Stuff You Should Know - Maggots: Good For Healing Wounds, Turns Out

Episode Date: November 11, 2015

Cultures around the world over the years have been inspired by, then repulsed, then inspired by maggots' ability to heal persistent wounds. We are in an inspired-by phase right now. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass

and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Welcome to Stuff You Should Know, from HowStuffWorks.com. Hey, and welcome to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant, and no one.

No one else is in here with us yet again, because we've graduated to the point where we don't even need a producer. We need somebody who presses record and leaves. Yep. That's it, because we're pros. Yep. Not P-R-O-S-E, P-R-O-S.

That's right, we're not, but we are prosaic. Yes, but definitely not P-R-O apostrophe-esque. Very few things drive me crazier than that, and I know it's stupid and pedantic, but to see somebody take out a huge billboard or something, and a word has an apostrophe that shouldn't. Oh, pros. People say like, leave it to the pros.

And they'll put an apostrophe? Yes, and that graphic designer should be, you know, doctor, half a day's pay maybe. 80 bucks. Something. We want to issue, and you probably would get this from the title of the episode, but we want to issue a meal warning.

Oh, good thinking. Because we've gotten complaints in the past when people are eating and get sick listening to some of these. Yeah, this would do it possibly for some people. I was fine, I ate a runny yolk egg sandwich while I was researching this. Yeah, right.

It didn't bother me, but I could totally see how it could for many people. I also want to say, if it comes up, do not go Google image search wound sloth. Well, I just put do not Google image search maggot therapy at all. Okay, sure. But definitely stay away from wound sloth.

S-L-O-U-G-H. Yeah. Wow. And definitely don't look at wound sloth while you're eating. Yeah. Okay, so that's all out of the way. Yes.

I predict we're going to be kind of excited about this one. I'm feeling a little pumped about it. Well, we did cover in 10 bizarre medical treatments, leech therapy, which is still being used. And I'm surprised this wasn't in that article, to be honest. I am as well.

But this gets its own special deal. And it, well, it should actually, because it's a pretty amazing thing. Agreed. We're talking about maggot therapy. Also, great band, by the way. Yes, it is. They were awesome.

So, or they really, or is that a band name? Well, it's a band name to end all band names. There probably was a band name that. So there's, it's called maggot therapy, maggot debridement therapy, larval therapy, or bio, there's another one called, I think like bio, bio debridement. Or therapeutic wound myses.

Yeah. And that's basically all the, all of them, no matter what you call it, no matter how you church it up. It is the application of live maggots, fly larvae, to purposefully, to an open wound. Yep. In order to help that wound heal faster. Yeah.

And better and cleaner and all that good stuff. What everything Dothpunk said. Oh, yeah. You know. Should we talk about some of the history of this stuff? Let's just say that one more time. Okay. Maggot debridement therapy is taking live maggots

and putting them in an open wound on a human being or an animal that's used in veterinary medicine as well. Wrapping it up tight. And letting them just eat the dead and dying flesh in that wound. Yeah, while you get your foot tickled. Okay. I would be so skieved out by this.

I just wanted to make sure that everybody knows exactly what we're talking about. Right. And goodbye to everyone. Everyone who fainted. Okay. Yeah. Let's talk about history Chuck,

because this is in use today, but it's actually pretty old. Yeah. I mean, it's some say it's an even an ancient tradition like in places like Burma and Central America with the Mayans, they were smart enough to know that maggots do a pretty good job of consuming human flesh.

Right. And it can be used for good in that regard. Yeah. At some point, I guess healers noticed like, yeah, people who had maggots in their wounds tended to have wounds heal. Mm-hmm. And actually as far as the Western literature goes, that's exactly how maggot therapy first finds its way,

first crawls into the medical literature. Yeah. Is from a French surgeon named Ambro Ambrose Paré. Yeah. How would you say it? I don't know. I don't speak French. Ambrose Paré.

I'll say Paré, even though it doesn't have the little, what is that, an accent, a goo? Yeah, it's just the E. But he was a 16th century surgeon and he noticed that people didn't necessarily fall over dead if there was a maggot in the wound. Yeah, he was the first doctor to actually come out and say, you know, I had this patient

who had a big skull wound. Right. And unbeknownst to me, there were maggots in there. I saw them crawling out one day. And even though they had a lot of bone, the guy was great. He healed. Yeah. Like he lost a hand-sized slab of skull.

