Surgeons' Rx: leeches and maggots

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The Grim Squeaker
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Surgeons' Rx: leeches and maggots

Post by The Grim Squeaker »

Leeches, those bloodsucking worms of medical procedures yore, are enjoying renewed popularity among today's high-tech surgeons.

So much so, in fact, that the Food and Drug Administration is seeking to establish guidelines dictating how the creatures should be safely grown, transported and sold.

According to a fascinating if initially slightly shocking article by New York Times writer Gardiner Harris, leeches have become useful tools as modern microsurgeons tackle complex feats like reattaching hands, scalps and even faces. Leeches are particularly adept at draining excess blood during these procedures, the article said.

"I'll use one to three leeches every couple of hours," Duke University surgeon Dr. L. Scott Levin told The New York Times.

Leeches, the article explains, inject victims with a chemical mix that includes an anticoagulant, an anesthetic, an antibiotic and a chemical that dilates blood vessels. This cocktail encourages fast bleeding to empty the appendage of extra blood, reducing pressure and allowing veins to form on their own.

And don't forget that other age-old medical remedy--maggots, which are hard to beat when it comes to cleaning festering wounds. The FDA is also considering maggot regulation in its quest to safely bring medieval medicine into the modern age.

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I still do'nt want a leech on my balls :P
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Mr Bean
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Post by Mr Bean »

No Maggots no were no how. Period

Leeches I can deal with assuming I don't know about it and I'm under at the time.

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Post by Naaman »

We've had maggots on the NHS for over a year now because they are effective at treating infected woundsHere's the manufacturers (breeders home page).
No Maggots no were no how. Period
Given the choice between a persistent ulcerated wound in your leg that you could fit your fist in or having maggot therapy? Don't forget they're applied and then bandaged, most patients feel a slight tickle under the dressing for a few hours and that's it.
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Post by Ace Pace »

Awesome, ancient medical miracles to the rescue!
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Mr Bean
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Post by Mr Bean »

Naaman wrote: Given the choice between a persistent ulcerated wound in your leg that you could fit your fist in or having maggot therapy? Don't forget they're applied and then bandaged, most patients feel a slight tickle under the dressing for a few hours and that's it.
....Let me just say from someone who spent some time cleaning out old shitters and portas... Eww.


Good thing I've got this little two hundred years of modern medican to turn to. Because you know steril wipes and blood clotting drugs not being alive and all are much more portable and easier to keep on hand. When the ambulance shows up at my bedside because I've managed to nick my leg off I don't think there is going to be room for a leeach barrel or maggot farm aboard it, what will all those handy easier to store and apply drugs and sutures aboard.

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Post by Naaman »

First let me say I agree with the "Eeeewww" factor, when my Girlfriend showed me the picture of the little buggers and the wound they were chomping on I couldn't eat for 12 hours :wtf:

Second - They're used for the type of wounds that are generally restricted to the elderly population, poor blood flow and or inactivity. These are large ulcers that are generally hard to heal normally, quite often because the patient can't take the pressure off the wound site because they've got an ulcer - it's a horrible, nasty spiral. Normally I'd try and link to pictures but since they normally make me want to barf I'll skip this part. This is from their site
During this time, many reports have been published that describe how the use of maggots have revolutionised the treatment of all manner of infected or necrotic wounds. In numerous instances it has been reported that maggot therapy has prevented the need for aggressive surgery or even amputation. It has also been shown that this treatment is effective against antibiotic resistant strains of micoorganisms such as the 'super-bug' MRSA.
Third - They are cheaper and work better than the alternative. Storage is IIRC a small sealed pot that has a shelf life of a week or two (they have a smal supply of sterile food)

Fourth - You're looking at this from (hopefully) the hale and hearty side of health. Being afflicted with a persistent wound may well change your mind.

Just looking in the English Drug Tariff as an example of how nasty and big this type of wound can get. CombiDERM dressings range from 10x10cm with a wound contact pad of 5x5 to 20x20cm with a pad that's 13x13...
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Post by Tsyroc »

We have a few leaches in the refrigerator in the Pharmacy I work at. They are left over from a guy who was being treated for having his thumb "degloved" by a drill press. He had to put a new leach on the stub of his thumb every six hours.

I think it was to keep blood flowing to the edges of his wound so the surgeons would have a better shot at saving his thumb, or something along those lines. All I know is that it helped keep him from having to have the whole thing amputated.

This is the first time in the 6 plus years I've worked in this pharmacy that we've had leaches around.

There is a commercial anticoagulant medication that is derived from leaches that we use semi-regularly but this is the first time we've had live leaches.
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Post by GrandMasterTerwynn »

Mr Bean wrote:
Naaman wrote: Given the choice between a persistent ulcerated wound in your leg that you could fit your fist in or having maggot therapy? Don't forget they're applied and then bandaged, most patients feel a slight tickle under the dressing for a few hours and that's it.
....Let me just say from someone who spent some time cleaning out old shitters and portas... Eww.


Good thing I've got this little two hundred years of modern medican to turn to. Because you know steril wipes and blood clotting drugs not being alive and all are much more portable and easier to keep on hand. When the ambulance shows up at my bedside because I've managed to nick my leg off I don't think there is going to be room for a leeach barrel or maggot farm aboard it, what will all those handy easier to store and apply drugs and sutures aboard.
Well, that's all well and good, but the little creepy-crawlies may well have a use when you're on the mend. Maggots are surprisingly finicky eaters, and have an enormous appetite for dead flesh, while refusing to eat live flesh. As a result, they are much better at cleaning dead, necrotic tissue from a wound than we are (as we would wash and hack and slice and induce further trauma if we tried.) And you want to quicly get rid of the necrotic tissue, as the microorganisms taking hold in it are adept at creating even more necrotic tissue, and before you know it, gangrene and sepsis have set in. At that point, you have an amputation on your hands, and you get to find out just how antibiotic resistant your raging infection really is.
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Max
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Post by Max »

I don't think I'd have an issue with the leeches or the maggots...as long as it wasn't painful. I'm pain shy.
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