Some of the following presentation
may be disturbing to some viewers. If
worms, bugs, medical pictures or
hearing about wounds makes you feel
squeamish or ill please take caution
before deciding to listen to this
presentation.
Increase in the use of Biotherapy
in Today’s Medical Field
Jacob Pence
Educ 601
Teachers as Consumers of Research
Vocabulary
• Biotherapy – The medical use of live organisms.
• Maggot – Larva of the fly. Maggots from the green
blowfly are used for medical purposes.
• Leech – A species of the annulose worm. Can go 6
months without a meal.
• Debridement – The removal of necrotic tissue
• Necrotic Tissue – Dead tissue
• Blood letting – Removal of blood in certain areas of the
body in order to heal illnesses.
• Venous Congestion – blood continues to flow from
arteries to veins, but veins become congested and tissue
begins to become oxygen deprived.
The Resurgence of Medieval
Medicine
• The popularity of Biotherapy is growing in
the United States and around the world.
• Doctors are beginning to use medicine
that had been previously used from as far
back as into the middle ages.
• Hospitals are turning to animals like
leeches and maggots that can accomplish
some tasks better than any doctor would
be able to.
Medieval Medicine
• Medieval Medicine is known as the medical
system of the Middle Ages
– It was a fairly sophisticated system of treating the ill,
and wounded during this era.
– Many individuals who were wounded during this time
ended up dying because of infections and disease.
• Medieval medicine utilized materials that were
easy to find in their environment.
– These included things such as herbs, plants, mud,
and animals.
– Some animals used included maggots and leeches.
Continued…
• Leeches have been intentionally used in
healing since the time of the Egyptians.
• Maggots were first seen as a medical
benefit in times of early medieval battles.
– Maggots were used to clean wounds from
battles to prevent infection.
– Without the aid of maggots wounds would
become infected and many people had limbs
amputated because of small wounds that
could not be healed.
An Introduction to the Leech
• Leeches are a species of the
annulose worm. They are a
parasite that lives near or in
water.
• In medieval medicine leeches
were used for blood-letting.
• During medieval days
leeches were used so much
for medicine that “leech” was
synonymous with physician.
• In today's medical world
leeches are used most often
by micro surgeons, and ER
doctors.
Continued…leech
• A leech uses several secretions that
benefit their use for medical purposes:
– Their saliva includes an antiseptic which
allows the leech to pierce the skin without any
pain to the host.
– Leeches release hirudin, an anticoagulant,
which stops blood from clotting, and can stop
venous congestion.
How are leeches currently used in
medicine?
• Plastic Surgery
• Limb and body parts reattachment,
– Leeches are placed on tissue before it is reattached
to make sure the blood does not clot.
– The leech removes stagnant blood that would
otherwise clot and kill live tissue.
• If clotting occurs and the tissue dies, further
surgeries may be required.
• Leeches can also be used to stop venous
congestion in people with poor circulation, and
blood clots.
A leech can hold up to 3 times its
weight in blood.
Alternatives to the Leech
• The Robo-Leech:
– Nadine Connor, Ph.D., an associate scientist at the
University of Wisconsin-Madison and other doctors
are designing a robotic leech.
• The robo-leech is used for patients that are squeamish about
having a live parasite sucking blood from them.
– The Robo-Leech is designed with a bellows system
that causes blood to be removed from the area, and
also can release anticoagulants into the area.
• Cumadin or other blood thinners:
– Some blood thinning medicine can help solve blood
circulation and venous congestion problems.
• But is difficult to monitor, and can be dangerous.
The Robo-Leech vs. The Leech
An Introduction to Maggots
• The larva of a fly is called a maggot.
– Flies lay their eggs in tissue that is dead or rotting, because maggots
need to feed on the dead tissue to survive.
• In certain aspects of medicine, maggots can be much more
effective than any physician.
• Maggots used for medical purposes are hatched in a
controlled and sterile environment to prevent an introduction
of bacteria.
How are maggots currently used in
medicine?
• Maggot Debridement Therapy (MDT) –
The use of maggots in the removal of
necrotic tissue.
• Maggots are used in wounds that are non
receptive to antibiotics and are deemed as
non-healing wounds.
• Maggots from the Green Blowfly are used,
because they are a species that only eat
necrotic tissue.
Continued…
• Maggots are great for debridement for three
reasons:
– Digest necrotic tissue:
• If necrotic tissue is not removed gangrene can develop.
– Control infections:
• Maggots secrete an enzyme that is microbial (kills bacteria).
– Promote healing:
• Maggots secrete an enzyme that turns dead flesh into a
semi-liquid, but does not affect healthy tissue.
Maggot Debridement Therapy
• Patients with non-acute, non-healing wounds
are presented with the suggestion of MDT.
• A dressing is applied so that the maggots will not
escape the wound
• The area is covered with a mesh bandage so
that the maggots are able to breathe.
• The maggots are left at the affected area for 4872 hours and then removed and discarded.
• If necrotic tissue is still present the process is
repeated.
Possible Reasons for the Use of
MDT
• MDT is often used on patients with chronic
problems such as :
– diabetes patients can develop peripheral vascular
disease (PVD).
• Ulcers can develop because of PVD that are non-healing and
require MDT.
– Pressure Ulcers (Bed Sores) can usually be cleaned
50% faster with MDT than any other methods.
– Gangrene develops when infection occurs at a high
rate, usually appears in lower limbs.
THE NEXT TWO SLIDES HAVE
MEDICAL PICTURES THAT MAY BE
DISTURBING TO SOME.
The Benefits of MDT
Before MDT
After MDT
MDT: a wound after 4 treatments
1
3
2
4
Alternatives to maggots
• Antibiotics
– Antibiotics can help some tissue heal.
• Physician debridement treatment
– Sometimes painful, not accurate, high rates of
infection.
• Whirlpool debridement
– Very Painful, and difficult if patient is immobile.
• Amputation
– Permanent loss of limb. 
Conclusions
• Leeches and Maggots are being used
more and more in hospitals throughout the
world.
• The use of biotherapy seems to be a valid
method for many medical procedures.
• Although disturbing to some patients,
animals can provide better results than
physicians.
• One vial of maggots can cost less than a
vial of antibacterial cream.
References
• B., K. Maggots as healers: the increasing use of maggot
debridement therapy. University of Washington, Zoology, 2000.
• Church, J.C.T. The traditional use of maggots in wound healing,
and the development of larva therapy (biosurgery) in modern
medicine. J. Alt. Compl. Med. Vol 2 Iss 4, 525, 1996.
• McGovern, Celeste. Brave new world. Report/Newsmagazine,
Vol. 28, Issue 10, 60, 2001.
• Namias, N., Varela, et al. Biodebridement: A case report of
maggot therapy for limb salvage after fourth-degree burns. J.
Burn Care Rehab, Vol 21, 254, 2000.
• Reames, M.K, Christensen, C., and Luce, E.A. The use of
maggots in wound debridement. Annual Plastic Surgery, Vol 21,
Iss 4, 388, 1988.
• Sherman, R.A. et al. Maggot debridement therapy in
outpatients. Archives of Physical Medicine and Rehabilitation,
Vol 82, 1226, 2001.
• Shinkman, Ron. Worms and squirms. Modern Healthcare, Vol
30, Iss 43, 54, 2000.
Questions