Yeah. And he lived. And I think it might have something to do with the maggots. Yeah, and he presumably wore a helmet for the rest of his life. Probably. So he had a probably big, soft skull there. Yeah, I would guess so.

That was followed in with the mid 1700s by another Frenchie, Baron Dominique Jean Leroy, and he said, you know what? On this Egyptian expedition, these blue fly maggots are actually doing the right thing and helping us out. Right. So it's almost like these doctors just noticed this. Exactly. And it meant enough to him that they were like,

I should probably write this down. This is going to be my great contribution to medical history or the history of science, right? Magot therapy. Magot therapy. It wasn't until the, I guess the Civil War that a doctor actually said, I'm going to purposely put maggots in a wound.

Yes. And see what happens. And that doctor was John Forney Zacharias. He probably didn't tell his patient that. I think probably he was just like, just bite down on this broomstick and look the other way. Do you want to lose your foot or do you want to try something really weird?

Well, supposedly in studies, 95% of people, modern patients who are offered this therapy say yes to it. Well, yeah. Because I think that's what it comes down to. Yeah, it's a last resort, basically. It's not the first thing they offer. Not necessarily. Right.

So anyway, Dr. Zacharias, he had a great quote. He said, during my service in the hospital at Danville, Virginia, I first used maggots to remove the decayed tissue in hospital gangrene. And with my eminent satisfaction, in a single day they would clean a wound much better than any agents we had at our command. I used them afterwards at various places.

I am sure I saved many lives by their use, escaped septicemia, and had rapid recoveries. Period, end quote. Pretty great. Yeah, so he was a huge believer and not just a passive observer, like people who came before him. He said, yeah, I put maggots on wounds and it helps.

That's right. And people experimented with it for a little while until a guy named Louis Pasteur and Robert Koch came along, microbiologist and germ theorist that basically said, you know, this is disgusting. We might wanna not do this. Yeah, maggots are dirty. Yeah, yeah.

And it's true, maggots naturally in the wild carry lots of pathogens with them that can infect us in other ways, can make a wound worse, can actually kill you. So the idea behind germ theory as far as maggots go is right. Yeah. But it seems like there's this long history of necessity

and disgust with maggot therapy. That kinda way ebbs and flows. Right, and necessity rears its head on the battlefield. It did in the Civil War and it also did in World War I. There was a surgeon named William S. Bayer and he was working on the front lines in France and he used maggots on stomach wounds and open fractures. Gah.

Yes. And he found to his great satisfaction, just like Dr. Zacharias and the others performed, that this stuff actually worked. Yeah, and he actually said, you know what, I have some further advancements. Maybe we should put a bandage over this thing so it doesn't completely disgust the patient.

Right. And let me put bandages around the wound so they don't start creeping onto the healthy flesh and doing damage or just itching you or creeping you out further. Right, exactly. Which are still in use today. These techniques.

He also pioneered another huge technique and this is after the war was over, 10 years later. Yeah. When he was back at Johns Hopkins. He pioneered another really important technique and that was using sterilized maggots, like germ-free maggots. They were raised as eggs in a sterile environment

and so when they were introduced to the wounds, they weren't carrying these pathogens anymore and he found this is the jackpot. Now you can use maggots from now on. That's right. And it was a big boom in the 30s, up until the mid 1940s, more than 300 American hospitals

were using maggot treatment and maggot therapy. And then in 1944, antiseptics came along or new antiseptics and they said, you know what, maybe there was another lull in the use of maggot therapy. Right, necessity. That's right. Didn't spur this stuff.

And it was, they went back to just being gross again. There was a guy who by the 80s wrote what this one article calls the majority opinion. Fortunately, maggot therapy is now relegated to a historical backwater of interest more for its bizarre nature than its effect on the course of medical science. A therapy, the demise of which no one is likely to mourn.

That's just that kind of Western medicine hubris. Sure. We're like, we can do anything except everything. You know? Yeah, that's right. And in the 1990s, a dude named Ronald Sherman and Edward Pector basically championed the technique again and kind of brought it into the modern age.

Yeah, and still very much is Ronald Sherman is one of the first, I think, to receive a license to produce sterile maggots for use as medical devices. And there's another guy over in the UK named John Church who brought the maggot therapy into the fore. So it was an ancient thing. It was, it's found to be disgusting.

