November 10, 2015 • 37 mins
Cultures around the world over the years have been inspired by, then repulsed, then inspired by maggots' ability to heal persistent wounds. We are in an inspired-by phase right now.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to Stuff you should know from house stuff Works
dot com. Hey, and welcome to the podcast. I'm Josh Clark,
There's Charles w Chuck Bryant, and uh no one, no
one else is in here with us yet again, because
we've graduated to the point where we don't even need
(00:23):
a producer. We need somebody who presses record and leaves.
That's it. Because we're pros. Yep, not p R O
s E. P r O S that's right, we're not.
But we are prosaic, yes, but definitely not p r
O apostrophe es. Very few things drive me crazier than that,
And I know it's stupid and pedantic, but to see,
(00:44):
like somebody take out a huge billboard or something and
so a word has an apostrophe. That shouldn't pros. People say, like,
leave it to the pros and they'll put an apostrophe. Yes,
and it's it's that graphic designer should be, you know,
doctor half a day's paying maybe bucks. Something we want
(01:05):
to issue and you probably would get this from the
title of the episode, but we want to issue a
meal warning. Oh good thinking, because we've gotten complaints in
the past when people are eating and get sick listening
to some of these. Yeah, this would do it possibly
for some people. I was fine. I ate a running
yolk egg sandwich while I was right. It didn't bother me,
(01:28):
but I could totally see how it could be any people.
I also want to say, um, if it comes up,
do not go Google image search wound sloth. Well, I
just put do not Google image search maggot therapy at all. Okay, sure,
but definitely stay away from wound sloth s l o
U g h. Yeah wow, and definitely don't look at
(01:52):
wound slough while you're eating. Yeah. Okay, so that's all
out of the way. Yes, I predict we're going to
be kind of excited about this one. I'm feeling a
little pumped about it. Well, we did cover in uh
tin Bizarre medical Treatments uh leech therapy, which is still
being used, and I'm surprised this wasn't in that article.
To be honest, I am as well. But this gets
(02:13):
its own special deal, and well it should actually because
it's a pretty amazing thing. Um, we're talking about maggot therapy.
Yes it is so, or they really or is that
a name? Well, it's a band name. To end all
band names. There probably wasn a band name that. So
there's it's called maggot therapy, maggot dibridement therapy, larval therapy,
(02:35):
or bio. There's another one called I think like bio
biodebridements or therapeutic wound miasses. Yeah, and that's basically all
the all of them, no matter what you call it,
no matter how you church it up. It is the
application of live maggots fly larva to purposefully to an
(03:01):
open wound in order to help that wound heal faster. Yeah,
and better and cleaner and all that good stuff everything.
Daft Punk said, Oh yeah, you know, should we talk
about some of the history of this stuff. Let's just
say that one more time. Okay. Maggot de bridemant therapy
(03:22):
is taking live maggots and putting them in an open
wound on a human being or an animal. It's used
in veterinary medicine as well, wrapping it up tight and
letting them just eat the dead and dying flesh of
that wound while you get your foot tickled. Okay, I
would be so skiped out by this. I just wanted
to make sure that everybody knows exactly what we're talking about, right,
(03:44):
and goodbye to everyone everyone who fainted. Okay, yeah, let's
talk about the history, chuck, because this is um, this
is in use today, but it's actually pretty old. Yeah,
I mean it's it's some say it's an even an
ancient tradition like in place is like Burma in Central
America with the Mayans. Um, they were smart enough to
(04:05):
know that maggots do a pretty good job of consuming
human flesh. Uh, And it can be used for good
in that regard. Yeah, at some point, I guess healer's noticed,
like y, people who had maggots in their wounds tended
to have wounds heal Uh. And actually, as far as
the Western literature goes, that's exactly how UM maggot therapy
(04:25):
first finds its way, first crawls into the medical literature
is from a French surgeon named Ambro Ambras Pore. Yeah,
but how would you say, I don't know, I don't
speak French Ambras even though it doesn't have the little
(04:45):
what is that an accent? Yeah, it's just the e.
But he was a sixteenth century surgeon and he noticed that, um,
that people didn't necessarily fall over dead if there was
a maggot in the wound. Yeah. He was a first
doctor to actually come out and say, you know, I
had this patient got a big skull wound, and unbeknownst
(05:07):
to me, there were maggots in there. I saw them
crawling out one day and even though they had a
lot of bone. Um, the guy was great. He healed
like he lost a hand sized slab of skull and
he lived. And I think it might have something to
do with the maggots. Yeah, and he presumably wore a
helmet for the rest of his life. Probably he had
a probably big soft skull there. Uh. That was followed
(05:31):
in uh with the mid seventeen hundreds by another Frenchy baron,
Dominique Jean Laoie Uh, and he said, you know what,
on this Egyptian expedition, Uh, these blue fly maggots are
actually doing the right thing and helping us out. So
it's almost like these doctors just noticed this exactly and
(05:55):
it meant enough to him that they were like, I
should probably write this down. This is gonna be my
contribution to medical history of the history of science right there. Um.
So it wasn't until the uh, I guess the Civil
War that a doctor actually said I'm going to purposefully
put maggots in a wound and see what happens. And
(06:16):
that doctor was John Forney Zacharias. He probably didn't tell
his patient that. I think probably that he was just like,
just bite down on this brooms and look the other way.
Do you want to lose your foot or do you
want to try something really weird? Well, supposedly in studies
of people, modern patients who are offered this therapy say
yes to it. Well, yeah, because I think that's what
(06:36):
it comes down to you. It's a last resort. Basically,
it's not the first thing they offer, not necessarily. Um So, anyway,
doctor Zacharias um Hey had a great quote. He said,
during my service in the hospital at Danville, Virginia, I
first used maggots to remove the decayed tissue in Hospital
Gang Green, and with my eminent satisfaction, in a single day,
(06:58):
they would clean a wound much better than any agents
we had at our command. I used them afterwards at
various places. I am sure I saved many lives by
their use escape septicemia and had rapid recoveries period. End quote.
Pretty great. Yeah, So he was a huge believer and
not just a passive observer like people who came before him.
He said, yeah, I put maggots on wounds and it helps,
(07:20):
that's right. And uh, people experimented with it for a
little while until um, a guy named Louis Pasteur and
Robert Coke came along, Uh, microbiologists and germ theorists that
basically said, you know this, this is disgusting. We might
want to not do this. Yeah, because they're dirty. Yeah, yeah,
And it's true maggots naturally in the wild carry lots
(07:44):
of pathogens with them that um can infect us in
other ways, can make a wound worse, can actually kill you.
So this the idea behind germ theory as far as
maggots goes right. But um, it seems like there's this
long history of necessity and discussed with maggot therapy that
kind of wayne ebbs and flows right, and necessity rears
(08:07):
its head on the battlefield. It did in the Civil War,
and it also did in World War One. There was
a surgeon um named William S. Baer, and he was
working on the front lines in France, and he used
maggots on stomach wounds and open fractures and he found,
to his great satisfaction, just like Dr Zacharias and the
(08:27):
other before him, that this stuff actually worked. Yeah, and
he actually said, you know what, I have some further advancements. UM,
maybe we should put a bandage over this thing so
it doesn't completely discussed the patient. Uh, and let me
UM put bandages around the wound so they don't start
creeping onto the healthy flesh and doing damage or just
(08:49):
itching you or creeping you out further right exactly, UM,
which are still in use today. These techniques. He also
pioneered another huge technique, and this is after the war
was over. Ten years later, when he was back at
Johns Hopkins UM. He he pioneered another really important technique,
and that was using sterilized UM maggots. Like germ free maggots,
(09:10):
they were raised as eggs in a sterile environment, and
so when they were introduced to the wounds, they weren't
carrying these pathogens anymore. And he found this is the jackpot.
