Meeska, Musca, Mousketeer!
I’ve recently discussed a short and tiny infestation of flies, and how I killed all four when they were dazzled by my laptop’s screen. However, before one died she laid some eggs on a wound on my shin. I found this out when I changed the wound’s dressing. It was all wet and bloody and when I removed it I found it held a mass of maggots, with more on the wound. As a student of Civil War and WWI medicine my reaction was not revulsion but interest. I had heard maggots would only eat dead tissue and and released antibiotic spit, so I considered leaving them there 'til the job was complete. I thought better of it, both because they had struck blood so they were starting on flesh I wanted to keep and because purposely growing a brood of maggots on my person was gross, even for me, though the spider family I’m raising in the laundry room would appreciate the free eats. I knocked those off and squashed them and saved the ones on the bandage for further study. Then I cleaned the wound REAL well, put on a fresh dressing, and decided to not “air it out” until it closes better.
I mention this here because it’s not something I can talk about at work or with my family and because some of you might have some stories of self-experimentation of your own. After all, if you can’t experiment on yourself, who can you experiment on? Legally, that is.
My doctor–a real MD from Mumbai where they know from weeping sores ;)–suggested that I dry the wound with calamine lotion. I might need another doctor, but they get so prissy when I experiment. Anyway, how could I pass up an unintentional opportunity to investigate biodebridement?
Uh, yeah, as you discovered, not all of them feast only on dead flesh. In fact, flystrike is a dangerous ailment for various animals - livestock, pets, and humans among them.
Who was that entomologist (probably all of them) who nurtured his wee blowfly until it emerged as an adult? THAT is gross.
Somewhere around here is my report on my first run in with maggots in a wound when I was a brand new nurse, which can be summed up by my phone consultation with the wound care nurse who simply asked, “well, how does the wound bed look?” and I answered, “Great! It’s never looked better!” And then I ran home, showered and did several shots of tequila to bleach my brain. I did learn to carry a bowl with a tight fitting lid and a bottle of rubbing alcohol in my wound care bag, because those little buggers crawl fast when they fall out of the wound. Picking them up and tossing them in rubbing alcohol kills them almost instantly. These days, I kind of like them, because yeah, even the “volunteers” help to heal necrotic wounds. Getting insurance to approve maggot therapy is difficult, but volunteers are free.
The idea that maggots only eat dead tissue is untrue, but widely believed, even in medical wound care circles. Maggots will eat whatever they can get their little mouths around. When we use them purposefully in wound care, they’re a species that has very little mouths, so they’re likely to go for the nice soft predigested necrotic tissue first. But we still watch them carefully, and when they’ve eaten their fill and the wound bed is nothing but healthy granulation tissue (red, not pink) we remove the maggots. The most common species, grown in labs in sterile medium specifically for maggot therapy, is Phaenicia sericata, the common green bottle fly. When used therapeutically and removed when granulation tissue is visible, they have a low probability of causing myiasis (fly strike) but in the wild, they do cause it.
Do be aware that not all the eggs hatch at the same time. You’ll probably be flushing your helpful hungry friends out for a few days as new ones emerge.
They haven’t yet because I’ve been using alcohol in the form of hand sanitizer (it stays in place better on a vertical surface) to clean the wound. And the wound bed is a nice pinkish red, but it always is. The edges are less scabby now.
I have lymph edema and young nurses all want to look at my calf because they’ve never seen it before. The wound started out as a small leakage site that I picked at (mea culpa) so it is several years old and quite large (3/4" x 1-1/2"). Yesterday’s dressings were drier than usual, which I read as a good sign. Maybe thanks to my insect friends it’s turned a corner because it’s starting to get on my nerves.
Bleh, lymphedema ulcers suck. Glad to hear it’s not infected or necrotic, though.