It's found to be useful. It's found to be disgusting. It's found ways you can make it better. It's found to be disgusting. And the now that this idea of complimentary medicine is kind of regaining some traction again. I think it's here to stay though. I think so too, unless someone comes along in 10 years

and says, well, you know what, it's disgusting. Well, you know, Chuck, I mean, probably what we're seeing is the next thing that'll happen is there'll be some huge leap, some huge development in science and science will get its hackles up again and it'll be great about itself. And we don't need any of that stupid nastiness. And then we'll find that, nope,

you still can't be good old fashioned maggots. And that's, that should be the title of this thing. You can't be good old fashioned maggots for healing a wound that won't heal otherwise. That's a great title. So you want to take a break? Yeah, let's do it. And we'll go treat our own wounds

and we'll be back shortly. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

We lived it and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends and nonstop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting frosted tips? Was that a cereal?

No, it was hair. Do you remember AOL instant messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy,

blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts or wherever you get your podcasts. Oh God. Seriously, I swear. And you won't have to send an SOS because I'll be there for you.

Oh man. And so will my husband, Michael. Um, hey, that's me. Yep, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life step by step. Oh, not another one. Kids, relationships, life in general can get messy.

You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, ya everybody about my new podcast and make sure to listen so we'll never ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts or wherever you listen to podcasts.

Learning stuff with Joshua and Charles, stuff you should know. All right. OK. Let's talk about diabetes for a second. Yeah. More than 23 million Americans are affected with diabetes. And one thing that can happen is nerve damage, especially in the extremities, the hands and feet and the toes

and the fingers. Your blood vessels become hard and they don't circulate the blood like you need. That can lead to open sores called ulcers, which can become infections, which can spread to nearby bone, which can lead to amputation. Yeah, and all of this happens a lot. All of this is just from a prolonged exposure

to high levels of blood sugar. And they're not sure how it can do it. But yeah, the blood vessels not helping pump blood very well. They get nutrients so your tissue can die. But also that neuropathy, that dead and nerve cell, that actually makes it hard for you to notice if you have like a really bad ulcer on the bottom of your foot.

You can't feel it. Yeah. And so you don't get treatment early enough so an infection can get out of hand. And when it spreads to bone, that's called osteomyelitis. That's problematic because that very quickly will lead to an amputation.

And there's some pretty shocking stats here from this article that Tom wrote about. Was this a sheave jam? Yeah. Nice. It's yeah, for sure. But about amputations from diabetes. Yeah, 70,000 toe foot and leg amputations each year

in the United States alone. So crazy. And they say around the world, they estimate every 30 seconds someone gets a limb cut off because of diabetes. Yeah. That's sad. Yeah, it really is.

And we'll do one on diabetes for sure. Oh yeah, I'm surprised we haven't already. Yeah, me too. But the so amputation is used to halt the progress of an infection. Yes. And that's usually the last resort. But what Tom points out is that there

are plenty of doctors around the world, I imagine, that aren't aware that you can use maggots or have never done it before. And if you are facing an amputation from, say, like a wound, a persistent wound, a chronic wound that won't heal, you may want to suggest maggots to your doctor. You may have to actually take the initiative on this one and say, let's make sure that amputation is

the absolute last resort. Let's see if we can put one more resort in there before then. I'm willing to let maggots crawl inside my body in this wound, this open wound, if you're willing to apply them. And they, like most doctors, love hearing when patients suggest treatments. Oh, they do. They love feedback.

They love to be guided in their diagnoses and prognoses. Yeah. Love it. That's a tough jam. I get it. Doctors are frustrated a lot these days with self-diagnosis and online doctoring. Sure.

But you should also be your own advocate. We've championed that before. Yeah, it's your leg. Yeah. If you want to keep your leg, you tell that doctor to go get some maggots. You're going to replace them with a doctor who will. I can find a guy.

Yeah. I can get a guy by noon that'll put maggots on that wound. And actually, there's a group. I think Ronald Sherman, the guy we mentioned earlier, who's like the US champion of maggot therapy, there's this group called the Beter Foundation, B-T-E-R Foundation. And they have all sorts of resources

for people in that very situation, like how to talk to your doctor. Right. If your insurance won't cover it, let them know. Because they say, insurance actually, most insurance covers maggot therapy. But most insurance claims people are not aware of that. So you may get denied at first.

