BIOSURGICAL NEWS Volume 1, Issue 1
Introduction to Biosurgery and the Biosurgical News
Welcome to this the first gical Research Unit began to wounds, often in situations
edition of the Biosurgical produce sterile maggots of the where traditional treatments
News! green bottle, Lucilia sericata, un- had proved ineffective.
der the brand name of LarvE. During the last five years
Biosurgery is a term that
has been coined specifi- maggot therapy has grown
cally to describe the use in popularity and the use of
of maggots in the treat- LarvE is now regarded by
ment of infected and many as the treatment of
necrotic wounds. choice for a variety of
This ancient treatment
was first used in Western Biosurgical News has
medicine during the been introduced as a vehicle
American Civil War, but to provide both new and
came to prominence after existing users of LarvE with
the First World War when information on recent devel-
Baer, an American ortho- opments in this area and as a
paedic surgeon, described forum for an exchange of
the use of the technique ideas and experiences.
for the treatment of Each edition will cover a
osteomyelitis in the wide range of topics, some
pre-antibiotic era. of which will be light-
Following the discovery of The treatment attracted consid- hearted in tone whilst others
penicillin, the therapy was erable interest in the nursing will be more serious in nature.
largely forgotten until it was press and media with the result Contributions are invited from
resurrected in America by that, despite the somewhat un- all practitioners of maggot
Sherman in the mid 1980s. conventional nature of the tech- therapy to future editions of
Maggot therapy was reintro- nique, many hospitals around this newsletter. Please contact
duced into the United King- the UK began to use maggots the editor at the address shown
dom in 1995 when the Biosur- for the management of problem on page four.
BIOSURGICAL RESEARCH UNIT
LarvE: Produced by the NHS for the NHS
LarvE are produced by the testing dressings and medical
Biosurgical Research Unit, devices, and is believed to be the Inside this issue:
part of the Bro Morgannwg only NHS laboratory accredited
LarvE: An award winning product 2
NHS Trust, based in the Prin- by the United Kingdom Ac-
cess of Wales Hospital in creditation Service (UKAS) for LarvE in veterinary practice
Bridgend. its work in this field .
Spreading the word 2
The BRU is actually part of Staff from a variety of scientific
Maggot therapy in the 2nd 3
the Surgical Materials Testing disciplines are involved in mag- World War
Laboratory (SMTL), a depart- got production to ensure that
ment that has been involved these are produced to the high- LarvE and the diabetic foot 3
in wound management for est possible standard as might Maggots in the treatment of 3
many years. be expected from an NHS-based pressure sores
The laboratory specialises in organization. Become a registered maggot user! 4
Page 2 BIOSURGICAL NEWS
LarvE: An award winning product
The unique nature of the LarvE project This is not the first award that the BRU has received, for
was recognized in 2001 when the Biosurgi- in 1999 the LarvE brand of maggots was granted Millen-
cal Research Unit was granted a Queen’s nium Product Status.
Award for Innovation.
This was presented by His Royal Highness
the Duke of Kent when he visited the
SMTL earlier this year.
During his visit the Duke was given a tour
of the production unit including the fly
room, where the adult insects are kept, the
‘nursery’ where the young maggots are
raised prior to dispatch, and the clean room
areas where the aseptic manipulations are
The Duke was also shown the various
pro cesses involved in the production of
sterile maggots, and he later spoke to a pa-
tient who had previously undergone a pro-
longed course of maggot treatment which
had prevented the amputation of his foot!
The Duke also toured the rest of the SMTL
to learn a little about the testing work of His Royal Highness, The Duke of Kent presenting the Queen’s Award to
the department. Dr Steve Thomas, Director of the Biosurgical Research Unit.
LarvE win a veterinary award!
