Selects: Maggots: Good For Healing Wounds, Turns Out

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. Learn more in this classic episode.

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Episode Transcript

Speaker 1 (00:00):
Hello there, it's Josh and for this week's S Y
s K Selex, I've chosen maggots colon good for healing wounds.
Turns out, uh, and that is absolutely true. Um, I
really listened to all of our select episodes, and I
listen to this one, and I'm clearly excited in the episode.
But I was just as excited listening to it all

(00:21):
these years later, but five years after we released it. Um,
So I hope it excites you. It is groty, but
it's also pretty awesome. So enjoy slash prepared to be
grossed out. Welcome to Stuff you should know, a production
of My Heart Radios How Stuff Works. Hey, and welcome

(00:47):
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 a producer. We need so
body who presses record and leaves Yep, that's it, because
we're pros Yep, not p R O s E. P

(01:08):
R Oh that's right, we're not. But we are prosaic, yes,
but definitely not p r O apostrophees. Very few things
drive me crazier than that. And I know it's stupid
and pedantic, but to see, like somebody take out a
huge billboard or something and so a word has an
apostrophe that shouldn't prose. People say, like, leave it to

(01:28):
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 eight bucks. Something we want 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

(01:50):
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 runny yolk egg sandwich
while I white writer. Yeah right, it didn't bother me,
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

(02:13):
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, it definitely don't look at
wound slough while you're eating. Yeah, okay, so that's all
out of the way. Yes, I predict we're going to

(02:34):
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
its own special deal, and well it should actually because
it's a pretty amazing thing. Um, we're talking about maggot therapy. Also,

(02:57):
by the way, yes it is they were awesome so
or they really or is it a band name? Well,
it's a band name to end all band names. There
probably was a band name that, So there's it's called
maggot therapy, maggot debridement therapy, larval therapy, or bio. There's
another one called I think like bio biodebridement or therapeutic

(03:19):
wound misses. 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 open wound in order
to help that wound heal. Faster and better and cleaner

(03:42):
and everything. Dat 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 debridement
therapy is taking live maggots and put getting them in
an open wound on a human being or an animal.

(04:03):
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, and goodbye to everyone everyone who fainted. Okay, Yeah,

(04:24):
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 places like Burma in Central America
with the Mayan's um. They were smart enough to know
that maggots do a pretty good job of consuming human flesh. Uh,

(04:45):
and it can be used for good in that regard. Yeah,
at some point I guess healers noticed like yef. People
who had maggots in their wounds tended to have wounds
heal U. And actually, as far as the Western literature goes,
that's exactly how um maggot therapy first finds its way,
first crawls into the medical literature is from a French

(05:07):
surgeon named Ambro Ambras Poare. Yeah, but how would you say,
I don't know, I don't speak French Ambras even though
it doesn't have the little 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

(05:32):
fall over dead if there was a maggot in the wound. Yeah.
He was the first doctor to actually come out and say,
you know, I had this patient with a big skull wound,
and unbeknownst 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

(05:53):
skull and he lived. And I think it might have
something to do with the maggots. And he presumably were
a helmet for the us of his life. Probably he
had a probably big soft skull there, I guess so. Uh.
That was followed in uh with the mid seventeen hundreds
by another Frenchy baron, Dominique Jean Laoie uh, and he said,

(06:17):
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 it meant enough to him that they
were like, I should probably write this down. This is
going to be my great contribution to medical history of
the history of science, right. Um. So it wasn't until

(06:42):
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 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 the other way. Do you want
to lose your foot or do you want to try

(07:02):
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 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

(07:23):
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, 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,
escaped sept to semia, and had rapid recoveries period. End quote.

(07:46):
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,
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

(08:07):
basically said, you know, this is 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 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

(08:32):
like there's this long history of necessity and disgusted with
maggot therapy that kind of wayne ebbs and flows right,
and necessity rears 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.
Bayer and he was working on the front lines in France,

(08:53):
and he used maggots on stomach wounds and open fractures,
and he found, to his great satisfaction, just like Dr
Zacharias and the 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,

(09:15):
And let me UM put bandages around the wound, so
they don't start creeping onto the healthy flesh and doing
damage or just 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

(09:36):
back at Johns Hopkins UM. He he pioneered another really
important technique, and that was using sterilized um maggots. Like
germ free maggots. 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.