Now you can use maggots from now on. That's right.
And there was a big boom uh in the thirties
up until the mid nineteen forties. Uh, three hundred more
than three hundred American hospitals. Uh, we're using maggot treatment,
(09:34):
maggot therapy. And then in uh, antiseptics came along, or
you know, new antiseptics, and they said, you know what,
maybe there was another lull in the use of maggot.
They right, necessity didn't didn't spur this stuff, and it
was they went back to just being gross again. There
was a guy UM who by the eighties wrote what
what this one article calls the majority opinion. Fortunately, maggot
(09:57):
therapy is now relegated to a historical backwater of interest,
more for its bizarre nature than its effect on the
course of medical science. A therapy the demise of which
no one is likely to mourn. That's just that kind
of Western medicine hubris, where like we can do anything
except everything, you know, that's right. And in the nineteen nineties,
(10:21):
UM a dude named Ronald Sherman and Edward Pector basically
champion the technique again and kind of brought it into
the modern age. Yeah, and still very much is UM.
Ronald Sherman is one of the first, i think, to
receive a license to produce sterile maggots for use as
(10:43):
medical devices. Um. And there's another guy over in uh
the UK named John Church um who uh who brought
the maggot their maggot therapy into the four So it
was an ancient thing, it was. It's found to be disgusting,
it's found to be useful, it's found to be disgusting.
(11:04):
It's it's found ways you can make it better. It's
found to be disgusting. And then now that this idea
of complimentary medicine is is kind of regaining some traction again. Um,
I think it's here to stay, though I think so too,
unless someone comes along in ten years is you know
what it's disgusting, well, you know the chuck. I mean
probably what we're seeing is the next thing that will
(11:26):
happen is there will be some huge leap, some huge
development in science, and science will get its tackles up
again and great about itself and we don't need any
of that stupid nastiness. And then we'll find that Nope,
you still can't beat good old fashioned maggots. And that's
that should be the title of this thing. You can't
beat good old fashioned maggots for healing a wound that
won't heal otherwise it's a great title. So you want
(11:49):
to take a break. Uh, yeah, let's do it, and
we'll go um treat our own wounds and we'll be
back shortly. All right, Let's talk about diabetes for a second. Yeah,
(12:29):
more than twenty three million Americans are affected with diabetes.
And one thing that can happen, uh is nerve damage,
especially in the extremities the hands and feet and the
toes and the and the fingers. Your blood vessels become
hard and they don't circulate the blood like you need.
That can lead to open sores called ulcers, which can
(12:52):
become infections, which can spread to nearby bone, which can
lead to amputation. Yeah. It all this is just from
a long exposure to high levels of blood sugar and
they're not sure how it can do it. But yeah,
the blood, the blood vessels not helping pump blood very well,
get nutrients, or your tissue can die. But also that neuropathy,
that dead and nerve cell um that actually makes it
(13:15):
hard for you to notice. If you have like a
really bad ulcer on the bottom of your foot, you
can't feel it and so you don't get treatment early enough,
so it can get an infection can get out of
hand and when it spreads to bone that's called osteomyelitis.
That's problematic because that very quickly will lead to an amputation.
And there's some pretty shocking stats here from this article
(13:38):
that Tom wrote. Um about this sheave jam Yeah nice,
it's yeah for sure, Um. But about amputations from diabetes. Yes,
seventy thousand to foot and leg amputations each year in
the United States alone, and uh they say around the world,
they estimate every thirty seconds someone gets a limb cut
(13:58):
off because of diabetes. Yeah, that's sad, Yeah, it really is,
and we should We will do one on diabetes for sure.
Oh yeah, I'm surprised we haven't already. Um. But the
so amputation is used to halt the progress of an infection,
and that's usually the last resort. But what's what Tom
(14:20):
points out is that there are plenty of doctors around
the world I imagine that aren't aware that you can
use maggots or have never done it before. And if
you are facing an amputation from say like a wound,
a persistent wound, a chronic wound that won't heal, um,
you may want to suggest maggots to your doctor. You
(14:40):
may have to actually take this the the initiative on
this one, and say, let's make sure the amputation is
the absolute last resort. Let's see if we can put
one more resort in there before then. I'm willing to
let maggots crawl inside my body in this wound is
open wound if you're willing to apply them. And they like.
Doctors love hearing when patients suggest treatments. Oh, they do.
(15:04):
They love feedback. They love to be guided in their
diagnoses and prognoses. Yeah, I love it. That's a tough jam.
I get it. Doctors are frustrated a lot of these
days with self diagnosis and online doctoring. Sure, but you
should also be your own advocate. We can't be in
that before. Yeah, it's your leg. Yeah, if you want
to keep your leg, you tell that doctor to go
(15:24):
get some maggots. You're going to replace them with the
doctor who will. How can I can find a guy? Yeah,
I can get a guy by noon that'll put maggots
on that wound. And actually there's a there's a group.
I think Ronald Sherman, the guy we mentioned earlier, who's
like the the US champion of maggot therapy. Um, it's
there's this group called the b Turf Foundation b t
e Er Foundation, UM, and they have all sorts of
(15:48):
resources for people in that very situation, like how to
talk to your doctor, UM that if your insurance won't
cover it, let them know, because they say insurance actually
most insurance covers maggot therapy, but most insurance claims people
are not aware of that, so you may get denied
at first. And here's how to talk to your insurance
(16:09):
company that it really is. That beats going to your
doctor and saying, well, you know what Josh and Chuck said.
He you're not gonna like hearing this, right because you think, doctor,
please take a sleep and be put maggots on my feet, right.
And and that's the other thing too. I mean, like
we wouldn't be suggesting this and the betur Foundation probably
wouldn't be such advocates for it if it didn't work
(16:32):
so amazingly well. It study after study, and we'll talk
about the details of it, but there's so many studies
out there. UM. Again. Sherman, who agreed, is an advocate,
but in a pure reviewed journal published a survey of
studies that he could find on maggot therapy and it's
very clear that it works really, really well, and not
(16:55):
only necessarily um as a means of last resort, but
even just compare to the standard of care using like
hydrogell or other things that you might use to treat
a chronic wound. Maggots destroy it. They leave it in
the dust. Yeah. And if it doesn't work, it's not
gonna hurt anything, I can tell. Yeah, it just puts
off how much longer before they amputate your foot? Pretty much?
(17:18):
Uh So what will happen is they will Well, let's
get into this a little bit. Um. There are four
different and you where did you find this? Was this
a a research paper? Yeah? This is by Ronald Sherman
Mechanisms of Maggot Induced Wound Healing colin What do we
know and where do we go from here? It was
in the journal Evidence Based, Complimentary and Alternative Medicine in
(17:40):
two thousand fourteen, that's right. And he describes for different
phases of basically healing a wound um homeostasis, inflammation, ploriferate. Man,
I'm so bad at that one. Oh yeah, keep it coming,
proliferation and uh, remodeling and maturing, and what happens is
(18:01):
the cells get to work, they recruit other cells, they
alter their activities and basically say, let's get to work
cleaning and uh, well on all four of these stages
to help heal the wound. Yeah, and at any any
one of those stages, um, the the next process can
stall out. Um. Normally it stalls out at inflammation because
(18:25):
the infection gets out of hand in the body can't
fight off the infection faster than it's laying the extra
cellular matrix for the new cells to be rebuilt, the
new tissue to recro um. And that's that's it's a
common thing that leads to chronic wounds that just won't heal.
