MAGGOT 'microsurgeons' will be put to work at Tan Tock Seng Hospital (TTSH) from next month, making it the first hospital here to use the larvae to treat its patients' festering wounds.

They will be deployed in the hospital's Specialist Wound Clinic and help heal infection wounds of diabetics, amputees and burns victims for a start, said Dr Ooi Lai Hock, deputy head of TTSH's orthopaedic surgery department.

Those types of wounds do not heal readily, and if left untreated, dead tissue is an ideal breeding ground for bacteria.

The 2mm-long maggots 'treat as they eat' - they gobble up dead tissue and produce infection-fighting secretions.

Sandwiched between two pieces of gauze or other type of dressing, they are left in a wound for up to 48 hours. After that, they are treated as biohazard waste and discarded.

Ten-month-old research lab Origin Scientia, currently the only lab breeding the larvae, will supply the hospital with 100 vials of maggots each month.

Maggot therapy is apparently less risky and speeds up recovery.

Ordinarily, dead tissue from festering wounds is removed by surgically cutting it away, said Mr Carl Baptista, head of research and development at Origin Scientia, which is collaborating with Nanyang Technological University (NTU) on the maggot project.

'One of the risks with surgical removal is damaging new tissues that have formed. What the maggots do is to eat away only the necrotic tissues, leaving the new ones to regenerate,' he said.

With the therapy, patients who would otherwise take eight months to recover could get better in two weeks or less. The treatment is also cheaper than conventional surgery, with studies in Britain pegging savings of about 80 per cent off the medical bill.

Maggot medicine was tried and tested back in the 1800s by military doctors in the field where medicines and sterile facilities were in short supply.

It is now used in hospitals in Britain, Germany and the United States, but has not been used here until now.

TTSH's incorporation of maggots into treatment follows about five months of clinical trials involving 20 patients, most of whom were elderly diabetics, whose wounds do not heal easily, said Mr Baptista.

They received the idea well, he added, even if others might be queasy at the thought of maggots feeding on their flesh.

But Alexandra Hospital podiatrist Matthew Herd feels that good explanation can help overcome initial fears. 'Once you explain to patients how it works, they are quite open to it,' said Mr Herd.

The hospital has been conducting trials on diabetic patients for the past four months, with positive results, but has not yet decided if it will make the option available to patients.

Origin Scientia has a stock of about 4,000 Lucilia cuprina - the common green bottle fly.

They are fed a mixture of milk powder and sugar, with a side of vitamin B-12 enriched syrup.

After the flies mate and lay their eggs, the eggs are harvested and sterilised to ensure the hatched maggots are bacteria-free.

Beyond treating wounds, the lab hopes to one day harness the maggots' bacteria-killing abilities for use in products such as creams and serums.

juditht@sph.com.sg

taniat@sph.com.sg

This story was first published in The Straits Times on Feb 28, 2008.