And here's how to talk to your insurance company. That's a great resource. It really is. That beats going to your doctor and saying, well, you know what? Josh and Chuck said, A, you're not going to like hearing this because you think you know it all.

Doctor, please take a seat. And B, put maggots on my feet. Right. And that's the other thing, too. I mean, we wouldn't be suggesting this. And the Beter Foundation probably wouldn't be such advocates for it if it didn't work so amazingly well. In study after study.

And we'll talk about the details of it. But there's so many studies out there. Again, Sherman, who agreed is an advocate, but in a peer-reviewed journal, published a survey of studies that he could find on maggot therapy. And it's very clear that it works really, really well. And not only necessarily as a means of last resort, but even just compared to the standard of care using

like hydrogel or other things that you might use to treat a chronic wound. Maggots destroy it. They leave it in the dust. Yeah, and if it doesn't work, it's not going to hurt anything from what I can tell. It just puts off how much longer before they amputate your foot. Pretty much.

Yeah. So what'll happen is they will, well, let's get into this a little bit. There are four different, and where did you find this? Was this a research paper? Yeah, this is by Ronald Sherman, mechanisms of maggot-induced wound healing. Colin, what do we know, and where do we go from here?

It was in the journal Evidence-Based Complimentary and Alternative Medicine in 2014. That's right. And he describes four different phases of basically healing a wound, homeostasis, inflammation, proliferate, man, I'm so bad at that one, proliferate. Oh, yeah. Keep it coming.

Proliferation. Nice going. And remodeling and maturing. And what happens is the cells get to work. They recruit other cells. They alter their activities and basically say, let's get to work cleaning and, well, on all four of these stages to help heal the wound.

Yeah, and at any one of those stages, the next process can stall out. Sure. Normally, it stalls out at inflammation because the infection gets out of hand and the body can't fight off the infection faster than it's laying the extracellular matrix for the new cells to be rebuilt, the new tissue to regrow.

And that's a common thing that leads to chronic wounds, wounds that just won't heal. And that's where maggots are really, really useful to basically interrupt that stall and get the car moving again in the right direction. That's exactly right. They kickstart it. So debridement is removing dead tissue,

and that is really where maggots excel. They said in here, each maggot can chew, well, they don't exactly chew, which we'll get to. They remove 25 milligrams of necrotic material, dead flesh, in just 24 hours, that's pretty good. Yeah, and there's actually three ways that maggots clean a wound, but debridement, which is getting in there and just cleaning out,

removing, physically removing that dead material, that's like the key. That seems to be the key. And then there's also antimicrobial activity, like actually killing the bacteria that's killing the flesh. Leaving it cleaner than when they came in, which is amazing. And then, even more astounding, stimulating new growth,

like the presence of maggots in your wound stimulates new tissue growth around your skin. It's the most, they're just like wonder creatures. Who knew? One of the ways that they remove this dead tissue is just by the nature of what their body is like. And they have these little prickly spines all over their body that act as a surgeon's rasp,

rasper, or file wood. It basically, just the fact that they're moving around on the wound is going to file this stuff down and scrape the wound, which helps loosens it up. It's like a plow. It burrows through this dying and dead tissue. And it just, yeah, it loosens up. That's part one of debridement, right?

Just part one. There's another part of it, which is the digestive enzymes that they excrete and secrete. It's called alimentary secretions and excretions, ASE. And it's basically their digestive juices, right? And they puke these up as they're moving around. And they just puke them everywhere. And it dissolves this flesh.

Yeah, I remember in the Body Farms episode, we talked about this, one of the old classics. Sure. And that's why I said earlier, they don't bite or chew something. They just liquefy it and then suck it in. And this ASE stuff is so greedy that it liquefies more dead flesh

than the maggots can even consume. And they consume quite a bit. Like you said, 25 milligrams. That's a lot for a little tiny maggot in one day. But even more than that, they're liquefying even more of this dead tissue so that part of the process of maggot debridement therapy is draining out this liquefied necrotic tissue

that's become liquefied from the alimentary, or the ASE stuff, the digestive enzymes, right? So you've got them burrowing around. You've got them puking into your wound. Yeah, liquefying the dead tissue. Leaving pretty much entirely the living tissue alone. And then you just kind of drain out the stuff that's in there.