And that's where maggots are really really useful to basically
(18:46):
interrupt that stall and get the car moving again in
the right direction. It's exactly right, they kick started. Uh
So de Bradmant is removing dead tissue. And that is
really where maggots excel um. They said, Uh, in here,
each maggot can chew, well, they don't exactly chew, which
we'll get to. Uh. They remove twenty five milligrams of
(19:08):
necrotic material dead flesh, uh in just twenty four hours.
That's pretty good. Yeah, and uh, there's there's actually three
ways that maggots clean a wound. But the bridemant, which
is getting in there and like just cleaning out, removing
physically removing um that dead material. That's like the key
that seems to be the key. And then there's also
(19:30):
um anti microbial activity like actually killing the bacteria that's
killing the flesh, leaving it cleaner than when they came in, yeah,
which is amazing. And then even more astounding, stimulating new growth,
like the act the presence of maggots in your wound
stimulates new tissue growth around your skin. It's the most
(19:52):
they're just like wonder creatures who knew. One of the
ways that they remove this dead tissue is just by
the nature of what their body is like. And they
have these little prickly spines all over their body that
act as a surgeon's rasp rasper or file what It
(20:13):
basically just the fact that they're moving around on the
wound is going to like file the stuff down and
scrape the wound, which helps loosens it up. It's like
a plow. It burrows through this dying and dead tissue
and it just yeah, it loosens up. That's part one
of deprived Part one. There's another part of it, which
is the digestive enzymes that they excrete and secrete. It's
(20:36):
called alimentary secretions and excretions a s. It's basically they're
digestive juices, right, and they puke these up as they're
moving around, and they just they just puke them everywhere
and it dissolves this flesh. Yeah, I remember in the
Body Farms episode we we talked about this one one
of the old classics. And that's why I said earlier.
(20:57):
They don't bite or choose something, they just lickquify it.
And then and this this A s. C. Stuff is
so greedy that it liquefies more dead flesh than the
maggots can even consume, and they consume quite a bit,
like you said, twenty five milligrams. That's a lot for
a little tiny maggot in one day. But even more
than that, they're liquefying even more of this dead tissue.
(21:20):
So that part of the process of maggot debridemant therapy
is draining out this liquefied necrotic tissue that's become liquefied
from the alimentary or the the A S C stuff,
the digest events ons, right, So you've got them burrowing around,
you've got them puking into your wound, liquefying the dead tissue,
(21:43):
leaving pretty much entirely the living tissue alone, and then
you just kind of drain out the stuff that's that's
in there. And the reason um that maggots are considered
by the FDA a medical device rather than a drug
is because the whole process of debridement isn't just a
(22:03):
reaction to the chemicals. It is part of that mechanical
movement of the maggots through the wound. So it's a drug,
it's a device. I mean it's a device. Look at them, yea.
And those that the secretions are so potent. They have
basically DNA destroying qualities, Like they not only just break
(22:25):
down tissue, they destroy the DNA. It's pretty amazing stuff
it is. Should we take another break? Yeah, I'm a
little excited. We probably should. I'm gonna go to the vomitorium.
Are you grossed out slightly? I am not in the least.
What does that say about me? I don't know. You
have a stronger stomach, but I don't necessarily. I'm I'm
(22:48):
just excited. All right, we'll go watch me vomited. At
least that will gross me out, all right, Well that
(23:13):
was disgusting, it was. It made me throw up in turn. Uh.
So here's a couple of questions. Um, does it hurt
Maybe a little bit at first. Yeah, I don't get
the feeling that it's extremely painful. It probably depends on
the wound. Um, But it can the first few treatments
can apparently be a little bit painful. Right, And there's
(23:35):
there's actually two mechanisms for the pain. One is that
of an open wound, right, and you have maggots crawling
over the exposed nerves in your open wound. That's not
gonna feel good, No, it won't. Uh. And then number two,
pressure in the wound can increase as the maggots get
bigger from eating so much dead flesh. So, yes, the
the the cura to that is pain killers, which, frankly,
(23:58):
if you have an open wound with exposed is nerves,
you should probably be on those anyway. Sure you will be,
so it probably won't hurt because there'll be some sort
of pain management going on, but you will still feel
most likely unless the doctor completely numbs the area. Maggots
crawling around inside you see, That's what That's the part
that gets me is actually thinking about undergoing this therapy
(24:21):
myself is what gets me, not like seeing it or
reading about it, but thinking about having an open wound
on the bottom of my foot and having maggots creeping
around in there. See. The thing is is I think
anybody would feel that way. There's very few, included myself.
I'm not grossed up by this, but I wouldn't want
maggots talking wound. But I think if your backs against
the wall, uh that, or you lose your foot, I try.
(24:44):
I would definitely try. I think people would apparently man
and I would demand some high quality drugs. And they
also have um, what is it called amnesiotics to make
you forget about it so you can't form memor while
it's happening. So maybe that would be a nice thing
to do too. So the other question is can you
(25:04):
just use any kind of maggot And the answer is no.
What they found is the most useful is the larva
of the green blowfly. And like we said earlier, these
things are now grown just sort of like the medical
leeches there shipped and sterile containers. Uh, as if it
were medicine, even though it's a device and the B
T E R. Foundation. They go into a lot about this,
(25:28):
like could anybody do this? And they say, well, no,
because you need a prescription. It's an FDA control yourself.
But they say, anybody who can read can basically follow
the instructions on the package. Yeah, I wouldn't. I mean,
I wouldn't advise that as your nondoctor. Sure, I'm not
saying that either, but I mean this may be your
(25:49):
doctor's first time too. There. Their point was, it's not
it's not difficult, just follow the instructions on the packet.
What if you went into your doctor though he got
the maggots out and he put on his bifocals, was like,
all right, let's see how to do this right, or
like he tears the package open. They go everywhere you
have like Jerry Lewis as a doctor. Uh oh. But
(26:10):
although they do say, um, you can't just load it
up with maggots. There should be no more than eight
maggots per square centimeter. Yeah, I saw five to eight.
And so when you have the maggots applied to your
UM wound. They're going to make sure that the healthy
area around the wound is covered up so the maggots
can't get to it, which goes back to World War Two.
(26:32):
They're going to cover it, cover up the wound after
they apply the maggots five to eight per square centimeter,
like you say, they're gonna cover it up so they
can't wander off because maggots like to leave before their
work is done. Um TV. They're full pretty much, UM,
but they can still eat more if you'll keep them
in there, so they will cover up. They will put
(26:53):
the maggots in five to eight, cover it up with
this bandage and basically they will just sit there and
eat for between forty eight and seventy two hours, and
then the bandage will be removed. The maggots will then
sadly be incinerated or put into an autoclave or put
into a plasma gas of fire, or bronzed and hung
(27:16):
on your wall for real, like an ant farm. Yeah,
because it's like, thank you for this great contribution to
saving my foot, Now go be autoclave today. I would
name them and save them and preserve them. Um, you'd
be violating, I'm sure all sorts of medical waste laws,
but who cares and so and then that's that's what's
(27:37):
called the treatment cycle, and most patients UH supposedly go
between two and four treatment cycles. And again, while this
is happening, what's going on is the maggots are debriding
the dead flesh, they're liquefying it, they're eating it, and
they're also disinfecting it and stimulating growth. Right, pretty amazing.
(27:57):
So with the with this, with the disinfecting, figured that
there was some sort of gut flora that the maggots
have that prevents them from being infected by microbial That
would make sense because they're in that rotting flesh as well,
and they're right, So what gives Well, it turns out
that there are a couple of um types of I'm
(28:19):
not quite sure what what kind of um bacteria they are,
but they are. That's not true. The proteus mirabilious is
a type of symbiotic microbe that you find in the
gut of a maggot, right, And this thing just destroys
microbial life. So it's killing the bacteria that's causing this
(28:39):
infection in your wound. But there's something that that maggots.
