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Although it may sound crazy, many doctors use maggots today to clean wounds of dead and infected tissue. This process, called debridement, is important for preventing the spread of infection in a world of increasing antibiotic resistance. Hank has more details on the marvelous maggot in today's episode of SciShow.

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Pop quiz!

A doctor is presented with a wound. The wound is dirty. There is dead and infected tissue in the wound. In order to treat the patient, the doctor applies insect larvae to the wound to allow the maggots to consume the flesh of the patient. This scenario occurred with regularity A. during the American Civil War or B. last Tuesday.

Congratulations! No matter which one you picked, both answers are correct.

[intro music]

 Wait, what?

Dr. J.F. Zacharias, a doctor during the Civil War, said: "Maggots... in a single day, would clean a wound much better than any agents we had at our command... I am sure I saved many lives by their use."

This sounds insane, obviously, but it turns out that maggots are a sign of disease, they're not a cause of disease. Most maggots will only eat dead or dying flesh. Indeed none of this is that surprising, we've known that maggots are an effective treatment for infected wounds for years, but the rise of antibiotics made them pretty much obsolete. Now, in a world of increasing antibiotic resistance, maggots are making a resurgence.

 But why?

Debridement is the process of cutting out and removing dead or infected tissue around the wound. Sometimes doctors do it with scalpels and it's a dirty job. It's hard to know when you've gotten all of the dead tissue, and often more tissue was taken than is necessary. But maggots, they seem to know where that line between diseased and healthy tissue is better than doctors do. In 2005 FDA approved maggots as, and I'm not kidding here, "a medical device."

 Advantages and disadvantages

Maggots, it turns out, actually serve the body in two ways. First by cleaning away dead and infected tissue standing in the way of the closure of the wound, and second by mildly modulating the immune system, preventing chronic inflammation.

This is not to say that maggot therapy is without its problems. The therapy can be more painful than traditional debridement, maggots have a short shelf life, and patients often report an 'uncomfortable, tickling sensation'.

The critters are kinda picky, preferring certain types of wounds to others. Gross. And because they have to be 100% sterile raised from an egg without any exposure to actual potential pathogens, they're not particularly cheap either.

 Okay then.

But these maggots have done some amazing things. They've helped rehabilitate patients infected with MRSA, an extremely dangerous and resistant strain of staph. More than fifty thousand people per year are treated with maggots and frankly, I'm shocked we haven't talked about it sooner! Sometimes medical marvels are just waiting there to be rediscovered, and sometimes they're a little bit gross.

I'd be fascinated to hear if anybody in the comments has experiences, or had a friend go through maggot therapy. It seems like, as with a lot of medical procedures, the first instinct would be like: "Uhm, no, you are not going to do that to me." but then, when compared with the prospect of losing your legs to flesh eating bacteria, get over your hang-up real fast.


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