And the reason that maggots are considered by the FDA a medical device rather than a drug is because the whole process of debridement isn't just a reaction to the chemicals. It is part of that mechanical movement of the maggots through the wound. So it's a drug. It's a device, I mean, it's a device.

Well, they are a device, look at them. And those that the secretions are so potent, they have basically DNA destroying qualities. Like they not only just break down tissue, they destroy the DNA. It's pretty amazing stuff. It is. Should we take another break?

Yeah, I'm a little excited, we probably should. All right, I'm gonna go to the vomitorium. Are you grossed out? Slightly. I am not in the least. What does that say about me? I don't know, you're, I don't know. You have a stronger stomach.

But I don't necessarily, I'm just excited. All right, well go watch me vomit at least. Okay, that will gross me out. I may feel you strongly hugs or words or words or phrase or phrase. We'll get back to it in a minute. All right, guys take a penalty break. She's coming to you.

I don't give a shit. No. No oppen its gonna go. No, this is sweet here. Hey, dude, what'swig for? No I realized that we were standing next to him all night, like lovers. You just know that you can't run the world was your overall.

90s. We lived it and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to, hey dude, the 90s called on the iHeart radio app,

Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough or you're at the end of the road. Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. This, I promise you. Oh god. Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh man. And so will my husband, Michael. Um, hey, that's me. Yep, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life

step by step. Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. All right. Well, that was disgusting. It was. It made me throw up in turn. Uh, so here's a couple of questions. Um, does it hurt? Maybe a little bit at first? Yeah. I don't get the feeling that it's extremely painful. It probably depends on the wound. Um, but it can, the first few treatments can apparently be a little bit painful. Right. And

there's, there's actually two mechanisms for the pain. One is that you have an open wound, right? Yes. And you have maggots crawling over the exposed nerves in your open wound. That's not going to feel good. No, it won't. Uh, and then number two, pressure in the wound can increase as the maggots get bigger from eating so much dead flesh. That's right. So yes, the, the, the cure to that is painkillers, which frankly, if you have an open wound with exposed nerves, you should probably be on those anyway. Sure, you will be. So it probably won't hurt because there'll be some sort of pain management going on, but you will still feel most likely, unless the doctor completely numbs the area, maggots crawling around inside the wound. See, that's what, that's the part that

gets me is actually thinking about undergoing this therapy myself is what gets me. Yeah. Not like seeing it or reading about it, but thinking about having an open wound on the bottom of my foot and having maggots creeping around in there. See, the thing is, is I think anybody would feel that way. I think there's very few, including myself, I'm not grossed out by this, but I wouldn't want maggots crawling around in my open wound. But I think if you're backs against the wall, uh, and it's that or you lose your foot, I try, I would definitely try. I think 95% of people would apparently. A man and I would demand some high quality drugs. Yeah. And they also have, um, what is it called? Amnesiotics. They make you forget about this. Yes. So you can't form memories

while it's happening. So maybe that would be a nice thing to do too. So the other question is, can you just use any kind of maggot? And the answer is no. What they found is the most useful is the larva of the green blowfly. And like we said earlier, these things are now grown, uh, just sort of like the medical leeches. They're shipped in sterile containers, right? Uh, as if it were medicine, even though it's a device. And the, the B T E R, um, foundation, they go into a lot about this. Like, could anybody do this? And they say, well, no, because you need a prescription. It's an FDA controlled medial device, but they say anybody who can read can basically follow the instructions on the package. Yeah.

Yeah. I wouldn't, I mean, I wouldn't advise that as your non-doctor. Sure. I'm not saying that either, but I mean, this may be your doctor's first time too. Their point was, is it's not, it's not difficult. It just follow the instructions on the package. What if you were in your doctor, though, you got the maggots out and he put on his bifocals. It was like, all right, let's see how to do this. Right. Or like he, he tears the package open, they go everywhere. You have like Jerry Lewis as a doctor. Uh, oh, although they do say, um, you can't just load it up with maggots. There should be no more than eight maggots per square centimeter. Yeah. I saw five to eight. And so when you have the maggots applied to your, um, wound, they're going to make sure that the,

the healthy area around the wound is covered up so the maggots can't get to it, which goes back to World War II. Yep. They're going to cover it, cover up the wound after they apply the maggots, five to eight per square centimeter, like you say, they're going to cover it up so they can't wander off, because maggots like to leave before their work is done. Sure. They want it on TV. They're full. Pretty much. Um, but they can still eat more if you'll keep them in there. Yeah. So they, they will cover up, they will put the maggots in five to eight, cover it up with this bandage. And basically they will just sit there and eat for between 48 and 72 hours. And then the bandage will be removed. The maggots will then sadly be incinerated or put into an autoclave. That's sad.