This is yet another thing. So think about it, Chuck,
Like you said, maggots, the very structure of a maggot
body dibrides the wound. That's pretty amazing. This maggot anti
microbial stuff not only does it kill microbes, it destroys
the thing that naturally protects microbes, which called biofilm. Yeah,
(29:01):
we've talked about biofilm a lot on this show, and um,
it's basically it's basically a film, like a literal film,
like a They call it a polymeric matrix. But the
easiest way to say in Leyman's Terman is it's a film, right,
It's like a protective coding. Yeah, and the little spiny bodies,
like one way they get rid of the thing is
by roughing it up, And that's exactly what the little
(29:22):
bodies do, right, And that's part of surgical derived mint
with like um, like going in there and scrubbing a wound,
um with I don't know, steel wool or something like
that that will break up the biofilm. It's also must
be awfully painful, right. Maggots naturally can destroy not just
the bacteria, but also the biofilm that protects it too.
(29:43):
Which makes them extremely handy with things like MERSA and
other antibiotic resistant um bacteria and all kinds of ulcers, right,
not like internal ulcers, but the open wound kind right
exactly from diabetes, from bed sore um. And there's been
a lot of studies of people with bedstors that have
(30:03):
found that maggots helped those kind of ulcers tremendously. So, uh,
let's talk about this one study or a couple of studies. Actually, UM,
there was one study of spinal cord injury patients that
had non healing ulcers, which is the problem. They monitored
them over three to four weeks UM, and they were
getting regular wound care at the same time, like sometimes
(30:24):
it's used in conjunction, I think usually is used in
conjunction with like standard care. Uh. And they found that, uh,
after three or four weeks of maggot therapy, tissue quality
and wound size were ressessed weekly, and they found that
debridement was achieved in less than fourteen days an average
of ten days, and none of the control group wounds
(30:45):
were more than fifty dibrided after a month. A month
not even half dibrided. None of the wounds not half
the wounds were divided. None of the wounds were even
half dibrided after a month, chuck of the control group, Yes,
amazing where they didn't use the mag gets that. Yes,
that's that's objectively amazing it is. And then they did
(31:05):
a larger clinical trial and found UH. This time they
got two hundred and sixty three subjects, which is pretty
good for this kind of rare treatment for UH. And
they found that um using the hydrogel which you mentioned earlier,
compression dressings, just the standard care. That was the control. Yeah,
that's obviously the control they um. It differed significantly between
(31:27):
the three groups. Um, what was the third group? The
third group used bio bags, which are like it's like
a little pouch. You said, it was like a rav
healthy Yeah, and it's filled with live maggots, but it
prevents them from burrowing. All it is is using their
chemical secretions. Yeah, I don't That to me is just
like why go halfway? Right? Exactly? Well, people, I don't
(31:48):
want a maggot crawling in my wound, but a bag
of them is fine doing the shake shake near my wound. Right. So, um,
it actually has been shown to be not nearly as
effective as just letting what's called free range maggots burrow
through the wound. So they found the media time for
debryment was fourteen days with free range, twenty eight days
(32:08):
with the bag ravioli, and seventy two days for the control. Yeah,
that's pretty amazing. Yeah, Like I I don't know, I
don't think it should be a last resort. You know,
I agree, and I think that increasingly it's becoming less
and less of the last resort, because I mean, you
can compare it to the control, Like the standard of
care took seventy two days for the wound to be divided,
(32:32):
free range maggots fourteen days. That to me says that
free range maggots top the standard of care as it
stands right now. But like you say, there's a lot
of people who are saying, this is just a last resort.
The next thing we're gonna do is amputate your foot.
But let's try this one last time. Or in the
case of persistent infections from like MERSA, where just antibiotics
(32:53):
just don't work, let's let's try maggots and see if
we can fix it. And maggots do work. There was
a study that found that of thirteen people treated who
had Merca treated with maggots alone. Twelve of the thirteen
had complete recovery and wound healing um from a mercer infection.
(33:14):
Mercy's nasty stuff too. Yeah, I think did we do
what I'm merca? I feel like we did. I know
we've talked about it. I don't know if it got
its own show, though it may have been in the
should we outlaw anti bacterial Soap episode? Well there's been
a lot of them, almost eight hundred. Uh you got
anything else? Surely I do, but I guess not. Um.
(33:42):
Oh yeah, Well, there's one other thing we kept kind
of teasing it. It actually stimulates growth. A couple of
studies have found that the presence of maggots um produce
more blood vessel redevelopment and tissue redevelopment than it's not
being present. So something about them actually stimulates tissue growth
(34:05):
and blood vessel growth, which promotes wound healing even more.
Up with maggots. Up with maggots indeed, Man, I love them.
I'm so psyched about maggots right now. Well, it definitely
changes the way you think about them, Like next time
you see a the dead squirrel that you've killed. They're
clearly trying to bring it back to life. Yeah, and
you see the maggots you can. You don't think that's disgusting.
(34:26):
You just think those are little things doing their thing,
doing their thing. Little things doing their thing. Now I'm
going to auto clay them. That's right. If you want
to know more about maggot therapy, you can type those
words in the search bar at how stuff forks dot com.
And since i said search parts, time forward listener, I'm
(34:47):
gonna call this taking the task somewhat over a term. Guys,
I want to say you are my favorite podcast by far.
I've been listening since you were just a little five
minute blurbs. Oh man, you sure have grown up. I've
never written in before, but felt I had to comment
on Josh's statement that climate change was for global warming
was settled science. No, I'm not disputing the data that
(35:10):
shows an increase in global temperatures. While you can certainly
argue it's accuracy, especially for older data, it's still just data.
It's not science. The part that gets me upset about
the term settled science that by definition, science is never settled,
and that's in all caps. I think we talked a
lot about this as a scientific method up this stuff.
You guys actually did a podcast on the scientific method,
(35:32):
So you should know that at best you can show
a particular theory is supported by existing data and not
contradicted by anything we know of at the time. But
there's a reason that ultra successful theories like Muton's theory
of gravity hind science theory of relativity are still theories.
They could be completely discredited by a single piece of
data contradicting them. So the whole idea of taking a
(35:53):
body of fact saying it's settled is far more political
concept than scientific. When while people with various viewpoints in
the subject would like to have uh someplace to plant
their ideological flag, saying something is indisputedly true as opposed
to probably false is simply not something science and the
scientific method is equipped to do. In short, science is
(36:13):
never settled. You cannot simply say this is true. Move on,
it's not how it works. And that is from Spencer
Carpenter right here in our own Smyrna, Georgia. We're not
in well, I mean it's it's nearby. What I just
did is what Spencer just did. Spencer, I was using
a literary device. I was actually using the same type
(36:35):
of argument that science that non science climate deniers use
against scientists. I was basically saying, like, it's done, drop it.
There's enough science there to say you're you're you're wrong.
Let's move on and just all except that climate science
is going. It's a layoff. So that was a clever ruse.
(36:56):
It wasn't a ruse at all. It was it was
just I was not be literal like apparently, which is
what Spencer deals in literal terms. Uh, if you want
to take us to test because you are overly literal,
we want to hear from you. You can tweet to
us at s y s K podcast. You can join
us on Facebook, dot com, slash stuff you Should Know.
