MAGGOTS are just as effective at treating some wounds as modern medicines, according to scientists at the University of York.
Academics in the university’s Department of Health Sciences co-ordinated a three-year trial comparing different therapies for treating leg ulcers.
The condition affects one per cent of the population and treatment is estimated to cost the NHS £600 million a year.
The trial was run in partnership with health trusts across the north, the Midlands and Northern Ireland, and included treating patients at York Hospital.
It was the largest clinical study into larval (maggot) therapy ever undertaken.
The results, which are published in the British Medical Journal (BMJ) Online today, revealed larval therapy has similar health benefits and costs compared with a standard treatment for leg ulcers.
The trial, called VenUS II, compared the clinical and cost-effectiveness of the two types of larval therapy with the more conventional treatment, as well as the effect on patients’ quality of life over 12 months.
The randomised trial involved a total of 267 leg ulcer sufferers.
During the wound cleaning phase, a third of patients were treated with loose sterile maggots, a third with sterile maggots in a bag while the remainder were treated with hydrogel.
Larval therapy significantly reduced wound cleaning time compared with hydrogel, but there was no evidence of a difference in time for the ulcers to heal – half of patients allocated to the larvae group were healed by 236 days, compared with 245 days for the hydrogel group.
Professor Nicky Cullum, who headed the trial, said: “Although larval therapy is more effective in cleaning wounds than hydrogel, there is no evidence to recommend it for routine use to speed healing or reduce bacterial load in leg ulcers.
“We believe further research is required to explore the relationship between wound cleansing, healing and microbiology, and to better understand the value of a clean wound to patients.”
Leg ulcers are chronic wounds most commonly caused by diseased veins in the legs.
The removal of dead tissue from the ulcer surface is a common part of ulcer management, and is widely viewed as having a role in promoting wound healing.
The medical value of maggots for cleaning wounds of dead tissue has been well known to physicians for centuries.
They were still used by doctors in the 1920s and 1930s, only being discarded when the development of antibiotics gathered pace.
There was no difference between larvae and hydrogel groups in health-related quality of life or in bacterial load (including MRSA).
Larval therapy was associated with twice as much pain in the 24 hours prior to removal of the first application compared with hydrogel.
In a separate analysis, the researchers calculated larval therapy was likely to have similar cost-effectiveness to hydrogel.
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