Or put into a plasma gasifier or bronzed and hung on your wall for real, like an ant farm. Yeah, because it's like, thank you for this great contribution to saving my foot. Yeah. Now go be autoclave today. I would name them and save them and preserve them. Sure. Um, you'd be violating, I'm sure, all sorts of medical waste laws, but who cares? And so, and then that's, that's what's called a treatment cycle. And most patients are supposedly go between two and four treatment cycles. And again, while this is happening, what's going on is the maggots are debriding the dead flesh, they're liquefying it, they're eating it, and they're also disinfecting it and stimulating growth, right? Pretty amazing. So with the, with this, with the disinfecting, they figured that

there was some sort of gut flora that the maggots have that prevents them from being infected by microbial life. Yeah, that would make sense because they're in that rotting flesh as well, and they're thriving. Right. So what gives? Well, it turns out that there are a couple of types of, I'm not quite sure what, what kind of bacteria they are, but they are, that's not true. The Proteus Mirabilis is a type of symbiotic microbe that you find in the gut of a maggot, right? Yeah. And this thing just, it destroys microbial life. So it's killing the bacteria that's causing this infection in your wound. But there's something that that maggots, this is yet another thing. So think about it, Chuck. Like you said, maggots, the very structure of a maggot

body, debrides the wound. That's right. Pretty amazing. This maggot antimicrobial stuff, not only does it kill microbes, it destroys the thing that naturally protects microbes, which is called biofilm. Yeah, we've talked about biofilm a lot on the show. And it's basically, it's basically a film, like a literal film, like a, they call it a polymeric matrix, but the easiest way to say it in layman's term is it's a film. Right. It's like a protective coating. Yeah. And the little spiny bodies, like one way they get rid of this thing is by roughing it up. Right. And that's exactly what the little bodies do. Right. And that's part of surgical debridement with like a, like going in there and scrubbing a wound with, I don't know,

steel wool or something like that. Yeah. That will break up the biofilm. It also must be awfully painful. Right. Maggots naturally can destroy not just the bacteria, but also the biofilm that protects it too, which makes them extremely handy with things like MRSA and other antibiotic-resistant bacteria. And all kinds of ulcers. Right. Not like internal ulcers, but the open wound kind. Right. Exactly. From diabetes, from bed sores. And there's been a lot of studies of people with bed sores that have found that Maggots helped those kind of ulcers tremendously. So let's talk about this one study or a couple of studies, actually. There was one study of spinal cord injury patients that had non-healing ulcers, which is the problem. They monitored them over

three to four weeks and they were getting regular wound care at the same time, like sometimes it's used in conjunction. I think usually is used in conjunction with like standard care. Sure. And they found that after three to four weeks of maggot therapy, tissue quality and wound size were assessed weekly, and they found that debridement was achieved in less than 14 days, an average of 10 days, and none of the control group wounds were more than 50% debrided after a month. A month. Not even half debrided. None of the wounds, not half the wounds, were debrided. None of the wounds were even half debrided after a month, Chuck. Of the control group. Yes. Amazing. Where they didn't use the maggots.

Yes, that's objectively amazing. It is, and then they did a larger clinical trial and found this time they got 263 subjects, which is pretty good for this kind of rare treatment. And they found that using the hydrogel, which you mentioned earlier, compression dressings, just the standard care. Right. That was the control. Yeah, that's obviously the control. It differed significantly between the three groups. What was the third group? The third group used bio bags, which are like, it's like a little pouch. You said it was like a ravioli. Yeah, and it's filled with live maggots, but it prevents them from burrowing. All it is is using their chemical secretions.