(37:18):
You can send us an email to Stuff Podcast at
how stuff Works dot com and has always joined us
at our home on the web, Stuff you Should Know
dot com For more on this and thousands of other topics,
is it how Stuff Works dot com
Welcome to Stuff you should know from house stuff Works
dot com. Hey, and welcome to the podcast. I'm Josh Clark,
There's Charles w Chuck Bryant, and uh no one, no
one else is in here with us yet again, because
we've graduated to the point where we don't even need
(00:23):
a producer. We need somebody who presses record and leaves.
That's it. Because we're pros. Yep, not p R O
s E. P r O S that's right, we're not.
But we are prosaic, yes, but definitely not p r
O apostrophe es. Very few things drive me crazier than that,
And I know it's stupid and pedantic, but to see,
(00:44):
like somebody take out a huge billboard or something and
so a word has an apostrophe. That shouldn't pros. People say, like,
leave it to the pros and they'll put an apostrophe. Yes,
and it's it's that graphic designer should be, you know,
doctor half a day's paying maybe bucks. Something we want
(01:05):
to issue and you probably would get this from the
title of the episode, but we want to issue a
meal warning. Oh good thinking, because we've gotten complaints in
the past when people are eating and get sick listening
to some of these. Yeah, this would do it possibly
for some people. I was fine. I ate a running
yolk egg sandwich while I was right. It didn't bother me,
(01:28):
but I could totally see how it could be any people.
I also want to say, um, if it comes up,
do not go Google image search wound sloth. Well, I
just put do not Google image search maggot therapy at all. Okay, sure,
but definitely stay away from wound sloth s l o
U g h. Yeah wow, and definitely don't look at
(01:52):
wound slough while you're eating. Yeah. Okay, so that's all
out of the way. Yes, I predict we're going to
be kind of excited about this one. I'm feeling a
little pumped about it. Well, we did cover in uh
tin Bizarre medical Treatments uh leech therapy, which is still
being used, and I'm surprised this wasn't in that article.
To be honest, I am as well. But this gets
(02:13):
its own special deal, and well it should actually because
it's a pretty amazing thing. Um, we're talking about maggot therapy.
Yes it is so, or they really or is that
a name? Well, it's a band name. To end all
band names. There probably wasn a band name that. So
there's it's called maggot therapy, maggot dibridement therapy, larval therapy,
(02:35):
or bio. There's another one called I think like bio
biodebridements or therapeutic wound miasses. Yeah, and that's basically all
the all of them, no matter what you call it,
no matter how you church it up. It is the
application of live maggots fly larva to purposefully to an
(03:01):
open wound in order to help that wound heal faster. Yeah,
and better and cleaner and all that good stuff everything.
Daft Punk said, Oh yeah, you know, should we talk
about some of the history of this stuff. Let's just
say that one more time. Okay. Maggot de bridemant therapy
(03:22):
is taking live maggots and putting them in an open
wound on a human being or an animal. It's used
in veterinary medicine as well, wrapping it up tight and
letting them just eat the dead and dying flesh of
that wound while you get your foot tickled. Okay, I
would be so skiped out by this. I just wanted
to make sure that everybody knows exactly what we're talking about, right,
(03:44):
and goodbye to everyone everyone who fainted. Okay, yeah, let's
talk about the history, chuck, because this is um, this
is in use today, but it's actually pretty old. Yeah,
I mean it's it's some say it's an even an
ancient tradition like in place is like Burma in Central
America with the Mayans. Um, they were smart enough to
(04:05):
know that maggots do a pretty good job of consuming
human flesh. Uh, And it can be used for good
in that regard. Yeah, at some point, I guess healer's noticed,
like y, people who had maggots in their wounds tended
to have wounds heal Uh. And actually, as far as
the Western literature goes, that's exactly how UM maggot therapy
(04:25):
first finds its way, first crawls into the medical literature
is from a French surgeon named Ambro Ambras Pore. Yeah,
but how would you say, I don't know, I don't
speak French Ambras even though it doesn't have the little
(04:45):
what is that an accent? Yeah, it's just the e.
But he was a sixteenth century surgeon and he noticed that, um,
that people didn't necessarily fall over dead if there was
a maggot in the wound. Yeah. He was a first
doctor to actually come out and say, you know, I
had this patient got a big skull wound, and unbeknownst
(05:07):
to me, there were maggots in there. I saw them
crawling out one day and even though they had a
lot of bone. Um, the guy was great. He healed
like he lost a hand sized slab of skull and
he lived. And I think it might have something to
do with the maggots. Yeah, and he presumably wore a
helmet for the rest of his life. Probably he had
a probably big soft skull there. Uh. That was followed
(05:31):
in uh with the mid seventeen hundreds by another Frenchy baron,
Dominique Jean Laoie Uh, and he said, you know what,
on this Egyptian expedition, Uh, these blue fly maggots are
actually doing the right thing and helping us out. So
it's almost like these doctors just noticed this exactly and
(05:55):
it meant enough to him that they were like, I
should probably write this down. This is gonna be my
contribution to medical history of the history of science right there. Um.
So it wasn't until the uh, I guess the Civil
War that a doctor actually said I'm going to purposefully
put maggots in a wound and see what happens. And
(06:16):
that doctor was John Forney Zacharias. He probably didn't tell
his patient that. I think probably that he was just like,
just bite down on this brooms and look the other way.
Do you want to lose your foot or do you
want to try something really weird? Well, supposedly in studies
of people, modern patients who are offered this therapy say
yes to it. Well, yeah, because I think that's what
(06:36):
it comes down to you. It's a last resort. Basically,
it's not the first thing they offer, not necessarily. Um So, anyway,
doctor Zacharias um Hey had a great quote. He said,
during my service in the hospital at Danville, Virginia, I
first used maggots to remove the decayed tissue in Hospital
Gang Green, and with my eminent satisfaction, in a single day,
(06:58):
they would clean a wound much better than any agents
we had at our command. I used them afterwards at
various places. I am sure I saved many lives by
their use escape septicemia and had rapid recoveries period. End quote.
Pretty great. Yeah, So he was a huge believer and
not just a passive observer like people who came before him.
He said, yeah, I put maggots on wounds and it helps,
(07:20):
that's right. And uh, people experimented with it for a
little while until um, a guy named Louis Pasteur and
Robert Coke came along, Uh, microbiologists and germ theorists that
basically said, you know this, this is disgusting. We might
want to not do this. Yeah, because they're dirty. Yeah, yeah,
And it's true maggots naturally in the wild carry lots
(07:44):
of pathogens with them that um can infect us in
other ways, can make a wound worse, can actually kill you.
So this the idea behind germ theory as far as
maggots goes right. But um, it seems like there's this
long history of necessity and discussed with maggot therapy that
kind of wayne ebbs and flows right, and necessity rears
(08:07):
its head on the battlefield. It did in the Civil War,
and it also did in World War One. There was
a surgeon um named William S. Baer, and he was
working on the front lines in France, and he used
maggots on stomach wounds and open fractures and he found,
to his great satisfaction, just like Dr Zacharias and the
(08:27):
other before him, that this stuff actually worked. Yeah, and
he actually said, you know what, I have some further advancements. UM,
maybe we should put a bandage over this thing so
it doesn't completely discussed the patient. Uh, and let me
UM put bandages around the wound so they don't start
creeping onto the healthy flesh and doing damage or just
(08:49):
itching you or creeping you out further right exactly, UM,
which are still in use today. These techniques. He also
pioneered another huge technique, and this is after the war
was over. Ten years later, when he was back at
Johns Hopkins UM. He he pioneered another really important technique,
and that was using sterilized UM maggots. Like germ free maggots,
(09:10):
they were raised as eggs in a sterile environment, and
so when they were introduced to the wounds, they weren't
carrying these pathogens anymore. And he found this is the jackpot.
