greenbottle fly.

I remember a pt. who came to the hospital with a cancerous breast that she had ignored. It was covered with maggots but it had turned into a very clean "home-grown" mastectomy. Of course the Ca had spread before that point but the sight/site was hard to forget. On the other hand, I saw a program on the Discovery Health channel that spoke of maggots (and leaches) used in wound care. The critters are raised in clean lab-type conditions, put on the wound and the area is dressed/changed periodically. As said before, the necrotic tissue is removed leaving all of the viable tissue.

It is an ancient treatment that is making somewhat of a comeback. Hard to overlook the gross factor though. Maggots make me retch and I can't imagine trying to console a freaked out patient as the maggots squirm and roll.

Yes, I had worked with a plastic surgeon who used these live necrotic agents to prevent swelling on certain facial surgeries. He believed that wound healing is hastened by the maggots' movements stimulating the capillaries and thus improving circulation to the wound. They are flown in sterile from a supplier and we would do occlusive dressing so they won't wander off to other areas. Likewise hungry maggots eat up dead tissues so they keep the wound sterile as well. This practice has been more popular in Europe.

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