Yeah, that to me is just like, why go halfway? Right, exactly. Well, a lot of people are like, I don't want a maggot crawling in my wound, but a bag of them is fine. Doing the shake, shake near my wound. Right. So it actually has been shown to be not nearly as effective as just letting what is called free range maggots burrow through the wound. So they found the median time for debridement was 14 days with free range, 28 days with the bag ravioli, and 72 days for the control. Yeah, that's pretty amazing. Yeah, like I don't know. I don't think it should be a last resort. You know, I agree. And I think that increasingly it's becoming less and less of the last resort,

because I mean, you can compare it to the control. Like the standard of care took 72 days for the wound to be debrided free range maggots 14 days. That to me says that free range maggots top the standard of care as it stands right now. Yeah, but like you say, there's a lot of people who are saying this is just a last resort. The next thing we're going to do is amputate your foot, but let's try this one last time. Right. Or in the case of persistent infections from like MRSA where just antibiotics just don't work. Let's let's try maggots and see if we can fix it. And maggots do work. There was a study that found that of 13 people treated who had MRSA treated with maggots alone. 12 of the 13 had complete recovery and wound healing from a MRSA

infection. MRSA is nasty stuff too. Yeah, I think did we do it on MRSA? I feel like we did. I know we've talked about it. I don't know if it got its own show though. It may have been in the should we outlaw antibacterial soap episode. Boy, there's been a lot of them. Almost 800. You got anything else? Surely I do. But I guess not. Oh, yeah, we there's one other thing. We kept kind of teasing it. It actually stimulates growth. A couple of studies have found that the presence of maggots produce more blood vessel redevelopment and tissue redevelopment than maggots not being present. So something about them actually stimulates tissue growth and blood vessel growth,

which promotes wound healing even more. Up with maggots. Up with maggots indeed, man. I love them. I'm so psyched about maggots right now. Well, it definitely changes the way you think about it. And like next time you see a dead squirrel that you've killed right off your porch. They're clearly trying to bring it back to life. Yeah. And you see the maggots, you don't think that's disgusting. You just think those are little things doing their thing. Doing their thing. Little things doing their thing. Now I'm going to autoclave them. That's right. If you want to know more about maggot therapy, you can type those words in the search bar at house2forks.com.

And since I said search bar, it's time for listener. I'm going to call this taking the task somewhat over a term. Guys, I want to say you're my favorite podcast by far. Been listening since you were just little five minute blurbs. Oh man. You sure have grown up. I've never written in before, but felt I had to comment on Josh's statement that climate change was or global warming was settled science. No, I'm not disputing the data that shows an increase in global temperatures. While you can certainly argue it's accuracy, especially for older data, it's still just data. It's not science. The part that gets me upset about the term settled science is that by definition, science is never settled. And that's in all caps.

I think we talked a lot about this as a scientific method. You guys actually did a podcast on the scientific method. So you should know that at best you can show particular theories supported by existing data and not contradicted by anything we know of at the time. But there's a reason that ultra successful theories like Newton's theory of gravity, Einstein's theory of relativity, are still theories that could be completely discredited by a single piece of data contradicting them. So the whole idea of taking a body of fact saying it settled is far more a political concept than scientific one. While people with various viewpoints in the subject would like to have someplace to plant their ideological flag, saying something is indisputedly true, as opposed to

probably false is simply not something science and the scientific method is equipped to do. In short, science is never settled. You cannot simply say this is true. Move on. That's not how it works. And that is from Spencer Carpenter right here in our own Smyrna, Georgia. Oh, we're not in Smyrna. Well, I mean, it's nearby. It's the suburb of Atlanta. What I just did is what Spencer just did. Spencer, I was using a literary device. I was actually using the same type of argument that non-science climate deniers use against scientists. I was basically saying like it's done. Drop it. There's enough science there to say you're wrong.

Let's move on and just all accept that climate science is going to lay off. So that was a clever ruse. It wasn't a ruse at all. It was it was just I was not being literal, like apparently, which is what Spencer deals in literal terms. If you want to take us to task because you are overly literal, we want to hear from you. You can tweet to us at syskpodcast. You can join us on facebook.com slash stuff you should know. You can send us an email to stuffpodcast.howstuffworks.com. And as always, join us at our home on the web, stuffyoushouldknow.com.

For more on this and thousands of other topics, visit howstuffworks.com. Jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it and now we're calling on all of our friends to come back and relive it. Guide you through life. Tell everybody about my new podcast and make sure to listen so we'll never ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the I Heart Radio app, Apple Podcast, or wherever you listen to podcasts.