Now you can use maggots from now on. That's right.
And there was a big boom uh in the thirties
up until the mid nineteen forties. Uh, three hundred more
than three hundred American hospitals. Uh, we're using maggot treatment,
(09:34):
maggot therapy. And then in uh, antiseptics came along, or
you know, new antiseptics, and they said, you know what,
maybe there was another lull in the use of maggot.
They right, necessity didn't didn't spur this stuff, and it
was they went back to just being gross again. There
was a guy UM who by the eighties wrote what
what this one article calls the majority opinion. Fortunately, maggot
(09:57):
therapy is now relegated to a historical backwater of interest,
more for its bizarre nature than its effect on the
course of medical science. A therapy the demise of which
no one is likely to mourn. That's just that kind
of Western medicine hubris, where like we can do anything
except everything, you know, that's right. And in the nineteen nineties,
(10:21):
UM a dude named Ronald Sherman and Edward Pector basically
champion the technique again and kind of brought it into
the modern age. Yeah, and still very much is UM.
Ronald Sherman is one of the first, i think, to
receive a license to produce sterile maggots for use as
(10:43):
medical devices. Um. And there's another guy over in uh
the UK named John Church um who uh who brought
the maggot their maggot therapy into the four So it
was an ancient thing, it was. It's found to be disgusting,
it's found to be useful, it's found to be disgusting.
(11:04):
It's it's found ways you can make it better. It's
found to be disgusting. And then now that this idea
of complimentary medicine is is kind of regaining some traction again. Um,
I think it's here to stay, though I think so too,
unless someone comes along in ten years is you know
what it's disgusting, well, you know the chuck. I mean
probably what we're seeing is the next thing that will
(11:26):
happen is there will be some huge leap, some huge
development in science, and science will get its tackles up
again and great about itself and we don't need any
of that stupid nastiness. And then we'll find that Nope,
you still can't beat good old fashioned maggots. And that's
that should be the title of this thing. You can't
beat good old fashioned maggots for healing a wound that
won't heal otherwise it's a great title. So you want
(11:49):
to take a break. Uh, yeah, let's do it, and
we'll go um treat our own wounds and we'll be
back shortly. All right, Let's talk about diabetes for a second. Yeah,
(12:29):
more than twenty three million Americans are affected with diabetes.
And one thing that can happen, uh is nerve damage,
especially in the extremities the hands and feet and the
toes and the and the fingers. Your blood vessels become
hard and they don't circulate the blood like you need.
That can lead to open sores called ulcers, which can
(12:52):
become infections, which can spread to nearby bone, which can
lead to amputation. Yeah. It all this is just from
a long exposure to high levels of blood sugar and
they're not sure how it can do it. But yeah,
the blood, the blood vessels not helping pump blood very well,
get nutrients, or your tissue can die. But also that neuropathy,
that dead and nerve cell um that actually makes it
(13:15):
hard for you to notice. If you have like a
really bad ulcer on the bottom of your foot, you
can't feel it and so you don't get treatment early enough,
so it can get an infection can get out of
hand and when it spreads to bone that's called osteomyelitis.
That's problematic because that very quickly will lead to an amputation.
And there's some pretty shocking stats here from this article
(13:38):
that Tom wrote. Um about this sheave jam Yeah nice,
it's yeah for sure, Um. But about amputations from diabetes. Yes,
seventy thousand to foot and leg amputations each year in
the United States alone, and uh they say around the world,
they estimate every thirty seconds someone gets a limb cut
(13:58):
off because of diabetes. Yeah, that's sad, Yeah, it really is,
and we should We will do one on diabetes for sure.
Oh yeah, I'm surprised we haven't already. Um. But the
so amputation is used to halt the progress of an infection,
and that's usually the last resort. But what's what Tom
(14:20):
points out is that there are plenty of doctors around
the world I imagine that aren't aware that you can
use maggots or have never done it before. And if
you are facing an amputation from say like a wound,
a persistent wound, a chronic wound that won't heal, um,
you may want to suggest maggots to your doctor. You
(14:40):
may have to actually take this the the initiative on
this one, and say, let's make sure the amputation is
the absolute last resort. Let's see if we can put
one more resort in there before then. I'm willing to
let maggots crawl inside my body in this wound is
open wound if you're willing to apply them. And they like.
Doctors love hearing when patients suggest treatments. Oh, they do.
(15:04):
They love feedback. They love to be guided in their
diagnoses and prognoses. Yeah, I love it. That's a tough jam.
I get it. Doctors are frustrated a lot of these
days with self diagnosis and online doctoring. Sure, but you
should also be your own advocate. We can't be in
that before. Yeah, it's your leg. Yeah, if you want
to keep your leg, you tell that doctor to go
(15:24):
get some maggots. You're going to replace them with the
doctor who will. How can I can find a guy? Yeah,
I can get a guy by noon that'll put maggots
on that wound. And actually there's a there's a group.
I think Ronald Sherman, the guy we mentioned earlier, who's
like the the US champion of maggot therapy. Um, it's
there's this group called the b Turf Foundation b t
e Er Foundation, UM, and they have all sorts of
(15:48):
resources for people in that very situation, like how to
talk to your doctor, UM that if your insurance won't
cover it, let them know, because they say insurance actually
most insurance covers maggot therapy, but most insurance claims people
are not aware of that, so you may get denied
at first. And here's how to talk to your insurance
(16:09):
company that it really is. That beats going to your
doctor and saying, well, you know what Josh and Chuck said.
He you're not gonna like hearing this, right because you think, doctor,
please take a sleep and be put maggots on my feet, right.
And and that's the other thing too. I mean, like
we wouldn't be suggesting this and the betur Foundation probably
wouldn't be such advocates for it if it didn't work
(16:32):
so amazingly well. It study after study, and we'll talk
about the details of it, but there's so many studies
out there. UM. Again. Sherman, who agreed, is an advocate,
but in a pure reviewed journal published a survey of
studies that he could find on maggot therapy and it's
very clear that it works really, really well, and not
(16:55):
only necessarily um as a means of last resort, but
even just compare to the standard of care using like
hydrogell or other things that you might use to treat
a chronic wound. Maggots destroy it. They leave it in
the dust. Yeah. And if it doesn't work, it's not
gonna hurt anything, I can tell. Yeah, it just puts
off how much longer before they amputate your foot? Pretty much?
(17:18):
Uh So what will happen is they will Well, let's
get into this a little bit. Um. There are four
different and you where did you find this? Was this
a a research paper? Yeah? This is by Ronald Sherman
Mechanisms of Maggot Induced Wound Healing colin What do we
know and where do we go from here? It was
in the journal Evidence Based, Complimentary and Alternative Medicine in
(17:40):
two thousand fourteen, that's right. And he describes for different
phases of basically healing a wound um homeostasis, inflammation, ploriferate. Man,
I'm so bad at that one. Oh yeah, keep it coming,
proliferation and uh, remodeling and maturing, and what happens is
(18:01):
the cells get to work, they recruit other cells, they
alter their activities and basically say, let's get to work
cleaning and uh, well on all four of these stages
to help heal the wound. Yeah, and at any any
one of those stages, um, the the next process can
stall out. Um. Normally it stalls out at inflammation because
(18:25):
the infection gets out of hand in the body can't
fight off the infection faster than it's laying the extra
cellular matrix for the new cells to be rebuilt, the
new tissue to recro um. And that's that's it's a
common thing that leads to chronic wounds that just won't heal.
