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Bay City
Doctor Uses Maggots to Help Save Foot of Diabetes Patient
Bay City Times, July 23, 2005
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BAY CITY, Mich.
(AP) -- Barbara Enser wasn't very comfortable at first with the
idea of using maggots to clean the wound on her right foot.
But if it meant saving it from amputation, she was willing to
give it a try.
The 57-year-old Bay City woman was diagnosed with diabetes 40
years ago and subsequently lost her left leg to the disease. She
also suffers from neuropathy, meaning she has no feeling in her
foot or leg, and ulcers or wounds can develop from constantly
putting pressure on the foot.
"I'm just hoping this works because I think this is the last
straw for saving the foot," Enser told The Bay City Times before
a recent treatment. "I don't like creepy, crawly things. I won't
even kill a creepy, crawly thing."
Enser went through a number of other procedures to stem the
infection that is spreading through her foot. She had the wound
cleaned with a scalpel and has been on antibiotics.
But after those failed, she turned to Dr. Gerald L. Dowling,
head of the podiatry section of the Orthopedics Department at
Bay Regional Medical Center. He first treated Enser with maggots
on July 6.
For the procedure, the maggots -- about 2 millimeters each in
size -- are placed on the wound, then surrounded by an adhesive
foam, clear tape, and a gauze bandage.
By July 8, the maggots had swelled to twice their normal size
and eaten away part of the infection. When Dowling removed the
bandages two days later, Enser's foot was looking better.
Healthy, pink skin was replacing the dead tissue, and the
swelling was down in her foot and ankle.
The maggots do more than just clean a wound. They also dissolve
the infected tissue, kill bacteria and leave an enzyme behind
that stimulates healing. They will only eat the infected tissue,
leaving healthy tissue alone.
"In general, maggots have the capacity to distinguish viable and
dead tissue on a cell-by-cell basis," said Dr. Steven M.
Holland, chief of the laboratory of clinical infectious diseases
at the National Institute of Allergy and Infectious Diseases.
As much good as the first treatment did, Dowling decided to go
with one more treatment. And when the bandages from the second
procedure were removed 72 hours later, Dowling deemed the
procedure a success.
Once the bandages were taken off, the maggots were removed using
tweezers and the area was rinsed with a saline solution. Dowling
then cut away leftover dead skin.
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