• Kyodo

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A Japanese heart surgeon is successfully treating diabetics via a method once used by Australian aborigines and Native Americans — maggot therapy.

Hideya Mitsui of Okayama University Hospital has been applying the creatures to skin wounds that won’t heal and would otherwise lead to amputation following the onset of gangrene.

The traditional cure has proved far more effective than modern medical therapy. The sterile Australian maggots that are used in Japan are four or five days old after hatching from black fly eggs.

Mitsui has used maggots since last March on several patients who faced foot amputation. The patients ended up keeping their feet and their lesions have healed well.

A 65-year-old woman stricken with diabetes and renal failure was Mitsui’s first maggot therapy patient. An ulcer was deteriorating and she was scheduled to have her foot amputated even while continuing to receive conventional treatment.

Mitsui applied a maggot several millimeters long to the wound. The wiggly creature ate the gangrenous tissue and grew to about 1 cm within 36 hours.

It was removed from the ulcer after a week, before it developed into a pupa, and was replaced by another maggot. The process was repeated three times.

The woman’s foot was cleansed while the first maggot consumed the necrotized tissue, and the surrounding flesh healed a week later, reducing the size of the ulcer, according to Mitsui. The wound healed after the therapy.

Mitsui said narcotics were administered to the woman before the therapy because she was in severe pain. But her suffering eased and she was able to walk after the treatment.

He said maggots secrete digestive fluid into a wound and feed only on dead tissue. In addition, they release antibacterial proteins and disinfect the fringe area.

Despite the gross-out specter of patients’ flesh being eaten by maggots, Mitsui said the treatment is “nothing special,” as the medicinal value of maggots has long been known. The therapy has already been recognized as effective in Europe and the United States, he added.

He explained that in modern times, it was known that soldiers wounded in battle saw their injuries heal if maggots were left to feed on decaying body parts. The creatures also saved lives.

Some hospitals in Europe and the United States used maggot therapy in the first half of the 20th century, though the treatment went out of fashion when antibiotics became ubiquitous.

However, maggots staged a comeback following the emergence of antibiotic-resistant bacteria.

A U.S. medical scientist reported in the 1990s that the use of maggots to treat gangrene among diabetics produced better results than conventional medical care.

The therapy is said to have won recognition in Britain as a low-cost and effective treatment.

Each treatment costs about 300,000 yen in Japan because importing germ-free maggots is expensive. The cost is currently covered by research funds for the testing of highly advanced therapies.

Experts say the price could fall once a supply of similar insects becomes available domestically. Since no special equipment is necessary, they could be developed in Japan.

Mitsui said maggots have the advantage of not producing side effects, adding there have been no cases of contraindication.

“They might be applicable in wider areas, not only in diabetes and arterial hardening, but also in arterial ulcers, bedsores and burns,” he said.

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