And that's where maggots are really really useful to basically
(18:46):
interrupt that stall and get the car moving again in
the right direction. It's exactly right, they kick started. Uh
So de Bradmant is removing dead tissue. And that is
really where maggots excel um. They said, Uh, in here,
each maggot can chew, well, they don't exactly chew, which
we'll get to. Uh. They remove twenty five milligrams of
(19:08):
necrotic material dead flesh, uh in just twenty four hours.
That's pretty good. Yeah, and uh, there's there's actually three
ways that maggots clean a wound. But the bridemant, which
is getting in there and like just cleaning out, removing
physically removing um that dead material. That's like the key
that seems to be the key. And then there's also
(19:30):
um anti microbial activity like actually killing the bacteria that's
killing the flesh, leaving it cleaner than when they came in, yeah,
which is amazing. And then even more astounding, stimulating new growth,
like the act the presence of maggots in your wound
stimulates new tissue growth around your skin. It's the most
(19:52):
they're just like wonder creatures who knew. One of the
ways that they remove this dead tissue is just by
the nature of what their body is like. And they
have these little prickly spines all over their body that
act as a surgeon's rasp rasper or file what It
(20:13):
basically just the fact that they're moving around on the
wound is going to like file the stuff down and
scrape the wound, which helps loosens it up. It's like
a plow. It burrows through this dying and dead tissue
and it just yeah, it loosens up. That's part one
of deprived Part one. There's another part of it, which
is the digestive enzymes that they excrete and secrete. It's
(20:36):
called alimentary secretions and excretions a s. It's basically they're
digestive juices, right, and they puke these up as they're
moving around, and they just they just puke them everywhere
and it dissolves this flesh. Yeah, I remember in the
Body Farms episode we we talked about this one one
of the old classics. And that's why I said earlier.
(20:57):
They don't bite or choose something, they just lickquify it.
And then and this this A s. C. Stuff is
so greedy that it liquefies more dead flesh than the
maggots can even consume, and they consume quite a bit,
like you said, twenty five milligrams. That's a lot for
a little tiny maggot in one day. But even more
than that, they're liquefying even more of this dead tissue.
(21:20):
So that part of the process of maggot debridemant therapy
is draining out this liquefied necrotic tissue that's become liquefied
from the alimentary or the the A S C stuff,
the digest events ons, right, So you've got them burrowing around,
you've got them puking into your wound, liquefying the dead tissue,
(21:43):
leaving pretty much entirely the living tissue alone, and then
you just kind of drain out the stuff that's that's
in there. And the reason um that maggots are considered
by the FDA a medical device rather than a drug
is because the whole process of debridement isn't just a
(22:03):
reaction to the chemicals. It is part of that mechanical
movement of the maggots through the wound. So it's a drug,
it's a device. I mean it's a device. Look at them, yea.
And those that the secretions are so potent. They have
basically DNA destroying qualities, Like they not only just break
(22:25):
down tissue, they destroy the DNA. It's pretty amazing stuff
it is. Should we take another break? Yeah, I'm a
little excited. We probably should. I'm gonna go to the vomitorium.
Are you grossed out slightly? I am not in the least.
What does that say about me? I don't know. You
have a stronger stomach, but I don't necessarily. I'm I'm
(22:48):
just excited. All right, we'll go watch me vomited. At
least that will gross me out, all right, Well that
(23:13):
was disgusting, it was. It made me throw up in turn. Uh.
So here's a couple of questions. Um, does it hurt
Maybe a little bit at first. Yeah, I don't get
the feeling that it's extremely painful. It probably depends on
the wound. Um, But it can the first few treatments
can apparently be a little bit painful. Right, And there's
(23:35):
there's actually two mechanisms for the pain. One is that
of an open wound, right, and you have maggots crawling
over the exposed nerves in your open wound. That's not
gonna feel good, No, it won't. Uh. And then number two,
pressure in the wound can increase as the maggots get
bigger from eating so much dead flesh. So, yes, the
the the cura to that is pain killers, which, frankly,
(23:58):
if you have an open wound with exposed is nerves,
you should probably be on those anyway. Sure you will be,
so it probably won't hurt because there'll be some sort
of pain management going on, but you will still feel
most likely unless the doctor completely numbs the area. Maggots
crawling around inside you see, That's what That's the part
that gets me is actually thinking about undergoing this therapy
(24:21):
myself is what gets me, not like seeing it or
reading about it, but thinking about having an open wound
on the bottom of my foot and having maggots creeping
around in there. See. The thing is is I think
anybody would feel that way. There's very few, included myself.
I'm not grossed up by this, but I wouldn't want
maggots talking wound. But I think if your backs against
the wall, uh that, or you lose your foot, I try.
(24:44):
I would definitely try. I think people would apparently man
and I would demand some high quality drugs. And they
also have um, what is it called amnesiotics to make
you forget about it so you can't form memor while
it's happening. So maybe that would be a nice thing
to do too. So the other question is can you
(25:04):
just use any kind of maggot And the answer is no.
What they found is the most useful is the larva
of the green blowfly. And like we said earlier, these
things are now grown just sort of like the medical
leeches there shipped and sterile containers. Uh, as if it
were medicine, even though it's a device and the B
T E R. Foundation. They go into a lot about this,
(25:28):
like could anybody do this? And they say, well, no,
because you need a prescription. It's an FDA control yourself.
But they say, anybody who can read can basically follow
the instructions on the package. Yeah, I wouldn't. I mean,
I wouldn't advise that as your nondoctor. Sure, I'm not
saying that either, but I mean this may be your
(25:49):
doctor's first time too. There. Their point was, it's not
it's not difficult, just follow the instructions on the packet.
What if you went into your doctor though he got
the maggots out and he put on his bifocals, was like,
all right, let's see how to do this right, or
like he tears the package open. They go everywhere you
have like Jerry Lewis as a doctor. Uh oh. But
(26:10):
although they do say, um, you can't just load it
up with maggots. There should be no more than eight
maggots per square centimeter. Yeah, I saw five to eight.
And so when you have the maggots applied to your
UM wound. They're going to make sure that the healthy
area around the wound is covered up so the maggots
can't get to it, which goes back to World War Two.
(26:32):
They're going to cover it, cover up the wound after
they apply the maggots five to eight per square centimeter,
like you say, they're gonna cover it up so they
can't wander off because maggots like to leave before their
work is done. Um TV. They're full pretty much, UM,
but they can still eat more if you'll keep them
in there, so they will cover up. They will put
(26:53):
the maggots in five to eight, cover it up with
this bandage and basically they will just sit there and
eat for between forty eight and seventy two hours, and
then the bandage will be removed. The maggots will then
sadly be incinerated or put into an autoclave or put
into a plasma gas of fire, or bronzed and hung
(27:16):
on your wall for real, like an ant farm. Yeah,
because it's like, thank you for this great contribution to
saving my foot, Now go be autoclave today. I would
name them and save them and preserve them. Um, you'd
be violating, I'm sure all sorts of medical waste laws,
but who cares and so and then that's that's what's
(27:37):
called the treatment cycle, and most patients UH supposedly go
between two and four treatment cycles. And again, while this
is happening, what's going on is the maggots are debriding
the dead flesh, they're liquefying it, they're eating it, and
they're also disinfecting it and stimulating growth. Right, pretty amazing.
(27:57):
So with the with this, with the disinfecting, figured that
there was some sort of gut flora that the maggots
have that prevents them from being infected by microbial That
would make sense because they're in that rotting flesh as well,
and they're right, So what gives Well, it turns out
that there are a couple of um types of I'm
(28:19):
not quite sure what what kind of um bacteria they are,
but they are. That's not true. The proteus mirabilious is
a type of symbiotic microbe that you find in the
gut of a maggot, right, And this thing just destroys
microbial life. So it's killing the bacteria that's causing this
(28:39):
infection in your wound. But there's something that that maggots.
