Maggot farts to the rescue (Feature)

By Christiane Oelrich Jun 14, 2010, 5:11 GMT

Singapore - They may be disgusting, but if medicine is at its wits' end fly maggots are often the only hope because they eat dead tissue and help clean open wounds.

In Singapore, researchers now not only research the maggots, but also whether their farts - their wind has anti-biotic properties - can be collected and put to good use.

The smell in the hermetically sealed lab of Medifly, run by Singapore-based life sciences company ORIGIN Scientia Pte Ltd, is awful. Sheep's hearts are rotting away on a table, covered in tiny white fly eggs.

The lab assistant is satisfied. On the decomposing meat, the capital which earns the company money and saves lives is growing.

The sterile maggots hatching from the eggs of Lucilia cuprina, or sheep blowfly, will soon be feasting on human tissue - on doctor's orders.

Used in so-called maggot debridement therapy, the maggots eat necrotic but not healthy tissue, thereby cleaning non-healing wounds. It is used on patients who would otherwise face amputations, for example diabetics or those with multi-resistant infections that do not respond to antibiotics.

In those cases, the maggots are often the last hope. 'When we started in 2007, we treated 14 patients scheduled for amputations. After two months, seven of them were taken off the list,' said Medifly general manager Donny Lim.

The centuries-old method of using maggots to clean and treat wounds is coming back into fashion in Europe, but in Asia, the technology is only slowly gaining ground as the creatures are regarded as too disgusting.

Australia's Aborigines and the Maya in Central America used the larvae in their treatments. During World War I a British military doctor rediscovered the maggots' healing properties when soldiers' wounds, after days of transport, were teeming with maggots, but were otherwise clean and healed quickly.

The development of antibiotics spelled an end to maggot therapy, until doctors rediscovered it following the emergence of antibiotic-resistant bacteria.

But the researchers in Singapore are entering uncharted territory. A group has discovered that if the maggots break wind, they emit anti-biotic properties.

Medifly is continuously breeding a stock of 10,000 flies. They live in 37 glass cabinets, which are kept in a glass-walled chamber, secured with double doors to make sure that no fly gets out - and the smell stays in.

Lim's staff select a new pair from the wild every 10 generations. 'Too much inbreeding is not good,' he said.

The fly eggs on the rotting meat are sterilized before the larvae hatch, 18 hours after the eggs are laid. About 200 of the tiny, 2-millimetre long baby maggots are delivered in sterile bottles containing a nutrient solution to hospitals.

Nurses then put the maggots directly in the open wound. The maggots secrete their digestive solution that liquidizes necrotic tissue, and then suck that up.

After 48 hours in the wound, the fully gorged maggots, now up to 8 millimetres long, are removed and drowned in alcohol.

Medifly also supplies maggots in something resembling a teabag - called 'baggots' by the company. Some patients prefer this because the maggots don't roam free. They can still secrete and suck through the tissue.

Researchers are still not 100 per cent sure what makes the maggot so effective in treating wounds. It is not only the digestive solution, which has anti-biotic properties, but also their gases.

Researchers at Nanyang Technological University in Singapore reported recently that maggot flatulence slows the growth of bacteria that prevent wound healing.

'Maybe one could develop a kind of spray that can be used on wounds instead of the maggots,' Lim suggested. 'We are working on it.'