Despite the widespread use of culitis, an infection of fatty tissue wound that progressed rapidly
maggots in human wound man- on the flanks, which led to tissue to healing.
agement, to date the use of mag- breakdown and the formation of This article was subsequently
gots in veterinary medicine has a large necrotic wound. award the ‘William Hunting
been somewhat limited. Repeated surgical debridement Award’ which is awarded annu-
Nevertheless, in 2001, the Veteri- and antibiotic injections failed to ally for the best contribution to
nary Record, the leading veterinary eliminate the problem, so mag- the Veterinary Record from
journal in the United Kingdom, gots were used as a treatment of practitioners
published an article that described last resort.
the use of LarvE in the treatment
The paper described how the Bell, N. J., Thomas, S. . Veterinary Record
of an elderly female donkey1. maggots removed all the infected 2001; 149: 768-770
The donkey suffered from panni- material resulting in a clean
Spreading the word
The Biosurgical Research Unit has South West . ment to education and training,
recently appointed three new a further series of training days
All are very experienced in the
members to its team. wound management field and has been arranged for 2003.
These are based in different parts will undoubtedly prove be an These days are always oversub-
of the United Kingdom to meet invaluable resource for practitio-
scribed so early booking is
local needs for education and ners of maggot therapy in their
training in the use of LarvE. respective areas. All three may be
For further information and
The three new staff members are contacted via the Biosurgical Re-
registration forms contact Tony
Clare McIver, who works in the search Unit. Fowler, Customer Services
North East region, Pat Holman, Training Days Manager by phone or email
who works in the North West, and As part of the BRU’s commit- (firstname.lastname@example.org)
Andy Carthew who covers the
VOLUME 1 , I S S U E 1 Page 3
Maggot therapy during the second world war
Since Napoleonic times, the history of maggot therapy has been closely linked to military conflicts . Many soldiers
with appalling battlefield injuries had their wounds infested with maggots, which may have actually saved their
lives by preventing the development of septicaemia.
Less familiar perhaps, are accounts of soldiers who, perhaps in the absence of more traditional medicines, were
given maggot therapy during the Second World War. An insight into one officer’s experience was given in a
letter that was recently written to the BRU in response to an article that appeared in a national newspaper and
is reproduced her with his permission.
I was interested to read the article which was less painful than using a Our poor diet and primitive liv-
on Maggot Therapy in the Times scalpel (albeit a bamboo one) ing conditions in the jungle pre-
Magazine of 31 August 2002 and otherwise shrieks of pain rent the vented normal healing. We never
particularly about your work in air! had this problem in Singapore or
this field. The next step was to sprinkle sul- Malaya.
You might be interested to learn phonilamide powder (good old I am not sure where we got our
that POWs working on the ‘Death M&B 693) on the wound and the maggots from - possibly fer-
Railway’ in Thailand during the ulcer healed beautifully. mented rice - but we were not all
Second World War used maggots Sometimes a skin graft was carried that curious to find out and the
on their leg ulcers with great suc- out but this wasn't too popular kitchens were out of bounds for
cess. though it did provide a protective us!
After the maggots had done their coating on the wound. MHC Burns, Major (Retired), late
work the ulcers were syringed out The slightest scratch from a bam- Indian Army.
with Eusol or saline solution, boo and an ulcer formed rapidly.
in the land of
Canaan chose Baal,
LarvE in the treatment of the diabetic foot: an account of a new
king of the flies, as
The management of foot ulcers multidisciplinary approach to the involved the use of a zinc
their chief god.”
in diabetic patients is both costly treatment of a patient with an impregnated stocking which
and time consuming, and many extensive heel wound resulted in s u ccessfully prevented the
patients are at risk of amputation. complete healing and prevented maggots from escaping and
In a recent case history, that will an amputation. protected the surrounding skin
be published in full on the web- The application of maggots from excoriation.
site, Debbie Ruff, Vascular played an important part of this For full details of this and other
Nurse, Pennine Acute Hospitals treatment as they rapidly cleansed case histories see:
NHS Trust, and Melanie the wound which in turn allowed http://www.larve.com/
Stephens, Lecturer Adult Nurs- the process of granulation to take
ing, Department of Nursing, place.