This is yet another thing. So think about it, Chuck,
Like you said, maggots, the very structure of a maggot
body dibrides the wound. That's pretty amazing. This maggot anti
microbial stuff not only does it kill microbes, it destroys
the thing that naturally protects microbes, which called biofilm. Yeah,
(29:01):
we've talked about biofilm a lot on this show, and um,
it's basically it's basically a film, like a literal film,
like a They call it a polymeric matrix. But the
easiest way to say in Leyman's Terman is it's a film, right,
It's like a protective coding. Yeah, and the little spiny bodies,
like one way they get rid of the thing is
by roughing it up, And that's exactly what the little
(29:22):
bodies do, right, And that's part of surgical derived mint
with like um, like going in there and scrubbing a wound,
um with I don't know, steel wool or something like
that that will break up the biofilm. It's also must
be awfully painful, right. Maggots naturally can destroy not just
the bacteria, but also the biofilm that protects it too.
(29:43):
Which makes them extremely handy with things like MERSA and
other antibiotic resistant um bacteria and all kinds of ulcers, right,
not like internal ulcers, but the open wound kind right
exactly from diabetes, from bed sore um. And there's been
a lot of studies of people with bedstors that have
(30:03):
found that maggots helped those kind of ulcers tremendously. So, uh,
let's talk about this one study or a couple of studies. Actually, UM,
there was one study of spinal cord injury patients that
had non healing ulcers, which is the problem. They monitored
them over three to four weeks UM, and they were
getting regular wound care at the same time, like sometimes
(30:24):
it's used in conjunction, I think usually is used in
conjunction with like standard care. Uh. And they found that, uh,
after three or four weeks of maggot therapy, tissue quality
and wound size were ressessed weekly, and they found that
debridement was achieved in less than fourteen days an average
of ten days, and none of the control group wounds
(30:45):
were more than fifty dibrided after a month. A month
not even half dibrided. None of the wounds not half
the wounds were divided. None of the wounds were even
half dibrided after a month, chuck of the control group, Yes,
amazing where they didn't use the mag gets that. Yes,
that's that's objectively amazing it is. And then they did
(31:05):
a larger clinical trial and found UH. This time they
got two hundred and sixty three subjects, which is pretty
good for this kind of rare treatment for UH. And
they found that um using the hydrogel which you mentioned earlier,
compression dressings, just the standard care. That was the control. Yeah,
that's obviously the control they um. It differed significantly between
(31:27):
the three groups. Um, what was the third group? The
third group used bio bags, which are like it's like
a little pouch. You said, it was like a rav
healthy Yeah, and it's filled with live maggots, but it
prevents them from burrowing. All it is is using their
chemical secretions. Yeah, I don't That to me is just
like why go halfway? Right? Exactly? Well, people, I don't
(31:48):
want a maggot crawling in my wound, but a bag
of them is fine doing the shake shake near my wound. Right. So, um,
it actually has been shown to be not nearly as
effective as just letting what's called free range maggots burrow
through the wound. So they found the media time for
debryment was fourteen days with free range, twenty eight days
(32:08):
with the bag ravioli, and seventy two days for the control. Yeah,
that's pretty amazing. Yeah, Like I I don't know, I
don't think it should be a last resort. You know,
I agree, and I think that increasingly it's becoming less
and less of the last resort, because I mean, you
can compare it to the control, Like the standard of
care took seventy two days for the wound to be divided,
(32:32):
free range maggots fourteen days. That to me says that
free range maggots top the standard of care as it
stands right now. But like you say, there's a lot
of people who are saying, this is just a last resort.
The next thing we're gonna do is amputate your foot.
But let's try this one last time. Or in the
case of persistent infections from like MERSA, where just antibiotics
(32:53):
just don't work, let's let's try maggots and see if
we can fix it. And maggots do work. There was
a study that found that of thirteen people treated who
had Merca treated with maggots alone. Twelve of the thirteen
had complete recovery and wound healing um from a mercer infection.
(33:14):
Mercy's nasty stuff too. Yeah, I think did we do
what I'm merca? I feel like we did. I know
we've talked about it. I don't know if it got
its own show, though it may have been in the
should we outlaw anti bacterial Soap episode? Well there's been
a lot of them, almost eight hundred. Uh you got
anything else? Surely I do, but I guess not. Um.
(33:42):
Oh yeah, Well, there's one other thing we kept kind
of teasing it. It actually stimulates growth. A couple of
studies have found that the presence of maggots um produce
more blood vessel redevelopment and tissue redevelopment than it's not
being present. So something about them actually stimulates tissue growth
(34:05):
and blood vessel growth, which promotes wound healing even more.
Up with maggots. Up with maggots indeed, Man, I love them.
I'm so psyched about maggots right now. Well, it definitely
changes the way you think about them, Like next time
you see a the dead squirrel that you've killed. They're
clearly trying to bring it back to life. Yeah, and
you see the maggots you can. You don't think that's disgusting.
(34:26):
You just think those are little things doing their thing,
doing their thing. Little things doing their thing. Now I'm
going to auto clay them. That's right. If you want
to know more about maggot therapy, you can type those
words in the search bar at how stuff forks dot com.
And since i said search parts, time forward listener, I'm
(34:47):
gonna call this taking the task somewhat over a term. Guys,
I want to say you are my favorite podcast by far.
I've been listening since you were just a little five
minute blurbs. Oh man, you sure have grown up. I've
never written in before, but felt I had to comment
on Josh's statement that climate change was for global warming
was settled science. No, I'm not disputing the data that
(35:10):
shows an increase in global temperatures. While you can certainly
argue it's accuracy, especially for older data, it's still just data.
It's not science. The part that gets me upset about
the term settled science that by definition, science is never settled,
and that's in all caps. I think we talked a
lot about this as a scientific method up this stuff.
You guys actually did a podcast on the scientific method,
(35:32):
So you should know that at best you can show
a particular theory is supported by existing data and not
contradicted by anything we know of at the time. But
there's a reason that ultra successful theories like Muton's theory
of gravity hind science theory of relativity are still theories.
They could be completely discredited by a single piece of
data contradicting them. So the whole idea of taking a
(35:53):
body of fact saying it's settled is far more political
concept than scientific. When while people with various viewpoints in
the subject would like to have uh someplace to plant
their ideological flag, saying something is indisputedly true as opposed
to probably false is simply not something science and the
scientific method is equipped to do. In short, science is
(36:13):
never settled. You cannot simply say this is true. Move on,
it's not how it works. And that is from Spencer
Carpenter right here in our own Smyrna, Georgia. We're not
in well, I mean it's it's nearby. What I just
did is what Spencer just did. Spencer, I was using
a literary device. I was actually using the same type
(36:35):
of argument that science that non science climate deniers use
against scientists. I was basically saying, like, it's done, drop it.
There's enough science there to say you're you're you're wrong.
Let's move on and just all except that climate science
is going. It's a layoff. So that was a clever ruse.
(36:56):
It wasn't a ruse at all. It was it was
just I was not be literal like apparently, which is
what Spencer deals in literal terms. Uh, if you want
to take us to test because you are overly literal,
we want to hear from you. You can tweet to
us at s y s K podcast. You can join
us on Facebook, dot com, slash stuff you Should Know.
(37:18):
You can send us an email to Stuff Podcast at
how stuff Works dot com and has always joined us
at our home on the web, Stuff you Should Know
dot com For more on this and thousands of other topics,
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