(09:59):
That's right. And there was a big boom in the
thirties up until the mid nineteen forties. Uh, three more
than three hundred American hospitals. Uh, we're using maggot treatment,
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 theory. Right,

(10:20):
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 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

(10:42):
is likely to mourn. That's just that kind of Western
medicine hubris, where like we can do anything except everything,
you know. Uh, that's right. And in the nineteen nineties, UM,
a dude named Ronald Sherman and Edward peck Or basically
champion the technique again and kind of brought it into

(11:06):
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
medical devices. Um. And there's another guy over in uh
the UK named John Church um who who brought the

(11:28):
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,
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,

(11:51):
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
happen is there will be some huge leaps, 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,

(12:13):
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
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,

(13:04):
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

(13:27):
become infections, which can spread to nearby bone, which can
lead to amputation. Yeah, and all of all this is
just from a prolonged 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 nerves cell um

(13:49):
that actually makes it hard for you to notice. If
you have like a really bad ulcer on the bottom
of your foot, you can't feel it. Yeah, 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 osteo myelitis. That's problematic because
that very quickly will lead to an amputation. And there's

(14:10):
some pretty shocking stats here from this article 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

(14:31):
thirty seconds someone gets a limb cut 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

(14:52):
usually the last resort. But what's what Tom 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 ever 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

(15:13):
to suggest maggots to your doctor. You 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 wounds open wound if you're willing
to apply them. And they uh, like most doctors love

(15:36):
hearing when patients suggest treatments. Oh they do. 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. But you should also be your
own advocate. We can't be in that before. Yeah it's
your leg. Yeah you want to keep your leg. You

(15:58):
tell that doctor to go get some maggots. You're going
to replace them with the doctor who will. 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

(16:22):
have all sorts of 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

(16:43):
to your insurance company. That's 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 you know it all 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 Better Foundation probably

(17:04):
wouldn't be such advocates for it if it didn't work
so amazingly. Well, it's 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

(17:26):
very clear that it works really really well, and not
only necessarily um as a means of last resort, but
even just compared 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

(17:46):
gonna hurt anything. Yeah. Yeah, it just puts off how
much longer before they amputate your foot? Pretty much? Yeah.
Uh so what will happen is they will Well, let's
get into this a little bit. Um, there are four
differ friend, 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

(18:09):
we know and where do we go from here? It
was in the journal Evidence Based, Complimentary and Alternative Medicine
in two thousand and fourteen, that's right, And he describes
four 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,

(18:32):
nice going, and uh remodeling and maturing. And what happens
is 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 that the next process

(18:55):
can stall out. Um. Normally it stalls out at inflamation
ation because the infection gets out of hand in the
body can't fight off the infection faster than it's laying
The extracellular 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. Yes, they

(19:17):
just won't heal. And that's where maggots are really really
useful to basically interrupt that stall and get the car
moving again in the right direction. It's exactly right, they
kick started. Uh. So debridemant 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,

(19:39):
which we'll get to. Uh. They remove twenty five milligrams
of necrotic material dead flesh, uh, in just twenty four hours. Yeah,
that's pretty good. Yeah, and uh, there's there's actually three
ways that maggots clean a wound. But debridement, which is
getting in there and like just cleaning out, removing physically
removing um that dead material. That's like the key that

(20:02):
seems to be the key. And then there's also 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

(20:23):
stimulates new tissue growth around your skin. It's the most
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

(20:44):
act as a surgeon's rasp rasper or file what It
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 dieing and dead tissue
and it just, yeah, it loosens up. That's part one
of derived Part one. There's another part of it, which

(21:07):
is the digestive enzymes that they excrete and secrete. It's
called alimentary secretions and excretions a s C. 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

(21:29):
one of the old classics. And that's why I said earlier.
They don't bite or choose something. They just liquefy it
and then suck it in. 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.

(21:52):
But even more than that, they're liquefying even more of
this dead tissue. 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,

(22:16):
liquefying the dead tissue, 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

(22:37):
dibrid mint isn't just a 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 down tissue,

(23:02):
they destroy the d N A. It's pretty amazing stuff
it is. Should we take another break? Yeah, I'm a
little excited. We probably should. Alright, 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,

(23:23):
I'm I'm just excited. All right, we'll go watch me
vomited at least. Okay, that will gross me out? All right?

