Story by: Menisa Marshall on July 27, 2018
Fair warning: If you’re squeamish, you may find this a bit gross. However, it’s quite amazing when you consider the end results.
Jae Jung, M.D., Norton Cancer Institute, is melding ancient knowledge with new technology to heal hard-to-treat wounds. Dr. Jung, Kentucky’s only oncologic dermatologist, calls maggots “the real stars of this success story.”
Maggot debridement therapy (MDT) uses medical-grade, germ-free larvae to treat serious skin and soft tissue wounds. Typically, MDT is used for lesions that fail to respond to traditional treatments.
“Credible research supports the use of maggot therapy,” Dr. Jung said. “New advanced technology and bandaging applications have improved its effectiveness and made it easier to use.”
Medicinal maggots have been called “the world’s smallest surgeons” because they can precisely debride wounds without damaging surrounding healthy tissue. They secrete enzymes that break down dead tissue and help kill bacteria.
Their work helps stimulate growth of healthy new connective tissue and microscopic blood vessels. This is a critical step in the body’s ability to heal wounds.
Maggot debridement has been described from antiquity across many cultures. Its therapeutic use in the United States dates to the Civil War. In 2003, the U.S. Food and Drug Administration began regulating the use of medicinal maggots.
Judith Beumler, 73, knows firsthand about the benefits of MDT. She struggled for nearly a year with a 3-inch ulcer on her ankle that started from a medicine reaction.
“I hurt from my ankle to my knee. I couldn’t sleep. I needed help,” Judith said.
After seeing other providers, Judith was referred to Dr. Jung, who specializes in treating complicated cases. Dr. Jung had used MDT successfully to treat nonhealing ulcers related to graft-versus-host disease, a potentially fatal immune response sometimes seen in recipients of tissue or bone marrow transplants. She also had used it to treat ulcers related to radiation treatment and poor blood flow.
When Dr. Jung first recommended maggot therapy, Judith and her daughter cringed and said, “What?”
Then they weighed the options: Lidocaine shots and painful debridement every 10 days over numerous visits versus a one-time 48-hour application of maggots. Both agreed to try MDT.
“I was in horrible pain, and we were desperate,” Judith said.
Dr. Jung said Judith’s response is common.
“At first patients are grossed out, as you would expect, but they’re so fed up with the ulcer they just want something that will help,” she said.
On a Wednesday, Dr. Jung applied what looked like tiny white strings to Judith’s ankle inside a specially designed bandage. She said that while the treatment is not painful, it could cause some discomfort.
For the first 24 hours, Judith felt nothing. Late on day two, she felt something. By Friday morning, as she headed to Dr. Jung’s office to get the treatment removed, she admitted the sensation became a bit unnerving.
The good news is Judith’s ulcer responded remarkably well to MDT. She had to wear pressure stockings for some time, and she sees Dr. Jung for periodic wound checks — but she is thrilled with her outcome.
To Dr. Jung’s knowledge, she is the only provider in the area offering MDT. This unique therapy, while still uncommon in modern health care, offers hope for people with chronic nonhealing wounds.
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