University of Salford have The treatment was enhanced by a
described how a structured new application technique that
Maggots in the treatment of pressure sores
Sherman, the leading exponent treated and 49 conventionally n o n-maggot-treated wounds
of maggot therapy in the United, treated wounds. (p<0.001).
States has recently published the Eighty percent of maggot treated The area of conventionally-
results of an analysis of the treat- wounds were completely treated wounds increased by
ment of 103 patients with 145 debrided, while only 48% of 1.2cm 2/week, but the area of-
pressure ulcers. Fifty of these wounds were completely debrided maggot-treated wounds decreased
patients, with a total of 61 using conventional treatment by 1.2cm 2/week.
wounds, received maggot therapy alone (p=0.021).
at some point during their treat- Within three weeks maggot Sherman,R.A. Maggot versus conserva-
ment. treated wounds contained one- tive debridement therapy for treatment of
Debridement and wound healing pressure ulcers, Wound Repair and Regenera-
third the necrotic tissue (p=0.05) tion, 1992, 10:(4), 208-214.
were quantified in 43 maggot- and twice the granulation tissue of
Become a ‘registered maggot user’
As part of the Biosurgical Research to register simply send an email to Name
Unit’s commitment to promoting email@example.com with the
education and training in all aspects word ‘register’ in the subject line. …………………………
of maggot therapy, we are setting up Alternatively complete the details Position
a database of maggot users. in the panel below and return it in …………………………
Individuals whose details are an envelope to the BRU at the Address
included in this database will receive address shown below. …………………………
a personal copy of each edition of By registering in this way you can …………………………
Biosurgical News as well as informa- ensure that you are kept up-to-date …………………………
tion on other publications or events in this interesting and developing Phone
related to maggot therapy. area of wound management. …………………………
Membership of the group is free. Email
Maggots on the ‘net’
Few would dispute the value of will shortly be relaunched.
the internet as a source of infor- In the coming months, this new site Key web addresses
mation on virtually any topic and will develop into a freely available
maggot therapy is no exception. resource for anyone who has an Biosurgery Home Page:
The SMTL first established an interest in biosurgery. http://www.larve.com/
internet presence in 1996, then, in One important section will consist of
1997, the laboratory introduced case studies on maggot therapy that
“Maggots the World Wide Wounds:
‘World Wide Wounds’, the illustrate the use of the technique in a
larvae of flies, world’s first peer-reviewed variety of wound types. http://www.worldwidewounds.com
electronic wound management Some of these case studies will also
caterpillars are the
journal. be summarised in this and future Email:
larvae of butterflies Although the SMTL web site has editions of Biosurgery News.
or moths, and had a Biosurgery section for many The first of these new case studies is
years, this is being updated and summarised on page 3.
grubs are the
larvae of beetles.”
On a lighter note ….
I’ve come to help that job you do
I do not munch nor bite nor chew A maggot’s year: November
I liquefy slough and take it away
With all nasty bugs-even MRSA.
Please help me to do a really good job
Like you, I’m not cheap, I cost a few bob
If you cover me well – so that I can’t breathe
I won’t take the food, but any small chance to
If you leave me too wet, I’ll choke and I’ll drown
And you’ll never find me, you’ll think I’ve left town
If you leave me too dry, I’ll shrivel away
‘I’ll need two more pots’ to Mary you’ll say.
The moral here told is simple and fact
Biosurgical Research Unit Read my instructions and don’t be a prat.
SMTL Some moistened fresh gauze and change every
Princess of Wales Hospital day…
Coity Road I’ll be worth every penny that you’ve had to pay
Bridgend Remember, if I leave a bloody red trail
CF31 1RQ That shows I’m working and not that I’ve failed
‘Guy Forks’ thought he had found a way of
Phone: 01656 752820
Fax: 01656 752830 If in any doubt ring the contact that’s given removing slough faster than usual!
Email: firstname.lastname@example.org So I can do well in this short life I’m living.
Mair Fear 2002