(23:48):
Well that 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,

(24:10):
And there's there's actually two mechanisms for the pain. One
is that 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. That's right.
So yes, the the the cure to that is pain killers, which, frankly,

(24:33):
if you have an open wound with exposed 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 the wound. See, that's what That's the
part that gets me is actually thinking about undergoing this

(24:56):
therapy 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 I think
anybody would feel that way. There's very few included myself.
I'm not grossed out 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.

(25:20):
I would definitely try. I think as 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 so you can't form memories while
it's happening. So maybe that would be a nice thing
to do too. So the other question is can you

(25:40):
just use any kind of maggot and the answer is no.
What they found is the most useful is the larva
of the green blow fly. 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

(26:03):
about this 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. I wouldn't, I mean, I
wouldn't advise that as your non doctor. Sure, I'm not
saying that either, but I mean this may be your

(26:24):
doctor's first time to their Their point was is it's
not it's not difficult. Just follow the instructions on the packet.
If you win. Your doctor though, he got the maggots
out and he put on his bifocals and 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 although

(26:46):
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. Yeah,

(27:07):
they're going to cover it, cover up the wound after
they apply the maggots five to eight per square centimeter,
like you say, and they're going to 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'll put the

(27:28):
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 on

(27:51):
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 called

(28:12):
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. So with the

(28:33):
with this, with the disinfecting, they figured that there was
some sort of gut flora that the maggots have that
prevents them from being infected by micropoil. That would make
sense because they're in that riting flesh as well and
they're thriving, right, So what gives Well, it turns out
that there are a couple of um types of I'm

(28:54):
not quite sure what what kind of um bacteria they are,
but they are. Oh 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

(29:14):
this 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 amazing. This maggot anti microbial
stuff not only does it kill microbes, it destroys the
thing that naturally protects microbes, which is called biofilm. Yeah,

(29:36):
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 Layman's terment 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

(29:57):
bodies do, right, And that's part of surgical I've meant
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

(30:18):
to 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 sores um. And there's been
a lot of studies of people with bed sores that

(30:38):
have found that maggots help 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. And they monitored them over three to
four weeks UM, and they were getting regular wound care
at the same time, like sometimes it's used in conjunction

(31:01):
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 were more than fifty dibrided

(31:22):
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 maggots. Yes, that's that's objectively amazing. It is.
And then they did a larger clinical trial and found uh,

(31:43):
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 obvious. The control. They
differed significantly between the three groups. Um, what was the

(32:05):
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, a
lot of people are like, I don't want a maggot
crawling in my wound, but a bag of them is

(32:27):
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
with the bagged ravioli, and seventy two days for the control.

(32:48):
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,
free range maggots fourteen days. That to me says that

(33:10):
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
just don't work, let's let's try maggots and see if

(33:32):
we can fix it. And maggots do work. There was
a study that found that of thirteen people treated who
had MERSA treated with maggots alone, twelve of the thirteen
had complete recovery and wound healing um from a mercer infection.
Mercu's nasty stuff too. Yeah, I think did we do
what I'm MERSA. I feel like we did. I know

(33:55):
we've talked about it. I don't know if it got
its own show though 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. Oh yeah,

(34:18):
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 maggots not being present. So
something about them actually stimulates tissue growth and blood vessel growth,

(34:41):
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
maggot you can. You don't think that's disgusting. You just

(35:02):
think those are little things doing their thing, doing their thing.
Little things doing their thing. Now I'm going to autoclave them,
that's right. Uh. 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 gonna call this

(35:23):
taken to 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 a head to comment on Josh's
statement that climate change was for global warming was settled science. No,

(35:44):
I'm not disputing the data that 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 sciences.
By definition, science is never settled, and that's an all caps.
I think we talked a lot about this is the
scientific method of this stuff. You guys actually did a

(36:05):
podcast on the scientific method, 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 Newton'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

(36:27):
whole idea of taking a body of fact saying it's
settled is far more political concept than scientific one. While
people with various viewpoints in the subject would like to
have 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 has never settled. You cannot simply say

(36:50):
this is true, move on. That's not how it works.
And that is from Spencer Carpenter right here in our
own Smyrna, Georgia. We're not in St. 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 of argument that science

(37:12):
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 accept that climate science is going it's
a layoff. So that was a clever ruse. It wasn't
a ruse at all. It was it was just I

(37:34):
was not being 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
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(37:56):
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